Gabapentin-Related State Policies and Associations with Gabapentin Non-Medical Use Among a Nationally Representative Population in the United States

Aims: Gabapentin is not a federally controlled substance, yet multiple states have implemented gabapentin-specific policies in response to non-medical use (NMU). This study aims to compare prevalence of gabapentin NMU by state policy type and examine the association between gabapentin NMU and gabapentin-related state policy types. Methods: Data come from the Survey of Non-Medical Use of Prescription Drugs, which employed an online cross-sectional survey in the U.S. in 2021. Weighted, estimated prevalence of gabapentin NMU was compared by gabapentin state policy type: a) Schedule V controlled substance with mandated Prescription Drug Monitoring Program (PDMP) reporting; b) unscheduled, but PDMP reporting is required; and c) no policy. Additionally, weighted logistic regression analysis was performed to reveal the association between past 12-month gabapentin non-medical use and gabapentin-related state policies. Results: Gabapentin NMU was most prevalent in states where it is a controlled substance alongside mandatory PDMP reporting (prevalence 1.72% [1.41, 2.04]) compared to lower rates among states with mandatory PDMP reporting alone (1.43% [1.20, 1.67]) and states with no gabapentin policy (1.30% [1.18, 1.42]). Results of Tabel 4 show gabapentin NMU was significantly associated with past 12-month pain (OR: 3.80 [3.18, 4.53]), substance use treatment (OR: 2.89 [2.15, 3.89]), and receiving medication for opioid use disorder (OR: 1.95 [1.28, 2.97]). Conclusions: These findings represent the first apparent estimates of prevalence of gabapentin NMU in the U.S. and underscore the need for continued research on the effects of gabapentin state policies, including impacts on individuals, the ongoing opioid crisis, and NMU and diversion.