Notes from the Field: Trends in Gabapentin Detection and Involvement in Drug Overdose Deaths — 23 States and the District of Columbia, 2019–2020

Gabapentin is an anticonvulsant medication, which is also approved by the Food and Drug Administration to treat postherpetic neuralgia, a painful complication of shingles, which results from reactivation of the varicella zoster virus. *, Gabapentin is commonly used off-label to treat neuropathic pain (1). Gabapentin prescribing has steadily increased in recent years, and in 2019, 69 million gabapentin prescriptions were dispensed in the United States, making it the seventh most commonly prescribed medication nationally. Although gabapentin is generally considered safe and is infrequently associated with overdose on its own, when used with other central nervous system depressants such as opioids, there is risk for respiratory depression, potentially resulting in death (2). Gabapentin can be used to potentiate illicit opioids; data indicate gabapentin exposures associated with intentional abuse, misuse, or unknown exposures reported to U. S. poison centers increased by 104% from 2013 to 2017 (3). However, less is known about the drug's role in fatal overdoses (4). To assess quarterly trends in gabapentin-involved overdose deaths of unintentional or undetermined intent during 2019-2020, CDC analyzed data from the State Unintentional Drug Overdose Reporting System (SUDORS) in 23 states and the District of Columbia. ** SUDORS requires jurisdictions to abstract data from death certificates and medical examiner or coroner reports, including postmortem toxicology results, * https: //www. accessdata. fda. gov/drugsatfdadocs/label/2017/020235s064₀ 20882s047₀21129s046lbl. pdf https: //effectivehealthcare. ahrq. gov/products/nonopioid-chronic-pain/research https: //www. iqvia. com/insights/the-iqvia-institute/reports/medicinespending-and-affordability-in-the-us https: //www. fda. gov/drugs/drug-safety-and-availability/fda-warns-aboutserious-breathing-problems-seizure-and-nerve-pain