Prescriptions for a painkiller linked to suicidal thoughts have tripled in a decade – as doctors have been receiving more kickbacks from manufacturers, an explosive new study shows.
The uptick also suggests patients may be abusing the drug, experts say.
Gabapentin, which can ease both epilepsy and nerve pain by targeting certain brain receptors, is popular among US doctors in the height of the addiction epidemic because it does not interact with other drugs and it doesn’t trigger a rush of ecstasy like most prescription painkillers.
However, new research by public health professors at UConn Health suggests its soaring popularity might be fanned by manufacturers’ cash.
Gabapentin is popular among US doctors because it doesn’t interact with other drugs and it doesn’t trigger a rush of ecstasy like other drugs. But it does have dangerous side effects (file image)
Rates of prescriptions for brand-name versions of the drug soared three-fold between 2002 and 2015, particularly in the south and east.
In particular, they are prescribing more brand-name versions – such as Lyrica, Gralise or Horizant – which costs hundreds of dollars for a month’s supply, compared to $20 for a generic.
The findings are particularly alarming in the wake of a study last month which found gabapentin increases patients’ risks for suicidal behavior, overdoses, injuries and car crashes.
‘We found that the more physicians receive industry money, the more likely they were to prescribe gabapentin. But more research is needed to understand how much of that gabapentin goes to drug abuse,’ lead author Greg Rhee, an assistant professor of medicine and public health at UConn Health, said.
Gabapentin mimics a chemical in the brain called gamma-aminobutyric acid (or, GABA), which eases brain cells commonly overactive in epilepsy patients.
Its pain relief potential was discovered somewhat by accident, and though it’s still unclear, doctors have found it to be very effective, particularly as they hunt for drugs that may be less appealing to abuse.
Most other prescription painkillers carry a lure of a high, which can trap patients into addiction.
And so, gabapentin prescriptions started to rise in 2002, from 1.2 percent of US adults to 3.9 percent in 2015.
It seemed natural for rates to rise, but the sharp uptick puzzled Dr Rhee and his colleagues at Yale University.
They trawled Open Payments – where manufacturers are mandated to declare payments to US doctors – and Medicare Part D Prescriber – a database of all US prescriptions – for 2014-2016 to see whether the doctors prescribing the most gabapentin were receiving more money from manufacturers.
Their hunch was right.
Gabapentin manufacturers paid physicians $11.5 million between 2014 and 2016, the team found.
The payments went to about 14 percent of the doctors who prescribed any kind of gabapentin in those years, mostly pain doctors and general practitioners, most of whom were located in the southern and eastern parts of the country.
The researchers found that doctors who received payments from industry were more likely to prescribe a brand name version of gabapentin such as Lyrica, Gralise or Horizant.
These brand name drugs cost several hundred dollars for a one month supply, compared to less than $20 for a one month supply of the generic.
Besides cost, the rise in prescriptions is concerning because gabapentin has the potential to be abused.
Although it is not reported to be intoxicating when used as directed, searching for gabapentin on drug experience websites such as erowid shows that taking it in larger quantities can cause a long lasting high.
Some long-term users who took gabapentin at therapeutic doses for legitimate medical reasons also report it can be addictive.
Rhee and his colleagues are concerned that the three-fold increase in prescriptions over the last decade and a half indicate some gabapentin is being diverted for recreational purposes, but caution that more research needs to be done before that can be determined.