Gabapentin prevalence: clinical and forensic experience in St. Louis, Missouri, USA
Gabapentin (Neurontin) is an anti-epileptic drug that has had wide off-label prescription use since market release due to presumed negligible abuse potential. However, trends in drug misuse have demonstrated that gabapentin misuse is occurring, particularly in those with a history of opioid misuse....
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Oxford University Press
2021-07-01
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| Series: | Forensic Sciences Research |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/20961790.2021.1991075 |
| _version_ | 1797725030262505472 |
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| author | Sarah B. Riley Kelsie Garbutt Chelsea Crow T. Scott Isbell Anthony J. Scalzo |
| author_facet | Sarah B. Riley Kelsie Garbutt Chelsea Crow T. Scott Isbell Anthony J. Scalzo |
| author_sort | Sarah B. Riley |
| collection | DOAJ |
| description | Gabapentin (Neurontin) is an anti-epileptic drug that has had wide off-label prescription use since market release due to presumed negligible abuse potential. However, trends in drug misuse have demonstrated that gabapentin misuse is occurring, particularly in those with a history of opioid misuse. This is concerning, because although gabapentin has no direct ligand activity at opioid receptors, it does potentiate the analgesic effect of opioids, and concurrent use of gabapentin and opioids may increase the risk of respiratory depressive effects of opioids. This study investigates the incidence of gabapentin detected in urine samples collected for clinical drug screening purposes in a local hospital emergency department and in postmortem samples submitted by medical examiners in the St. Louis metropolitan area. The prevalence of gabapentin and co-detected drugs in both populations is contrasted, compared, and discussed. This study found that 30% of urine samples collected from patients with suspected drug intoxication presenting to SSM Health Saint Louis University Hospital, a quaternary care medical center, were positive for gabapentin, and nearly two thirds of those were also positive for oxycodone. Over a 6-month period, the incidence of gabapentin positive postmortem cases increased from 18% to 20%. Nearly all gabapentin positive postmortem cases were also positive for an opioid, the most significant being fentanyl, suggesting that gabapentin misuse may be due to its potentiating effect of opioid drug action. This study also highlights the limited utility of immunoassay-based urine drug screens. |
| first_indexed | 2024-03-12T10:25:19Z |
| format | Article |
| id | doaj.art-1c10103857504a05933553d5326b604f |
| institution | Directory Open Access Journal |
| issn | 2096-1790 2471-1411 |
| language | English |
| last_indexed | 2024-03-12T10:25:19Z |
| publishDate | 2021-07-01 |
| publisher | Oxford University Press |
| record_format | Article |
| series | Forensic Sciences Research |
| spelling | doaj.art-1c10103857504a05933553d5326b604f2023-09-02T09:42:16ZengOxford University PressForensic Sciences Research2096-17902471-14112021-07-016321822310.1080/20961790.2021.19910751991075Gabapentin prevalence: clinical and forensic experience in St. Louis, Missouri, USASarah B. Riley0Kelsie Garbutt1Chelsea Crow2T. Scott Isbell3Anthony J. Scalzo4School of Medicine Department of Pathology, Saint Louis UniversityDepartment of Sociology and Anthropology, Forensic Sciences Program, Saint Louis UniversitySchool of Medicine Department of Pathology, Saint Louis UniversitySchool of Medicine Department of Pathology, Saint Louis UniversitySchool of Medicine Department of Pediatrics, Saint Louis UniversityGabapentin (Neurontin) is an anti-epileptic drug that has had wide off-label prescription use since market release due to presumed negligible abuse potential. However, trends in drug misuse have demonstrated that gabapentin misuse is occurring, particularly in those with a history of opioid misuse. This is concerning, because although gabapentin has no direct ligand activity at opioid receptors, it does potentiate the analgesic effect of opioids, and concurrent use of gabapentin and opioids may increase the risk of respiratory depressive effects of opioids. This study investigates the incidence of gabapentin detected in urine samples collected for clinical drug screening purposes in a local hospital emergency department and in postmortem samples submitted by medical examiners in the St. Louis metropolitan area. The prevalence of gabapentin and co-detected drugs in both populations is contrasted, compared, and discussed. This study found that 30% of urine samples collected from patients with suspected drug intoxication presenting to SSM Health Saint Louis University Hospital, a quaternary care medical center, were positive for gabapentin, and nearly two thirds of those were also positive for oxycodone. Over a 6-month period, the incidence of gabapentin positive postmortem cases increased from 18% to 20%. Nearly all gabapentin positive postmortem cases were also positive for an opioid, the most significant being fentanyl, suggesting that gabapentin misuse may be due to its potentiating effect of opioid drug action. This study also highlights the limited utility of immunoassay-based urine drug screens.http://dx.doi.org/10.1080/20961790.2021.1991075forensic toxicologyclinical toxicologysubstance misusegabapentinurine drug screeningpostmortemmass spectrometry |
| spellingShingle | Sarah B. Riley Kelsie Garbutt Chelsea Crow T. Scott Isbell Anthony J. Scalzo Gabapentin prevalence: clinical and forensic experience in St. Louis, Missouri, USA Forensic Sciences Research forensic toxicology clinical toxicology substance misuse gabapentin urine drug screening postmortem mass spectrometry |
| title | Gabapentin prevalence: clinical and forensic experience in St. Louis, Missouri, USA |
| title_full | Gabapentin prevalence: clinical and forensic experience in St. Louis, Missouri, USA |
| title_fullStr | Gabapentin prevalence: clinical and forensic experience in St. Louis, Missouri, USA |
| title_full_unstemmed | Gabapentin prevalence: clinical and forensic experience in St. Louis, Missouri, USA |
| title_short | Gabapentin prevalence: clinical and forensic experience in St. Louis, Missouri, USA |
| title_sort | gabapentin prevalence clinical and forensic experience in st louis missouri usa |
| topic | forensic toxicology clinical toxicology substance misuse gabapentin urine drug screening postmortem mass spectrometry |
| url | http://dx.doi.org/10.1080/20961790.2021.1991075 |
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