Gabapentinoids are commonly prescribed for an array of off-label conditions, including management of chronic pain. Updating their 2015 report on gabapentinoid usage in the U.S., researchers used the 2002–2021 Medical Expenditure Panel Survey (MEPS) to investigate the proportion of the adult population using gabapentinoids, medications, and diagnoses associated with users, and the likelihood of starting, stopping, or continuing gabapentinoids. They found that gabapentinoid use has increased from 4.0% in 2015 to 4.7% in 2021. Gabapentinoids continue to be used in conjunction with other sedating medications, despite a 2019 FDA warning against doing so. Although off-label use is difficult to connect with specific medical conditions and is likely under-reported, numerous chronic pain conditions remain associated with gabapentinoids. Between the survey periods of 2011–2012 and 2017–2018, the percentage of those continuing to use gabapentinoids year on year was greater than those who stopped, though this difference appears to have decreased more recently.
What We Know: Gabapentinoid prescription and use continues to increase in the U.S., from 4.0% in 2015 to 4.7% in 2021. Despite a 2019 FDA warning, gabapentinoids continue to be used in conjunction with other sedating medications.
What This Study Adds: Gabapentinoid users have continued to increase since the authors' 2015 publication, despite a dearth of evidence supporting use in many cases. While these clinical scenarios can be challenging, continuation should be reconsidered at regular intervals.
Update to Gabapentinoid Use in the United States, 2002–2021
Michael E. Johansen, MD, MS
Grant Family Medicine, OhioHealth, Columbus, OH
Donovan T. Maust, MD, MS
Center for Clinical Management Research, VA Ann Arbor Health Care System, Ann Arbor, MI;
Department of Psychiatry, University of Michigan, Ann Arbor, MI
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