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This article is shared with permission from our friends at Medical Daily

Millions of Americans suffer from seizures, neuropathic pain, hot flashes, and restless leg syndrome, driving a demand for a medication to provide relief from hard-to-live-with symptoms. In 1993, the U.S. Food and Drug Administration approved gabapentin — a drug marketed under the brand name Neurontin — to combat epilepsy and later for pain relief in 2004. But it didn’t come without a price.

Shortly following gabapentin’s release into the United States, pharmaceutical giant Pfizer’s daughter company Parke-David began encouraging doctors to prescribe gabapentin for unapproved uses otherwise known as “off-label.” By relaxing restrictions, it increased the drug’s accessibility to healthcare providers, insurers, and consumers. Soon it was used for a wide range of ailments, from bipolar disorder to migraines.

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Between 10 and 20 percent of all prescriptions written in the U.S. today are for off-label purposes. While doctors often turn to off-label drugs because the FDA’s regulations haven’t caught up to science yet, many times the risks aren’t worth it.

In fact, a study published in JAMA Internal Medicine earlier this year found after examining more than 46,000 patients’ health records that 80 percent of off-label prescribing was not backed by strong scientific evidence. In addition, patients treated with an off-label medication were more than twice as likely to suffer from adverse side effects compared to those taking drugs approved by the FDA’s guidelines.

According to the Mayo Clinic, when deciding to use a medication, the risks must be weighed against the potential good it can do. Disconcerting side effects, including aggressive behavior, depression, rapid mood changes, distrust, false sense of well-being, hyperactivity, drowsiness, tremors, sexual dysfunction, and suicide followed closely behind its use.

After 25 years of the drug circulating through the market with off-label use, cases of adverse effects have accumulated. In one case, Caryl Westwood was prescribed Neurontin for her lower back pain. After months of experiencing insomnia, anxiety, and fog, Westwood confronted her doctor, only to find out that Neurontin wasn’t a painkiller at all, but in fact a powerful epilepsy medication.

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Despite the little proof of its efficacy to treat pain, Neurontin was prescribed to Westwood. In 2004, roughly 90 percent of Neurontin’s $2.7 billion in sales came from off-label use prescriptions, shedding some light into why doctors bend to make sure the prescriptions are filled even if they may not treat the patient.

Although Pfizer admitted guilt in promoting off-label use of Neurontin to doctors and agreed to pay out $430 million in a settlement, off-label use is still prolific today.

The Hearty Soul Edit:

Beyond Painkillers: Ohio Substance Abuse Alert

The Ohio Substance Abuse Monitoring Network (OSAM) has now issued a public warning about gabapentin after reports show it has become an increasingly popular street drug. Unliked narcotics, gabapentin is relatively easier to obtain, which increases the risk for abuse.

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“It’s a drug that needs to be tracked now. We’ve been noticing an uptake in reports from participants in our focus groups throughout the state. Gabapentin has been diverged in the street and it has been used illicitly since January of last year,” said Dr. Thomas Sherba who is the Principle Investigator for The Ohio Substance Abuse Monitoring Network.

OSAM reports gabapentin is commonly being abused along with heroin to create a stronger high as well as to cope with withdrawal effects.

Since both the street drug black market and patients prescribed gabapentin by their doctors are at risk of abuse, it’s crucial for doctors and pharmacists to pay attention to patient behavior such as refilling prescriptions earlier than anticipated. According to American Addiction Centers, if you suspect a person is abusing gabapentin, you can watch for the following red flags (people prescribed the drug may experience some of the first 11 side effects even when used appropriately, however more side effects tend to occur with increased use:
  1. Dizziness
  2. Drowsiness
  3. Memory loss
  4. Loss of coordination
  5. Tremors
  6. Jerky movements
  7. Unusual eye movements
  8. Double vision
  9. Fever
  10. Difficulty speaking
  11. Depression or anxiety
  12. Lying/exaggerating symptoms to doctor
  13. Changes in social behavior
  14. Switching doctors/visiting multiple doctors

You can consult your family doctor about a prescription addiction, ask for a referral to an addictions specialist, or consider a treatment facility. For more information on dealing with a prescription addiction, visit DrugAbuse.gov.

Source:

Verma A, Eguale T, and Buckeridge DL. Association of Off-label Drug Use and Adverse Drug Events in an Adult Population. JAMA Internal Medicine. 2016.

https://www.drugabuse.gov/related-topics/treatment/what-to-do-if-your-adult-friend-or-loved-one-has-problem-drugs

https://americanaddictioncenters.org/neurontin-abuse/

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