Neurotin prescriptions surge amid opioid crisis

According to JAMA Internal Medicine 2018, the use of gabapentinoids (Neurontin, Gralise, Horizant) and pregabalin have climbed from 1.2% in 2002 to 3.9% by 2015. According to Dr. Michael Johansen of the Heritage College of Osteopathic Medicine at Ohio University, “Nearly one in 25 adults takes a gabapentinoid during a year. This matters because we have little data to support much use of this drug class (for chronic pain) and minimal data to support long-term safety of the medications.” This class of drugs has been approved by the FDA to treat seizures and nerve pain of shingles; both short term dosing. Another version of gabapentin has also been approved for restless leg syndrome, fibromyalgia, and some nerve pain related to diabetes and spinal cord injuries. Doctors have begun to use this class of drugs for off-label use of chronic pain. This is controversial because this class of drugs is addictive as well. When you combine the addictive qualities, unknown long-term safety issues and side effects of sedation, dizzinessm and cognitive decline with higher doses, more studies are needed to see if this is a viable alternative to opioids. Researchers continue to offer non-pharmacological options for chronic pain patients, such as acupuncture, physical therapy, yoga, exercise, and mind body techniques. Although this study did not include IH chronic pain treatments, providers would be wise to encourage this population of patients to attempt non-pharmacological options as much as possible.