Gabapentinoids in Ireland 2010 to 2020: an observational study of trends in gabapentinoid prescribing, law enforcement drug seizures and post mortem toxicology

We explored trends in gabapentinoid prescribing, drug seizures and post mortem toxicology using a national pharmacy claims database, law enforcement drug seizures data and a population based post mortem toxicology database. Gabapentinoid prescribing rates per 100,000 eligible population (2010-2020),...

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Published in:British journal of clinical pharmacology 2023-12
Main Authors: Durand, Louise, O'Kane, Aoife, Tierney, Julie, Cronly, Mark, Bennett, Kathleen E, Kavanagh, Yvonne, Keenan, Eamon, Cousins, Gráinne
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container_title British journal of clinical pharmacology
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creator Durand, Louise
O'Kane, Aoife
Tierney, Julie
Cronly, Mark
Bennett, Kathleen E
Kavanagh, Yvonne
Keenan, Eamon
Cousins, Gráinne
description We explored trends in gabapentinoid prescribing, drug seizures and post mortem toxicology using a national pharmacy claims database, law enforcement drug seizures data and a population based post mortem toxicology database. Gabapentinoid prescribing rates per 100,000 eligible population (2010-2020), annual number of drug seizures involving gabapentinoids (2012-2020), and gabapentinoid detection (positive) rates per 100 post mortem toxicology case (2013-2020) were calculated. Negative binomial regression models were used to evaluate longitudinal trends for gabapentin and pregabalin separately. Gabapentin (Adjusted Rate Ratio (ARR) 1.06, 95% CI 1.05-1.06, p
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Gabapentinoid prescribing rates per 100,000 eligible population (2010-2020), annual number of drug seizures involving gabapentinoids (2012-2020), and gabapentinoid detection (positive) rates per 100 post mortem toxicology case (2013-2020) were calculated. Negative binomial regression models were used to evaluate longitudinal trends for gabapentin and pregabalin separately. Gabapentin (Adjusted Rate Ratio (ARR) 1.06, 95% CI 1.05-1.06, p &lt;0.001) and pregabalin (ARR 1.08, 95% CI 1.08-1.09, p&lt;0.001) prescribing increased annually, with higher rates of pregabalin (vs gabapentin) observed every year. Drug seizures involving pregabalin also increased over time (RR 1.54 95% CI 1.25-1.90, p&lt;0.0001). Of the 26,317 post mortem toxicology cases, 0.92% tested positive for gabapentin, 6.37% for pregabalin. Detection rates increased for both gabapentin (RR 1.28, 95% CI 1.11 - 1.48, p&lt;0.001) and pregabalin (RR 1.13, 95% CI 1.11-1.48, p&lt;0.001) between 2013 and 2020. A total of 1,901 cases (7.2%) tested positive for heroin/methadone; this sub-group had a higher detection rate for pregabalin (n=528, 27.8%) and gabapentin (n=41, 2.2%) over study period, with a high burden of co-detections for pregabalin with benzodiazepines (peaking at 37.3% in 2018), and pregabalin with prescription opioids (peaking at 28.9% in 2020) CONCLUSIONS: This study raises concerns regarding the wide availability of pregabalin in Ireland, including a growing illicit supply, and the potential for serious harm arising from poly drug use involving pregabalin among people who use heroin or methadone.</description><identifier>EISSN: 1365-2125</identifier><identifier>PMID: 38072974</identifier><language>eng</language><publisher>England</publisher><ispartof>British journal of clinical pharmacology, 2023-12</ispartof><rights>This article is protected by copyright. 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Gabapentinoid prescribing rates per 100,000 eligible population (2010-2020), annual number of drug seizures involving gabapentinoids (2012-2020), and gabapentinoid detection (positive) rates per 100 post mortem toxicology case (2013-2020) were calculated. Negative binomial regression models were used to evaluate longitudinal trends for gabapentin and pregabalin separately. Gabapentin (Adjusted Rate Ratio (ARR) 1.06, 95% CI 1.05-1.06, p &lt;0.001) and pregabalin (ARR 1.08, 95% CI 1.08-1.09, p&lt;0.001) prescribing increased annually, with higher rates of pregabalin (vs gabapentin) observed every year. Drug seizures involving pregabalin also increased over time (RR 1.54 95% CI 1.25-1.90, p&lt;0.0001). Of the 26,317 post mortem toxicology cases, 0.92% tested positive for gabapentin, 6.37% for pregabalin. Detection rates increased for both gabapentin (RR 1.28, 95% CI 1.11 - 1.48, p&lt;0.001) and pregabalin (RR 1.13, 95% CI 1.11-1.48, p&lt;0.001) between 2013 and 2020. A total of 1,901 cases (7.2%) tested positive for heroin/methadone; this sub-group had a higher detection rate for pregabalin (n=528, 27.8%) and gabapentin (n=41, 2.2%) over study period, with a high burden of co-detections for pregabalin with benzodiazepines (peaking at 37.3% in 2018), and pregabalin with prescription opioids (peaking at 28.9% in 2020) CONCLUSIONS: This study raises concerns regarding the wide availability of pregabalin in Ireland, including a growing illicit supply, and the potential for serious harm arising from poly drug use involving pregabalin among people who use heroin or methadone.</description><issn>1365-2125</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNqFj8tOwzAQRa1KqC2PX6jmA6hkO6QFtojXnn3lxJPIle2xxg6Q_kx_lSBAYtfV3Zx7j-5MLFW1qdda6XohznPeS6kqtannYlHdyq2-294sxfHZNCZhLC6SsxlchFdGb6IFLZWEQlNqeQ8mAjUZ-d0UR9F4yGWwI1AHhTH-NPv_W5AYc8uucbG_Bm8-AGNH3GKYCLA89JDRHYaJgm9dolwgEBcMk_XTteSpHy_FWWd8xqvfvBCrp8e3h5d1GpqAdpfYBcPj7u9RdRL4AhtcWRw</recordid><startdate>20231210</startdate><enddate>20231210</enddate><creator>Durand, Louise</creator><creator>O'Kane, Aoife</creator><creator>Tierney, Julie</creator><creator>Cronly, Mark</creator><creator>Bennett, Kathleen E</creator><creator>Kavanagh, Yvonne</creator><creator>Keenan, Eamon</creator><creator>Cousins, Gráinne</creator><scope>NPM</scope><orcidid>https://orcid.org/0000-0003-2985-7668</orcidid></search><sort><creationdate>20231210</creationdate><title>Gabapentinoids in Ireland 2010 to 2020: an observational study of trends in gabapentinoid prescribing, law enforcement drug seizures and post mortem toxicology</title><author>Durand, Louise ; O'Kane, Aoife ; Tierney, Julie ; Cronly, Mark ; Bennett, Kathleen E ; Kavanagh, Yvonne ; Keenan, Eamon ; Cousins, Gráinne</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-pubmed_primary_380729743</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Durand, Louise</creatorcontrib><creatorcontrib>O'Kane, Aoife</creatorcontrib><creatorcontrib>Tierney, Julie</creatorcontrib><creatorcontrib>Cronly, Mark</creatorcontrib><creatorcontrib>Bennett, Kathleen E</creatorcontrib><creatorcontrib>Kavanagh, Yvonne</creatorcontrib><creatorcontrib>Keenan, Eamon</creatorcontrib><creatorcontrib>Cousins, Gráinne</creatorcontrib><collection>PubMed</collection><jtitle>British journal of clinical pharmacology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Durand, Louise</au><au>O'Kane, Aoife</au><au>Tierney, Julie</au><au>Cronly, Mark</au><au>Bennett, Kathleen E</au><au>Kavanagh, Yvonne</au><au>Keenan, Eamon</au><au>Cousins, Gráinne</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Gabapentinoids in Ireland 2010 to 2020: an observational study of trends in gabapentinoid prescribing, law enforcement drug seizures and post mortem toxicology</atitle><jtitle>British journal of clinical pharmacology</jtitle><addtitle>Br J Clin Pharmacol</addtitle><date>2023-12-10</date><risdate>2023</risdate><eissn>1365-2125</eissn><abstract>We explored trends in gabapentinoid prescribing, drug seizures and post mortem toxicology using a national pharmacy claims database, law enforcement drug seizures data and a population based post mortem toxicology database. Gabapentinoid prescribing rates per 100,000 eligible population (2010-2020), annual number of drug seizures involving gabapentinoids (2012-2020), and gabapentinoid detection (positive) rates per 100 post mortem toxicology case (2013-2020) were calculated. Negative binomial regression models were used to evaluate longitudinal trends for gabapentin and pregabalin separately. Gabapentin (Adjusted Rate Ratio (ARR) 1.06, 95% CI 1.05-1.06, p &lt;0.001) and pregabalin (ARR 1.08, 95% CI 1.08-1.09, p&lt;0.001) prescribing increased annually, with higher rates of pregabalin (vs gabapentin) observed every year. Drug seizures involving pregabalin also increased over time (RR 1.54 95% CI 1.25-1.90, p&lt;0.0001). Of the 26,317 post mortem toxicology cases, 0.92% tested positive for gabapentin, 6.37% for pregabalin. Detection rates increased for both gabapentin (RR 1.28, 95% CI 1.11 - 1.48, p&lt;0.001) and pregabalin (RR 1.13, 95% CI 1.11-1.48, p&lt;0.001) between 2013 and 2020. A total of 1,901 cases (7.2%) tested positive for heroin/methadone; this sub-group had a higher detection rate for pregabalin (n=528, 27.8%) and gabapentin (n=41, 2.2%) over study period, with a high burden of co-detections for pregabalin with benzodiazepines (peaking at 37.3% in 2018), and pregabalin with prescription opioids (peaking at 28.9% in 2020) CONCLUSIONS: This study raises concerns regarding the wide availability of pregabalin in Ireland, including a growing illicit supply, and the potential for serious harm arising from poly drug use involving pregabalin among people who use heroin or methadone.</abstract><cop>England</cop><pmid>38072974</pmid><orcidid>https://orcid.org/0000-0003-2985-7668</orcidid></addata></record>
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title Gabapentinoids in Ireland 2010 to 2020: an observational study of trends in gabapentinoid prescribing, law enforcement drug seizures and post mortem toxicology
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