According to a study published in the July 2019 issue of the Journal of the American Medical Association (JAMA), there may be a connection between the reimbursement doctors receive from pharmaceutical companies and the drugs they prescribe.
Reviewing data gathered between 2014 and 2016, researchers found doctors who prescribed gabapentinoids received payment for prescribing the name brand over the generic alternatives. The cost of this passes to consumers, which raises ethical concerns.
Industry payments for drugs is not uncommon. By law, these payments are public record. Pharmaceutical companies use this method to encourage doctors to prescribe their medications. In this study, as much as half a million dollars was paid out to doctors in some states for prescribing name brand gabapentin, such as Lyrica, Horizant, Fanatrex, Gabarone, Gralise, Neurontin and Nupentin. Brand name drugs can cost several hundreds of dollars a month for the user, as opposed to generic alternatives that can cost as little as $20 a month.
Originally, these drugs were used to treat epilepsy, but are now used for a range of conditions, including chronic pain. These drugs are currently not classified as controlled substances by the Food and Drug Administration.
There are different opinions on this, and some states have taken action. Earlier this year, the Michigan Board of Pharmacy supported a move to classify gabapentin as a controlled substance. As a controlled substance, it would be subject to stricter standards of prescribing and dispensing.
Gabapentin can produce a high when combined with other drugs. Gabapentin abuse can be an issue when other drugs, such as opioids, are used at the same time.
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The Dangerous Game of Prescribing for Money
The potential for gabapentin abuse is just one of the many issues with doctors receiving incentives from pharmaceutical manufacturers. Pharmaceutical companies spend a significant amount of money on advertising and other elements that drive the cost of their products higher.
According to an article in The Washington Post, between 2006 and 2014, drug prices rose by 57%. In the past, pharmaceutical advertising was responsible for higher prescribing rates that some suggest contributed to the opioid epidemic. Prescribing practices have been subject to scrutiny and reform because of prescription drug addiction and the opioid crisis.
Signs of Gabapentin Abuse and Addiction
People who struggle with chronic nerve pain or epilepsy may have prescriptions for this drug. Migraines, fibromyalgia, diabetic neuropathy and shingles can be treated with this class of drugs. Ongoing research finds new ways to use this drug, some of which are in the testing phase. Some of these new conditions eligible for treatment with gabapentin are anxiety, hot flashes and restless leg syndrome.
Gabapentin has also been used for other conditions, including withdrawal management. While it has many helpful uses, it is also susceptible to abuse. Gabapentin abuse can lead to addiction. Signs of gabapentin abuse may include:
- Lack of coordination
- Tremors and shaking
- Suicidal thoughts
Gabapentin abuse symptoms should be taken seriously and may be the first indication someone is struggling with addiction and may need treatment.
Limiting Gabapentin Prescriptions to Prevent Potential Risks
One of the ways gabapentin abuse can be limited is through access. People who are abusing or are addicted to the drug may be getting it by prescription. Doctors have a responsibility to only prescribe this drug for its intended use. While there may not be definitive signs that indicate gabapentin abuse, the chance for this can always be reduced by limiting access and monitoring use. Doctors are accountable for prescription practices that reflect integrity and lead to each patient’s well-being.
It’s up to not only doctors to be aware of the risks and limitations of gabapentin, but patients need to serve as their own advocates as well.
Doctors were prescribing opioids for years, in large part because of influence from pharmaceutical companies. Now, in the midst of the opioid epidemic, some are concerned there could be similarities with trends in gabapentin prescriptions. It’s likely there will be more research on the long-term effects of gabapentin and similar drugs, and increasing scrutiny on prescribing practices.
If you’re struggling with prescription drug abuse, please contact The Recovery Village to learn more about treatment programs personalized to your needs.
Feldman, Robin. “Why Prescription Drug Prices Have Skyrocketed.” The Washington Post, November 26, 2018. Accessed August 4, 2019. Rhee, Greg Taeho et al. “Association Between Industry Payments to Physicians and Gabapentinoid Prescribing.” JAMA Network, July 8, 2019. Accessed August 4, 2019. Steinbrook, Robert. “Industry Payments and Physician Prescribing.” Journal of the American Medical Association, July 8, 2019. Accessed August 4, 2019. The Associated Press. “Drug Listing Story.” U.S. News and World Report, January 10, 2019. Accessed August 4, 2019.
Feldman, Robin. “Why Prescription Drug Prices Have Skyrocketed.” The Washington Post, November 26, 2018. Accessed August 4, 2019.
Rhee, Greg Taeho et al. “Association Between Industry Payments to Physicians and Gabapentinoid Prescribing.” JAMA Network, July 8, 2019. Accessed August 4, 2019.
Steinbrook, Robert. “Industry Payments and Physician Prescribing.” Journal of the American Medical Association, July 8, 2019. Accessed August 4, 2019.
The Associated Press. “Drug Listing Story.” U.S. News and World Report, January 10, 2019. Accessed August 4, 2019.