Gabapentoid
Gabapentoids is the collective term for Pregabalin and Gabapentin. The use of these drugs has steadily increased in England. There were 8.2 million prescriptions in 2013, which had risen to 12.1 million by 2016.
In April 2019, Pregabalin and Gabapentin were reclassified as Schedule 3 controlled drugs to reduce the growing number of deaths associated with their misuse. This followed a Government consultation and recommendations from the Advisory Council on the Misuse of Drugs for additional safeguards to be put in place because of concerns around the misuse of these drugs.
To put this into context, deaths associated with Pregabalin rose from 4 in 2012 to 111 in 2016. Similarly, deaths related to Gabapentin rose from 8 in 2012 to 59 deaths in 2016. Most of the deaths were related to a Gabapentoid being taken with an opiate drug (codeine, tramadol, morphine or morphine-like medication).
Patient safety is at the heart of our prescribing at The Lawson Practice. Due to the overwhelming evidence of harm associated with gabapentin and opiates, we are taking major steps to reduce this risk.
We will be doing the following:
An audit to identify patients at high risk of death, i.e. they are on a gabapentin and an opiate together. These patients will be invited to see their GP or our pharmacist to agree on a reduction plan. You will be expected to attend if you receive a text message or phone call.
Cocodamol will no longer be issued. It will be replaced by codeine alone to wean off and stop it. For those who are dependent on cocodamol, an appointment will be offered whereby you can discuss a reduction plan with your GP or our pharmacist.
For patients with acute pain, codeine will be limited to a 7-day script. If a more extended script is needed, it can only be issued by the doctor who first issued it.
All new patients where it is suggested by a hospital specialist to consider being started on gabapentin will first be discussed in a clinical meeting before a decision is made. Just because a hospital doctor recommends a drug does not mean that a GP will automatically prescribe it, as we have more information about drug interactions.
Quantities of gabapentin will not exceed 28 days. A GP or our pharmacist may also decide a smaller quantity is issued if they suspect misuse or diversion of these drugs or where a reduction plan is in place.
If evidence emerges that these drugs are being diverted, we will not issue further scripts.
If you have any concerns about any of the above don't hesitate to get in touch with your GP to discuss further