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My initial shock was for two reasons. First, as a pharmacist, pharmacology educator, speaker, and author for more than 30 years, surely I would have heard of an issue with the illicit use of yet another prescription drug. Nevertheless, the notifications and warnings went viral and I watched them quickly spread from the web to broadcast media.
The new menace was the prescription drug gabapentin, commonly known by its most popular brand-name, Neurontin. I must admit that initially these warnings struck me as a bit alarmist. Gabapentin is an anti-seizure drug that is also prescribed for nerve pain. It has been available in the US since I was unaware of any widespread reports concerning any safety issues with it. Indeed, my quick review of the literature indicated that the first peer-reviewed report Neurontin user reviews any gabapentin-linked death was published in in the Journal of Forensic Sciencesand that was an intentional suicide by overdose.
Well, many prescription and non-prescription drugs taken in excessive amounts may cause death, even such innocuous drugs as aspirin and acetaminophen. Further review of the literature revealed yet another report of fatality by overdose, which was published Neurontin user reviews International Journal of Legal Medicine in However, these two reports hardly constituted thousands. Was this just social and broadcast media hysteria or is this based on a real abuse Neurontin user reviews As it turns out, after my initial scratch of the surface, there was a lot for me to uncover about the truth behind these gabapentin warnings.
Since its introduction, gabapentin has been very popular and widely used as an adjuvant, an add-on drug that boosts the effects of other drugs, especially to help control partial seizures in adults. However, in the quarter century since its initial approval, off-label uses have exploded. Like almost all FDA-approved medications, when prescribed responsibly and taken as prescribed, gabapentin can offer great relief to those with these conditions.
However, Neurontin user reviews all know that we live in a world in which not every patient takes medications as prescribed. Since gabapentin works so well as an adjuvant, it is also frequently used in combination with drugs of abuse to intensify their effects, especially opioids. In Julya report in Kaiser Health News detailed the dangers of recreational drug users taking high doses of gabapentin along with opioids, a practice called stacking.
Also in that year, the state of Kentucky released data gathered from autopsies performed on people who died of drug overdoses. The data revealed the presence of gabapentin alongside deadly opioids such as heroin and fentanyl. In fact, gabapentin was the most frequently detected substance in these autopsies.
Well, when used recreationally in this way, gabapentin is often taken in doses that are much greater than its typical legitimate therapeutic dose. Some users report taking up to 5, milligrams at Neurontin user reviews, which is nearly 2. At those high doses, gabapentin, like many other anti-seizure medications, may produce exaggerated adverse effects, including, counterintuitively, seizures. In this respect, this issue with gabapentin seems to represent a bit of a perfect storm. First, gabapentin is prescribed for pain, and Neurontin user reviews no health professional wants to see a patient in pain, this may foster a bit of leniency when it comes to prescribing practices and quantity limits for this drug.
Fourth, gabapentin is not an opioid and this may foster a relative, and false, sense of safety about its use and reduce concerns about its potential for abuse. Finally, since gabapentin is often prescribed in large quantities and covered by most prescription plans with a low Neurontin user reviews drug copay, it is relatively inexpensive and widely available for both its prescribed use as well as for experimentation for abuse.
Recreational gabapentin abuse with or without a prescription needs to be on the radar of dental professionals due to its potential for producing not only additive adverse effects, but also serious drug-drug interactions with medications we commonly use during dental procedures, such as for conscious-sedation or the treatment of post-operative pain. Even when used for legitimate reasons, gabapentin taken in combination with opioids increases the risk of respiratory depression and death. That could make it easier for us to identify those patients who may be at elevated risk during and after dental procedures.
I feel fine! Dental Assisting. Jun 18th, Pharmacist Tom Viola was caught by surprise when he read online that the prescription drug gabapentin was causing alarm as a new drug that's being abused. What he learned may surprise you. Thomas A. View Image Gallery. Why should dental professionals take notice? Fourth, gabapentin is not an opioid and this may foster a relative, and false, sense of safety about its use and reduce concerns about its potential for abuse Finally, since gabapentin is often prescribed in large quantities and covered by most prescription plans with a low generic drug copay, it is relatively inexpensive and widely available for both its prescribed use as well as for experimentation for abuse.
Viola is on the faculty of 10 dental professional degree programs, and has instructed students in chemistry, anatomy and physiology, pathophysiology, pharmacology, and local anesthesia. He is well known for his contributions to many dental journals in the areas of pharmacology, pain management, and local anesthesia. For more information, visit tomviola. Latest in Patient Relations. Patient Relations The challenges of dental assisting: Meet them with compassion Jun 17th, Patient Relations The purpose, job description, and duties of dental assistants Kevin Tighe.
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