Author ORCID Identifier

http://orcid.org/0000-0002-7224-8916

Year of Publication

2016

Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation

College

Public Health

Department

Epidemiology and Biostatistics

First Advisor

Dr. Jennifer R. Havens

Abstract

Gabapentin is currently approved by the Food and Drug Administration (FDA) as an adjunctive anti-convulsant and an analgesic for post-herpetic neuralgia. Though gabapentin was initially presumed to have limited or no abuse potential, which may have contributed to its widespread off-label prescribing, there have been increasing anecdotal and published reports of its misuse by substance abusers in the community and penal system. However, to date, there has been limited systematic evaluation of the scope and risk of gabapentin misuse and its associated effects. This dissertation assesses the etiology and prevalence of gabapentin misuse, abuse, and diversion in a multi-faceted approach, namely by the individual, ecological, and pharmacoepidemiological factors associated with this phenomenon. Due to the importance of conducting theory-driven epidemiological research, this dissertation uses an adaptation of the Concurrent Triangulation Mixed Method Multilevel Theoretical Model to guide the study. Through qualitative analysis of focus group data in an existing cohort of opioid users, a systematic review of peer-reviewed published literature, and a pharmacovigilance assessment of adverse events reported to the FDA, this dissertation describes the present state of gabapentin misuse. Findings are important for providers and may help inform policy to establish for whom prescription of gabapentin is most appropriate.

Digital Object Identifier (DOI)

https://doi.org/10.13023/ETD.2016.517

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