Author ORCID Identifier
https://orcid.org/0009-0004-1291-8457
Date Available
12-4-2027
Year of Publication
2025
Document Type
Doctoral Dissertation
Degree Name
Doctor of Philosophy (PhD)
College
Public Health
Department/School/Program
Epidemiology and Biostatistics
Faculty
Rachel Vickers-Smith
Faculty
April Young
Faculty
Amanda Ellis
Abstract
Gabapentin, a medication commonly prescribed for neuropathic pain, has seen increasing nonmedical use in the United States, prompting states such as Kentucky to classify it as a Schedule V controlled substance. This three-paper dissertation examines patterns of nonmedical gabapentin use, the potential impact of scheduling on gabapentin-positive fatal overdoses, and the experiences of people who use drugs (PWUD) following scheduling. The first paper analyzes longitudinal data from the Social Networks among Appalachian People (SNAP) study (2008–2020) to evaluate trends in nonmedical use and sources before and after scheduling. Use continued to rise post-scheduling, with a shift from regulated to unregulated sources. The second paper uses statewide postmortem toxicology data and interrupted time series analysis to assess changes in gabapentin involvement in fatal overdoses, finding no significant reduction and notable differences by sex and rurality. The third paper employs qualitative interviews with 30 PWUD to explore healthcare access, street market changes, and shifts in use patterns. Together, these studies suggest that scheduling alone may not deter nonmedical use or reduce related overdoses and may redirect sourcing to unregulated channels. Findings highlight the need for multifaceted approaches, including harm reduction and education for prescribers and patients to address gabapentin misuse.
Digital Object Identifier (DOI)
https://doi.org/10.13023/etd.2025.547
Funding Information
This project was supported by pilot funds from the University of Kentucky’s Substance Use Priority Research Area (SUPRA), supported by the Vice President for Research. The Social Networks among Appalachian People (SNAP) study described in this analysis was supported by the National Institute on Drug Abuse under grants R01 iv DA024598 and R01 DA033862, awarded to Dr. Jennifer Havens at the University of Kentucky.
Recommended Citation
Cook, KaraLynne, "EXPLORING PATTERNS IN NONMEDICAL GABAPENTIN USE AND GABAPENTIN-POSITIVE OVERDOSE BEFORE AND AFTER SCHEDULING: A MULTI-METHODS STUDY OF APPALACHIAN AND STATEWIDE TRENDS IN KENTUCKY" (2025). Theses and Dissertations--Epidemiology and Biostatistics. 49.
https://uknowledge.uky.edu/epb_etds/49
