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Abstract

Objective: Assess the association between West Virginia’s classification of gabapentin as a schedule V controlled substance and fatal overdoses involving gabapentin, relative to a control state. Methods: Using a controlled interrupted time series design, we modeled a segmented linear regression using Newey-West standard errors to estimate the immediate and trend changes in gabapentin-involved fatal overdoses among adults in West Virginia associated with gabapentin’s scheduling in June 2018. Data from North Carolina (no gabapentin scheduling) was used as a control to account for potential secular changes. Quarterly rates were computed from 2016 to 2019. Results: The introduction of West Virginia’s policy was associated with an immediate decrease in the rate of gabapentin-involved fatal overdoses (drop of 0.39 overdoses per 100,000 adults) in West Virginia relative to North Carolina (95% CI: −0.75, −0.03). There was no evidence to suggest a change in trend relative to North Carolina (0.02 overdoses per 100,000 adults per quarter; 95% CI: −0.06, 0.10). Conclusions: Classifying gabapentin as a schedule V controlled substance was associated with an immediate decrease in the rate of gabapentin-involved fatal overdoses in West Virginia, relative to North Carolina. Policy Implications: Combined with broader efforts to address overdose deaths, scheduling gabapentin is a potential supply-side intervention that may contribute to reductions in gabapentin involvement in fatal overdoses.

Document Type

Article

Publication Date

8-1-2026

Notes/Citation Information

Publisher Copyright: © 2026 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC license. http://creativecommons.org/licenses/by-nc/4.0/

Digital Object Identifier (DOI)

10.1016/j.drugalcdep.2026.113189

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