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Substitute Pain Relievers Appear in Suicide Attempts

As doctors turn away from opioids for pain relief, the drugs they are prescribing instead are implicated in more suicide attempts.

Public health authorities have been working hard to control the opioid epidemic and reduce the number of people dying from narcotic overdoses. This effort has had some success, but it has also had some unanticipated and unwanted consequences, among them a change in suicide attempts.

Gabapentin Now Being Used in Suicide Attempts:

Opioid prescriptions have been dramatically curtailed because doctors have become reluctant to prescribe such medications. People in pain still need treatment, however, and many physicians have turned to an anticonvulsant called gabapentin (Neurontin). It is approved to treat epilepsy and the pain lingering after a shingles attack. Most prescriptions, however, are written for off-label uses such as neuropathic pain, migraines, fibromyalgia, bipolar disorder and hot flashes.

Now, a study published in the journal Clinical Toxicology shows an alarming increase in suicide attempts associated with gabapentin (Dec. 1, 2019). An analysis of calls to US Poison Centers found a 72% increase in toxic exposures to gabapentin. People abusing gabapentin to get high or in suicide attempts increased by 80% bwtween 2013 and 2017. Minnesota and South Dakota have been especially hard hit. Gabapentin can trigger depression or suicidal thoughts, and doctors should warn people of this possibility when they prescribe the drug. 

Baclofen Misuse Also on the Rise:

Doctors have also turned to another drug that works on GABA receptors, much as gabapentin does. Baclofen is a muscle relaxant that is now also being used for pain relief. Between 2013 and 2017, US Poison Centers logged 31% more calls regarding baclofen use or misuse, including suicide attempts. At least half of the people who had taken too much baclofen landed in a hospital or convalescent home as a result.  

A previous study in Sweden demonstrated a link between gabapentinoids (gabapentin and pregabalin) and suicide attempts (BMJ, June 12, 2019). Results of that research suggest that pregabalin (Lyrica) might cause even more trouble in this regard than gabapentin does. As a result, physicians should consider such risks carefully when prescribing non-opioid pain relievers.

Learn More:

If you are interested in the pros and cons of gabapentin, you may wish to read what we have written about this drug. The current study is not the first one to warn of a link between gabapentin and suicide attempts.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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