Historique
Article de Périodique
Experiences of misuse and symptoms of dependence among people who use gabapentinoids: A qualitative systematic review (2024)
Auteur(s) :
MCNEILAGE, A. G. ;
SIM, A. ;
NIELSEN, S. ;
MURNION, B. ;
ASHTON-JAMES, C. E.
Année
2024
Page(s) :
art. 104605
Sous-type de document :
Revue de la littérature / Literature review
Langue(s) :
Anglais
Domaine :
Autres substances / Other substances
Thésaurus mots-clés
ETUDE QUALITATIVE
;
ANTALGIQUES
;
MESUSAGE
;
DEPENDANCE
;
PREGABALINE
;
DOULEUR
;
TYPE D'USAGE
;
VOIE D'ADMINISTRATION
;
EFFET RECHERCHE
;
SYMPTOME
Autres mots-clés
Résumé :
Background: Gabapentinoids are among the most widely prescribed pain medications worldwide. However, there is growing evidence of harms associated with their use. The aim of this study was to systematically review and synthesise qualitative research exploring lived experiences of gabapentinoid (pregabalin and/or gabapentin) misuse and symptoms of dependence.
Methods: Six databases (MEDLINE, Scopus, Web of Science, CINAHL, EMBASE, PsycINFO) and grey literature sources were searched from inception to September 2023. The methodological quality of included studies was appraised using a modified 11-item version of the Critical Appraisal Skills Programme qualitative checklist, and higher quality studies were prioritised in the thematic synthesis. Confidence in the overall findings of the review was assessed using the GRADE-CERQual approach. The review was prospectively registered on PROSPERO (CRD42023401832).
Results: Twenty-six articles representing 21 original studies were included. The majority used interview methods and were of high methodological quality. Motives for gabapentinoid misuse included getting high, potentiating or offsetting the effects of other drugs, self-medicating for pain, distress, insomnia, or withdrawal symptoms, and substituting for another drug. Symptoms of dependence included the rapid development of tolerance and a severe withdrawal syndrome often involving psychiatric symptoms. Harms including dissociation, loss of consciousness, and overdose were generally reported as a consequence of polysubstance use. Confidence in most of the review findings was moderate with low confidence in one finding.
Conclusion: This review provides rich qualitative insights into the potential motives for gabapentinoid misuse as well as the diverse lived experiences of dependence symptomatology. Considering the increasing prescribing of these medications globally, and the potential for public health challenges resulting from misuse, the findings of this review can be used to develop more effective harm reduction strategies. [Author's abstract]
Methods: Six databases (MEDLINE, Scopus, Web of Science, CINAHL, EMBASE, PsycINFO) and grey literature sources were searched from inception to September 2023. The methodological quality of included studies was appraised using a modified 11-item version of the Critical Appraisal Skills Programme qualitative checklist, and higher quality studies were prioritised in the thematic synthesis. Confidence in the overall findings of the review was assessed using the GRADE-CERQual approach. The review was prospectively registered on PROSPERO (CRD42023401832).
Results: Twenty-six articles representing 21 original studies were included. The majority used interview methods and were of high methodological quality. Motives for gabapentinoid misuse included getting high, potentiating or offsetting the effects of other drugs, self-medicating for pain, distress, insomnia, or withdrawal symptoms, and substituting for another drug. Symptoms of dependence included the rapid development of tolerance and a severe withdrawal syndrome often involving psychiatric symptoms. Harms including dissociation, loss of consciousness, and overdose were generally reported as a consequence of polysubstance use. Confidence in most of the review findings was moderate with low confidence in one finding.
Conclusion: This review provides rich qualitative insights into the potential motives for gabapentinoid misuse as well as the diverse lived experiences of dependence symptomatology. Considering the increasing prescribing of these medications globally, and the potential for public health challenges resulting from misuse, the findings of this review can be used to develop more effective harm reduction strategies. [Author's abstract]
Affiliation :
Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Frankston, VIC, Australia
School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Frankston, VIC, Australia
School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
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