So…. looks like gabapentin that we use a LOT for withdrawals and for mood disorders might actually be precariously dangerous with taken with all the opioids and benzos. Kentucky has classified it as a schedule 5 and is now on the PDMP. The longer we go the more “sedating” meds we find that are involved in overdoses.

Why is gabapentin implicated? It might actually be that it simply causes sedation in addition to the opioid sedation (very much like seroquel is also pretty dangerous in combo with opioids). True gabapentin and seroquel aren’t addictive like benzos but it looks more and more like we definitely have to be careful with this medication also. Not that we cant use it, just need to be more careful.

How do we balance all of these needs??? We are taking patients OFF the dangerous opioids and sometimes we can fully get them off but some patients truly need opioids at a lower dose. The gaba has been such a great tool to help with pain management that we shouldnt completely abandon it for sure but how do we now use it more carefully.

My argument is still
-Taking less opioids is better
-Any opioid that can be replaced with gaba is still safer than the higher dose of opioids
-And of course keep looking and trying other non-opioid pain meds like antiinflammatories..

Makes sense doesn’t it???