Drugs Used to Replace Opioids Linked With Increase in Suicide Attempts Across U.S.

As opioid prescriptions have fallen amid an epidemic of overuse and overdose, suicide attempts linked to some non-opioid medications replacing them have risen, research has revealed.

The study, published in the journal Clinical Toxicology, looked at the effects of drugs called gabapentin and baclofen, both of which are used as opioid substitutes.

Researchers analyzed data collected by the U.S. Poison Centers for the National Poison Data System, and noted cases involving gabapentin between 2013 and 2017, and baclofen between 2014 and 2017. Both drugs are given to patients dealing with conditions that cause long-term—or chronic—pain.

Chronic pain affects around 20 percent of the U.S. population, or about 50 million adults. After the number of drug overdose deaths in the U.S. hit 70,237 in 2017, largely caused by the opioid epidemic, doctors started turning to other drugs to treat the condition.

Gabapentin is an anti-epileptic drug which is also used to treat nerve pain, as well as migraines, mental illness, and fibromyalgia. Between 2012 and 2016, the number of prescriptions for the drug in the U.S. rose by 64 percent, to 64 million. The drug can make users feel relaxed, calm, experience a marijuana-like "high" and even euphoria, according to the authors.

Baclofen, meanwhile, is a muscle relaxant and antispasmodic medication used to treat spasms, pain, and stiffness, including in those with spinal and central nervous system disorders. It is also given to people with lower back pain, "despite evidence of adverse effects without long term benefit," the scientists wrote. Regular use has been linked to dependency and withdrawal, and overdose of the drug to respiratory depression, seizures, and heart problems. The study did not include data on baclofen prescription rates, but the researchers said use has been rising.

Suicidal thoughts are among the potential side effects of both drugs, and chronic pain itself is linked to suicide attempts. This comes against a backdrop of suicide rates in the U.S. rising by 30 percent between 1999 and 2016, according to research cited by the scientists.

Over the period the drugs were studied, suicides attempts after people took just gabapentin rose by 80.5 percent, and by 43 percent for baclofen.

Kimberly Reynolds of the University of Pittsburgh who lead the study told Newsweek the research relied on reports submitted to poison control centers to a national database, so the study may not include the total cases in the U.S. during the period of study.

"We are seeing a worrying increase in harmful exposures to gabapentin and baclofen in U.S. adults over recent years, which may be an unintended consequence of the move away from opioid prescriptions for pain management," said Reynolds.

"Building a better understanding of the risks carried by these non-opioid medications is necessary so that providers and patients can make better-informed decisions about their role in pain management—and could also lead to the introduction of new public health measures."

Asked for the best course of actions for patients taking the drugs who might be worried by the findings, Reynolds said: "Patients should discuss their concerns about taking these medications with their healthcare provider.

"This research can build a better understanding of the risks so that providers and patients can make decisions regarding the role of these medications in their pain management based upon an evidence-informed risk-benefit analysis."

If you have thoughts of suicide, confidential help is available for free at the National Suicide Prevention Lifeline. Call 1-800-273-8255. The line is available 24 hours, every day.

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A stock image shows a bottle of pills. Scientist have investigated the effects of taking non-opioid painkillers. Getty
Drugs Used to Replace Opioids Linked With Increase in Suicide Attempts Across U.S. | Health