Researchers are revealing increased risks associated with the use of some common painkillers when taken with other medications, warning of a potential rise in drug poisoning cases and hospitalizations.
The results showed that combining gabapentinoids and benzodiazepines – sedatives such as diazepam and Valium used to treat anxiety and insomnia – doubles the risk of hospitalization due to drug poisoning.
The study also showed that the use of gabapentinoids with opioid substances such as codeine, tramadol, and morphine is associated with an increased risk of poisoning of approximately 30%.
Despite these risks, the data revealed that about 90% of the patients included in the study were prescribed opioids in conjunction with gabapentinoids, while more than half of them also received benzodiazepine sedatives.
Drugs in this class, such as gabapentin and pregabalin, are widely used, being prescribed to more than 4.5 million people annually in England, and are among the most commonly used drugs in the United States as well.
According to the researchers, the use of these drugs more than quadrupled globally between 2008 and 2018, reflecting the growing reliance on them as painkillers.
The study was based on an analysis of data from more than 16,000 patients in the United Kingdom between 2010 and 2020, with follow-up on hospital admissions resulting from drug poisoning before, during and after treatment.
The results showed that patients who combined gabapentinoids and benzodiazepines were four times more likely to be hospitalized for poisoning during the first weeks of treatment, compared to periods when they did not take these drugs.
It was also shown that combining gabapentinoids with opioid painkillers doubles the risk of poisoning during the same period.
Symptoms of drug poisoning range from nausea, confusion, and seizures, and in severe cases, may lead to difficulty breathing and death, which in many cases requires the patient to be admitted to the hospital for treatment.
Dr. Kenneth Mann, the study's lead author, said: "Prescriptions for gabapentinoids have seen a significant increase in recent years as a safer alternative to opioids, but they still carry risks that warrant caution."
He added that these drugs are effective in relieving pain, but they may pose a risk when used with other drugs, stressing the need to monitor patients carefully.
The researchers pointed out that some patients receive these drugs even though they are already at higher risk of drug poisoning, which may complicate the clinical picture.
They also explained that the reduced risk of poisoning after starting treatment does not eliminate the continued existence of a high risk that requires constant medical attention.
These findings come after warnings from the UK's Medicines and Healthcare products Regulatory Agency (MHRA), which recently stressed the risks of addiction, dependence, and withdrawal symptoms associated with these drugs.
The agency warned of the dangers of combining gabapentinoids with benzodiazepines, opioids, or alcohol, urging that they not be shared among patients and used only under strict medical supervision.
The researchers explain that these drugs affect the "GABA" pathways in the brain to relieve pain and produce a calming effect, but long-term use may lead to physical dependence and withdrawal symptoms upon stopping.
In some cases, patients resort to increasing doses or obtaining the drug from non-medical sources due to the development of "drug tolerance," which increases the risk of unsafe use.
