Addressing Gabapentinoids’ Access Challenges in Saudi Arabia Under New Prescription Regulations: An Expert View

Abstract Gabapentinoids, notably gabapentin and pregabalin, are crucial for managing neuropathic pain in conditions like diabetic neuropathy and specific types of cancer-related pain where opioids are ineffective or undesirable. However, the misuse potential of pregabalin has led to stricter regulat...

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Main Authors: Khaled K. Aldossari, Yazed AlRuthia, Ashraf Amir, Mohammed Alshurem, Hussein Elbadawi, Abdullah Kaki
Format: Article
Language:English
Published: Adis, Springer Healthcare 2025-06-01
Series:Pain and Therapy
Subjects:
Online Access:https://doi.org/10.1007/s40122-025-00749-z
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author Khaled K. Aldossari
Yazed AlRuthia
Ashraf Amir
Mohammed Alshurem
Hussein Elbadawi
Abdullah Kaki
author_facet Khaled K. Aldossari
Yazed AlRuthia
Ashraf Amir
Mohammed Alshurem
Hussein Elbadawi
Abdullah Kaki
author_sort Khaled K. Aldossari
collection DOAJ
description Abstract Gabapentinoids, notably gabapentin and pregabalin, are crucial for managing neuropathic pain in conditions like diabetic neuropathy and specific types of cancer-related pain where opioids are ineffective or undesirable. However, the misuse potential of pregabalin has led to stricter regulatory controls in many regions, including Saudi Arabia. This expert opinion presents insights from multidisciplinary experts about the impact of these regulations on clinical practice, patient care, and misuse patterns in Saudi Arabia. Pregabalin’s rapid onset of action and probable euphoric effects make it more prone to misuse, especially among younger individuals and those with a history of substance abuse. Gabapentin, in contrast, has a lower abuse potential. Experts discussed the implementation of the National Platform for Narcotic Drugs and Psychotropic Substances (Raqeeb) in Saudi Arabia, a system designed to monitor prescriptions of controlled substances. While effective in curbing over-prescription, it has also introduced unintended challenges. Physicians, fearing scrutiny, often hesitate to prescribe gabapentinoids, leading to delays in treatment and greater reliance on less appropriate alternatives. Moreover, stigma associated with controlled substances has further discouraged patients from seeking treatment, resulting in undertreated pain and a diminished quality of life. This expert opinion highlights the need for a more balanced approach to gabapentinoid regulation. It advocates for improved physician education on the management of neuropathic pain, and public awareness initiatives to curb misuse, reduce stigma, and promote the safe use of medications. Refining the Raqeeb platform could alleviate administrative burdens while ensuring robust oversight. Finally, adopting a risk-stratified approach to prescription would allow close monitoring of high-risk patients for substance abuse while ensuring that low-risk patients maintain access to essential treatments. Addressing these challenges would enable healthcare authorities to prevent abuse while ensuring effective pain relief for patients with legitimate medical needs.
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spelling doaj-art-64b1a5d66ddd472e80ffa49aedd8c6882025-08-20T03:45:40ZengAdis, Springer HealthcarePain and Therapy2193-82372193-651X2025-06-011441189120110.1007/s40122-025-00749-zAddressing Gabapentinoids’ Access Challenges in Saudi Arabia Under New Prescription Regulations: An Expert ViewKhaled K. Aldossari0Yazed AlRuthia1Ashraf Amir2Mohammed Alshurem3Hussein Elbadawi4Abdullah Kaki5Family and Community Medicine Department, College of Medicine, Prince Sattam Bin Abdulaziz UniversityPharmacoeconomics Research Unit, Department of Clinical Pharmacy, College of Pharmacy, King Saud UniversityFamily Medicine Consultant, Chief Medical Officer, International Medical Centre HospitalNeurology Department, College of Medicine, Imam Abdulrahman Bin Faisal universityDiabetes & Metabolic Unit, My Clinic InternationalConsultant, Department of Anesthesia and Pain Medicine, Alsalama HospitalAbstract Gabapentinoids, notably gabapentin and pregabalin, are crucial for managing neuropathic pain in conditions like diabetic neuropathy and specific types of cancer-related pain where opioids are ineffective or undesirable. However, the misuse potential of pregabalin has led to stricter regulatory controls in many regions, including Saudi Arabia. This expert opinion presents insights from multidisciplinary experts about the impact of these regulations on clinical practice, patient care, and misuse patterns in Saudi Arabia. Pregabalin’s rapid onset of action and probable euphoric effects make it more prone to misuse, especially among younger individuals and those with a history of substance abuse. Gabapentin, in contrast, has a lower abuse potential. Experts discussed the implementation of the National Platform for Narcotic Drugs and Psychotropic Substances (Raqeeb) in Saudi Arabia, a system designed to monitor prescriptions of controlled substances. While effective in curbing over-prescription, it has also introduced unintended challenges. Physicians, fearing scrutiny, often hesitate to prescribe gabapentinoids, leading to delays in treatment and greater reliance on less appropriate alternatives. Moreover, stigma associated with controlled substances has further discouraged patients from seeking treatment, resulting in undertreated pain and a diminished quality of life. This expert opinion highlights the need for a more balanced approach to gabapentinoid regulation. It advocates for improved physician education on the management of neuropathic pain, and public awareness initiatives to curb misuse, reduce stigma, and promote the safe use of medications. Refining the Raqeeb platform could alleviate administrative burdens while ensuring robust oversight. Finally, adopting a risk-stratified approach to prescription would allow close monitoring of high-risk patients for substance abuse while ensuring that low-risk patients maintain access to essential treatments. Addressing these challenges would enable healthcare authorities to prevent abuse while ensuring effective pain relief for patients with legitimate medical needs.https://doi.org/10.1007/s40122-025-00749-zAbuseAddictionEducationDependenceGabapentinoidGabapentin
spellingShingle Khaled K. Aldossari
Yazed AlRuthia
Ashraf Amir
Mohammed Alshurem
Hussein Elbadawi
Abdullah Kaki
Addressing Gabapentinoids’ Access Challenges in Saudi Arabia Under New Prescription Regulations: An Expert View
Pain and Therapy
Abuse
Addiction
Education
Dependence
Gabapentinoid
Gabapentin
title Addressing Gabapentinoids’ Access Challenges in Saudi Arabia Under New Prescription Regulations: An Expert View
title_full Addressing Gabapentinoids’ Access Challenges in Saudi Arabia Under New Prescription Regulations: An Expert View
title_fullStr Addressing Gabapentinoids’ Access Challenges in Saudi Arabia Under New Prescription Regulations: An Expert View
title_full_unstemmed Addressing Gabapentinoids’ Access Challenges in Saudi Arabia Under New Prescription Regulations: An Expert View
title_short Addressing Gabapentinoids’ Access Challenges in Saudi Arabia Under New Prescription Regulations: An Expert View
title_sort addressing gabapentinoids access challenges in saudi arabia under new prescription regulations an expert view
topic Abuse
Addiction
Education
Dependence
Gabapentinoid
Gabapentin
url https://doi.org/10.1007/s40122-025-00749-z
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