Incident gabapentin prescribing associated with opioid and benzodiazepine/Z-drug prescribing – a population-based longitudinal study in primary care

AimTo investigate the association between long-term prescribing of opioids, benzodiazepines and Z-drugs, and the incidence of gabapentin prescribing.MethodsFrom January 2009 to December 2012, 219,800 patients contacted primary healthcare centres in the Reykjavik metropolitan area. Of these, 94,840 p...

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Main Authors: Kristjan Linnet, Bjarni Pall Linnet Runolfsson, Johann Agust Sigurdsson, Larus Steinthor Gudmundsson
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Pharmacology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2025.1583415/full
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author Kristjan Linnet
Bjarni Pall Linnet Runolfsson
Johann Agust Sigurdsson
Johann Agust Sigurdsson
Larus Steinthor Gudmundsson
author_facet Kristjan Linnet
Bjarni Pall Linnet Runolfsson
Johann Agust Sigurdsson
Johann Agust Sigurdsson
Larus Steinthor Gudmundsson
author_sort Kristjan Linnet
collection DOAJ
description AimTo investigate the association between long-term prescribing of opioids, benzodiazepines and Z-drugs, and the incidence of gabapentin prescribing.MethodsFrom January 2009 to December 2012, 219,800 patients contacted primary healthcare centres in the Reykjavik metropolitan area. Of these, 94,840 patients aged 10–69 years, met the inclusion criteria. Data on relevant ICD-10 conditions related to multimorbidity were retrieved from a comprehensive medical records database for the primary healthcare centres in the area run by the Primary Healthcare of the Capital Area. Information on redeemed prescriptions for the relevant drugs was obtained from the Medicines Registry of the Directory of Health. The subjects were divided into four groups based on long-term use of opioids, benzodiazepines (BZDs) and Z-drugs (Defined Daily Doses, DDDs). The incidence rate ratio (IRR) of gabapentin was assessed using Cox regression. The effect of certain chronic conditions and long-term use of selective serotonin reuptake inhibitors (SSRIs) was also explored. Finally, the amount and duration of future gabapentin use were examined.ResultsLong-term use of opioids, BZDs or Z-drugs was associated with an increased risk of future gabapentin use. Individuals with the highest use of opioids and benzodiazepines or Z-drugs, i.e., ≥30 DDDs BZDs or Z-drugs were most likely to initiate gabapentin therapy (IRR 7.18: 95% CI 6.50–7.93). These individuals also had the longest average duration of future gabapentin use.ConclusionThe rise in gabapentin prescriptions must be carefully monitored as prior history of opioids, benzodiazepines and Z-drugs may pose a risk of problematic gabapentin use.
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spelling doaj-art-ead73b2db33e44398c929b67bb171d652025-08-20T04:00:48ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-08-011610.3389/fphar.2025.15834151583415Incident gabapentin prescribing associated with opioid and benzodiazepine/Z-drug prescribing – a population-based longitudinal study in primary careKristjan Linnet0Bjarni Pall Linnet Runolfsson1Johann Agust Sigurdsson2Johann Agust Sigurdsson3Larus Steinthor Gudmundsson4Development Centre for Primary Healthcare in Iceland, Primary Healthcare of the Capital Area, Reykjavik, IcelandFaculty of Pharmaceutical Sciences, School of Health Sciences, University of Iceland, Reykjavik, IcelandDevelopment Centre for Primary Healthcare in Iceland, Primary Healthcare of the Capital Area, Reykjavik, IcelandGeneral Practice Research Unit, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, NorwayFaculty of Pharmaceutical Sciences, School of Health Sciences, University of Iceland, Reykjavik, IcelandAimTo investigate the association between long-term prescribing of opioids, benzodiazepines and Z-drugs, and the incidence of gabapentin prescribing.MethodsFrom January 2009 to December 2012, 219,800 patients contacted primary healthcare centres in the Reykjavik metropolitan area. Of these, 94,840 patients aged 10–69 years, met the inclusion criteria. Data on relevant ICD-10 conditions related to multimorbidity were retrieved from a comprehensive medical records database for the primary healthcare centres in the area run by the Primary Healthcare of the Capital Area. Information on redeemed prescriptions for the relevant drugs was obtained from the Medicines Registry of the Directory of Health. The subjects were divided into four groups based on long-term use of opioids, benzodiazepines (BZDs) and Z-drugs (Defined Daily Doses, DDDs). The incidence rate ratio (IRR) of gabapentin was assessed using Cox regression. The effect of certain chronic conditions and long-term use of selective serotonin reuptake inhibitors (SSRIs) was also explored. Finally, the amount and duration of future gabapentin use were examined.ResultsLong-term use of opioids, BZDs or Z-drugs was associated with an increased risk of future gabapentin use. Individuals with the highest use of opioids and benzodiazepines or Z-drugs, i.e., ≥30 DDDs BZDs or Z-drugs were most likely to initiate gabapentin therapy (IRR 7.18: 95% CI 6.50–7.93). These individuals also had the longest average duration of future gabapentin use.ConclusionThe rise in gabapentin prescriptions must be carefully monitored as prior history of opioids, benzodiazepines and Z-drugs may pose a risk of problematic gabapentin use.https://www.frontiersin.org/articles/10.3389/fphar.2025.1583415/fullgabapentinopioidsbenzodiazepine/Z-drugslong-term co-prescribingprimary careICD-10 conditions
spellingShingle Kristjan Linnet
Bjarni Pall Linnet Runolfsson
Johann Agust Sigurdsson
Johann Agust Sigurdsson
Larus Steinthor Gudmundsson
Incident gabapentin prescribing associated with opioid and benzodiazepine/Z-drug prescribing – a population-based longitudinal study in primary care
Frontiers in Pharmacology
gabapentin
opioids
benzodiazepine/Z-drugs
long-term co-prescribing
primary care
ICD-10 conditions
title Incident gabapentin prescribing associated with opioid and benzodiazepine/Z-drug prescribing – a population-based longitudinal study in primary care
title_full Incident gabapentin prescribing associated with opioid and benzodiazepine/Z-drug prescribing – a population-based longitudinal study in primary care
title_fullStr Incident gabapentin prescribing associated with opioid and benzodiazepine/Z-drug prescribing – a population-based longitudinal study in primary care
title_full_unstemmed Incident gabapentin prescribing associated with opioid and benzodiazepine/Z-drug prescribing – a population-based longitudinal study in primary care
title_short Incident gabapentin prescribing associated with opioid and benzodiazepine/Z-drug prescribing – a population-based longitudinal study in primary care
title_sort incident gabapentin prescribing associated with opioid and benzodiazepine z drug prescribing a population based longitudinal study in primary care
topic gabapentin
opioids
benzodiazepine/Z-drugs
long-term co-prescribing
primary care
ICD-10 conditions
url https://www.frontiersin.org/articles/10.3389/fphar.2025.1583415/full
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