Quantifying Gabapentin Misuse With Opioids

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To the Editor: We read with interest the article by Tomko et al, which adds to the large body of previous work documenting an association between gabapentin misuse and opioid misuse. We agree with Tomko et al that regulatory agencies should consider tighter gabapentin regulation, potentially including reclassification as a controlled substance, as our team and other researchers have documented the prevalence and harms associated with gabapentin and opioid coadministration at high dosages. In addition, Tomko et al note that a knowledge gap exists concerning whether high-dose gabapentin signals potential opioid misuse and warrants further investigation.’ ‹