Sociodemographic and clinical correlates of gabapentin receipt with and without opioids among a national cohort of patients with HIV

ABSTRACT

Gabapentin is commonly prescribed for chronic pain, including to patients with HIV (PWH). There is growing concern regarding gabapentin's potential for harm, particularly in combination with opioids. Among PWH, we examined factors associated with higher doses of gabapentin receipt and determined if receipt varied by opioid use. We examined data from the Veterans Aging Cohort Study, a national prospective cohort including PWH, from 2002 through 2017. Covariates included prescribed opioid dose, self-reported past year opioid use, and other sociodemographic and clinical variables. We used multinomial logistic regression to determine independent predictors of gabapentin receipt. Among 3,702 PWH, 902 (24%) received any gabapentin during the study period at a mean daily dose of 1,469 mg. In the multinomial model, high-dose gabapentin receipt was associated with high-dose benzodiazepine receipt (adjusted odds ratio [aOR], 95% confidence interval [CI]= 1.53, [1.03–2.27]), pain interference (1.65 [1.39–1.95]), and hand or foot pain (1.81, [1.45–2.26]). High-dose gabapentin receipt was associated with prescribed high-dose opioids receipt (2.66 [1.95–3.62]) but not self-reported opioid use (1.03 [0.89–1.21]). PWH prescribed gabapentin at higher doses are more likely to receive high-dose opioids and high-dose benzodiazepines, raising safety concerns.

KEYWORDS:

• Opioid-related disorders
• HIV
• pain
• pharmacoepidemiology
• cohort studies

Acknowledgments

This work was supported by the National Institute on Drug Abuse (R01-DA040471) and by the National Institute on Alcohol Abuse and Alcoholism (U01-AA020790). The funding source was not involved in the design, conduct, or reporting of the work. No financial disclosures were reported by the authors of this paper.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by National Institute on Alcohol Abuse and Alcoholism: [Grant Number U01-AA020790]; National Institute on Drug Abuse: [Grant Number R01-DA040471].