Author(s): ,
Berwertz, M.*
Sheffield Teaching Hospital, Anaesthetics and Chronic Pain, Sheffield, United Kingdom
Das, S.
Sheffield Teaching Hospital, Anaesthetics and Chronic Pain, Sheffield, United Kingdom
Bendinger, T.
Sheffield Teaching Hospital, Anaesthetics and Chronic Pain, Sheffield, United Kingdom
ESRA Academy. Berwertz M. Sep 15, 2017; 190772; 278 Topic: MISCELLANEOUS
Dr. Martyna Berwertz
Dr. Martyna Berwertz

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Background and Aims:

Gabapentinoids are commonly prescribed to treat chronic neuropathic pain. There is increasing concern about its misuse and aberrant behaviour associated with treatment. We assessed this problem in our Chronic Pain Clinic by asking patients to fill in the Current Opioid Misuse Measure (COMM) questionnaire.


Patients taking regular Gabapentin/ Pregabalin were asked to voluntarily and anonymously fill the self administered COMM questionnaire. Potential substance misuse, length of treatment, dose, pain diagnosis, symptoms improvement, side effects and attempt on reducing dose were analyzed. The data was collected over one month.


52 patients filled in correctly the questionnaire. 12 were excluded from the evaluation as were taking regular opioids. Patients were divided into Gabapentin (n= 21) and Pregabalin (n=19) subgroups. In 62.5% treatment was initiated in the primary care. 45% reported only slight pain reduction and 25% no improvement. More than 50% patients were complaining of mood change. 62.5% of patients did not attempt drug reduction irrespective of side effects or efficacy. COMM results was similar in both groups where 57% of patients scored >9. That indicates abuse or misuse of medication, exhibiting medication-related problems, with mean score of 20 (SD±10.68)


Gabapentinoids possess a potential risk of substance misuse. Patients should be carefully monitored and educated about side effects and risks. The COMM questionnaire is an easy tool to aid establish aberrant behaviour but its results must be confirmed with clinical findings using prescription abuse DSM-IV criteria. Where appropriate attempt should be made to reduce or stop medication.

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