A comprehensive analysis of jurisdiction-specific laws related to scheduling or required prescription drug monitoring of gabapentin in the United States, 2016-2024

Gabapentin prescription use has increased across the United States since the late 2000s. Concerns of potential misuse and growing overdose involvement have led to the passage of jurisdiction-specific policies targeting gabapentin prescribing; however, the current legal landscape of these policies is not well documented or understood. We conducted a comprehensive, longitudinal analysis of policies related to scheduling or required prescription drug monitoring of gabapentin across 51 jurisdictions in the United States from January 2016 through December 2024. Across the study period, 25 jurisdictions (49 %) enacted policies related to gabapentin scheduling or required prescription reporting. Eight (16 %) jurisdictions classified gabapentin as a schedule V controlled substance and mandated reporting of gabapentin prescriptions in the jurisdiction's prescription drug monitoring program (PDMP) and 17 (33 %) jurisdictions required the reporting of gabapentin prescriptions to the jurisdiction's PDMP but did not classify gabapentin as a schedule V controlled substance. Both scheduling and mandated reporting policies were largely concentrated between 2016 and 2019. Though policy changes were observed across the entirety of the continental United States, the majority of jurisdictions with policies were concentrated in the Appalachian and Eastern Midwest regions. Our results provide a strong basis for future research on the impact of gabapentin scheduling and prescription drug monitoring policies on prescribing, dispensing, health care utilization, and overdose involvement. Future discussions at the state and federal level can also be informed by this analysis of the current legal landscape of gabapentin prescribing policies in the United States.