Abstract
INTRODUCTION: Gabapentinoid prescribing and related harms are increasing internationally, yet population-level evidence on non-medical use in Australia is lacking. This study estimated the prevalence and correlates of past-year non-medical gabapentinoid use and examined temporal trends. METHODS: Data were pooled from the 2016, 2019 and 2022-2023 National Drug Strategy Household Surveys (N = 67,103). Analyses applied person-level survey weights and accounted for the complex design. Weighted descriptive, trend and multinomial logistic regression analyses were conducted, with covariates prespecified using a directed acyclic graph. RESULTS: Past-year non-medical gabapentinoid use among Australians aged ≥ 14 years increased from 0.06% in 2016 to 0.15% in 2022-2023 (Adjusted Wald F = 5.86, p = 0.016; OR = 1.57, 95% CI 1.09, 2.25). Among those reporting any non-medical pain medication use, the proportion involving gabapentinoids rose from 1.7% to 9.3%. Individuals reporting non-medical gabapentinoid use were more likely to report chronic pain (adjusted relative risk ratio [aRRR] = 5.66, 95% CI 3.18, 10.08), high psychological distress (aRRR = 4.26, 95% CI 2.31, 7.84), and socioeconomic disadvantage (aaRRR = 3.45, 95% CI 1.91, 6.27), compared to those reporting no non-medical pain medication use. Most (71%) also reported non-medical opioid use. DISCUSSION AND CONCLUSIONS: Although non-medical gabapentinoid use remains uncommon in Australia, its prevalence is increasing. Findings are consistent with non-medical use occurring in the context of unmet pain and mental health needs rather than predominantly recreational use. Enhanced prescriber awareness, harm reduction initiatives, and expanded access to non-pharmacological pain and mental health care are needed.