Grant: DRA : Canada Graduate Research Scholarship - Doctoral Program (CGRS D)

Medications are rigorously tested for safety and efficacy before they are authorized to be used. However, this testing typically excludes people with complicated life circumstances-such as people who use drugs like heroin, fentanyl, or cocaine-leaving questions about drug safety and drug-drug interactions in these groups unknown. My project focuses on the use of gabapentin, a prescription medication widely used for a variety of health conditions, including chronic pain and anxiety disorders. Since 2017, several studies have shown that people who are prescribed gabapentin and opioids at the same time are more likely to experience an overdose death than those only prescribed opioids. Knowing this allows doctors to be more careful when prescribing these medications together; carefully weighing the risk and benefits of the drugs. People who use unregulated street-obtained opioids (such as heroin or fentanyl) have the highest risk of experiencing an overdose and are often prescribed gabapentin. However, we do not know if prescribed gabapentin increases their risk of overdose. To fill this knowledge gap, I will use data from repeat interviews with over a thousand people who use unregulated drugs in Vancouver, BC, and for whom I can access linked provincial data on prescriptions and hospital visits, including for non-fatal overdose. First, I will explore how information on non-fatal overdose from interviews aligns with information on these events in a provincial hospital database. This will help me, and other researchers, understand how best to use measures of overdose in this and future research projects. I will then investigate whether being prescribed gabapentin increases the risk of experiencing a non-fatal overdose. My research will shed light on the safety of gabapentin prescriptions among this high-risk population and will help support clinicians and people who use drugs in making informed decisions for their health and wellbeing.