An integrative review of the use of gabapentin in treatment-seeking adults with alcohol use disorder in an outpatient setting

Abstract

Background: Alcohol use disorders (AUD) and alcohol consumption are complex public health issues that involve multiple comorbidities and significant healthcare costs. In the United States, one-third of adults will be diagnosed with an AUD within their lifetime and over 59.5 million Americans are at risk for an AUD due to reported binge drinking. The State of Montana has one of the highest AUD statistics in the country costing Montanans millions of dollars managing AUD-related physical and psychological illnesses. Despite the high rate of AUDs in Montana, the State has very few inpatient treatment facilities for Medicaid recipients to address alcohol abuse and addiction, causing significant lag time to enter alcohol-abuse inpatient treatment. Gabapentin, an anticonvulsant, has recent evidence for use as a medication to aid in mild to moderate alcohol withdrawal symptoms, remedy symptoms of protracted abstinence, and help treatment-seeking individuals remain abstinent until inpatient alcohol addiction services are available. Objective: The purpose of this integrative literature review was to identify current knowledge related to the use of gabapentin in an outpatient setting for treatment-seeking adult patients (18-65 years) with an AUD, for preventing the symptoms of mild to moderate alcohol withdrawal syndrome, for treatment of symptoms related to protracted abstinence, and for assisting the individual to abstain from alcohol until initiation of inpatient substance-abuse treatment. Method: This topic was explored using an integrative literature review. Research articles were identified using the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, PubMed, PsycINFO, and Medline, from January 2014-December 2019. A review of abstracts using inclusion and exclusion criteria was conducted to determine relevant studies. Conclusion: The integrative review revealed limited evidence for the use of gabapentin to decrease symptoms of mild to moderate alcohol withdrawal and protracted abstinence in treatment-seeking adults on an outpatient basis. Heterogeneity of sample populations, interventions, and study aims should be addressed in future research studies.