Whether gabapentin is scheduled as a controlled substance in a state may affect prescribing patterns, a study in JAMA Network Open suggests.Why It’s Relevant
Although gabapentin is not scheduled at the federal level, several states have classified it as a Schedule V controlled substance because of the risk of misuse and other harms, including respiratory depression and death when used with other medications such as opioids. Determining if scheduling affects dispensing may help inform policy to ensure appropriate prescribing.
By the Numbers
- Michigan scheduled gabapentin as a controlled substance in January 2019 and descheduled the drug in May 2024. Researchers tracked quarterly gabapentin dispensing before and after this descheduling decision (from 2023 through 2025).
- Gabapentin dispensing rose immediately after descheduling, from about 35 prescriptions per 1,000 Medicaid enrollees in the second quarter of 2024 to about 40 per 1,000 enrollees in the third quarter.
- By the fourth quarter of 2025, gabapentin dispensing had risen to 43 prescriptions per 1,000 Medicaid enrollees.
- There was no significant change in dispensing of pregabalin (which is federally designated as Schedule V and used for similar conditions as gabapentin), with prescriptions hovering between 10 and 13 per 1,000 Medicaid enrollees during the study period.
The Other Side
The researchers used drug dispensing data, which do not capture the actual medication taken by patients or any gabapentin they may have obtained through other means. In addition, the analysis period was relatively short, so it’s unclear if the continued rise in gabapentin prescribing post-descheduling was significant.
Takeaway Message
“Our findings suggest that drug scheduling may serve as a supply-side policy to prevent overprescribing,” the researchers wrote. “Future research should evaluate how prescriber behaviors are influenced by a medication’s controlled substance status and assess the association of such policies with access among patients with legitimate need.”
Related Information
Source
Katherine Gora Combs, et al. Gabapentin use in Medicaid after descheduling. JAMA Network Open. Published online September 21, 2026. doi:10.1001/jamanetworkopen.2026.35059
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