Non-Prescribed Gabapentinoid Use: Demographic and Behavioural Risk Profiles in a Large International Sample.

INTRODUCTION: The harm potential of gabapentinoids is well established, with concerns about non-medical use increasing alongside prescribing rates. However, less is known about the characteristics of people who use gabapentinoids obtained through non-prescribed routes. This study explored demographic and behavioural factors associated with gabapentinoid use, including differences between prescribed and non-prescribed sources. METHOD: Data from the Global Drug Survey 2021 (N = 24,954). Multivariable logistic regression models identified correlates of: (i) past-year use; (ii) prescribed versus non-prescribed acquisition; and (iii) using gabapentinoids prescribed to others versus prescribed to oneself. RESULTS: Past-year gabapentinoid use was reported by 2.9% of respondents. In adjusted models, past-year use was associated with being a man, reporting a mental health or neurodevelopmental condition, use of benzodiazepines, opioids and illicit drugs. Among respondents who had ever used gabapentinoids (N = 1112), 45.6% reported using their own prescription, 27.2% used a non-prescribed source and 27.2% used medication prescribed to someone else. Non-prescribed use (i.e., not from a personal prescription) was more common among younger respondents, cis men and those reporting illicit drug or benzodiazepine use. Respondents with mental health or neurodevelopmental conditions were more likely to report prescribed use. DISCUSSION AND CONCLUSIONS: A substantial proportion of gabapentinoid use occurs outside formal prescribing pathways, including use of medications prescribed to others. Non-prescribed use is embedded within broader substance use behaviours, highlighting specific demographic groups with higher odds of nonprescribed use. These findings underscore the importance of targeted harm-reduction responses and continued attention to diversion-prevention strategies.