Opioid-Sparing Drugs (Ketamine, Gabapentin, Pregabalin, and Clonidine)

TL;DR: This chapter aims to highlight the important issues relating to the more commonly used opioid sparing analgesics.

Abstract: Pain is defined by the international association for the study of pain (IASP) as “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage”. Analgesics are a group of medications which are used by almost every individual at some point in their life and as with any drug have a potential for abuse. Chronic pain patients pose a specific group of individuals who may be at greater risk of drug abuse as a result of their access to certain drugs as well as psychological state. There has been a gradual introduction of new analgesics into medical practice including drugs such as ketamine, gabapentin, pregabalin, and clonidine. Opioids continue to be the mainstay analgesics and the use of opioid sparing drugs has increased. These changes in pain management have led to the need for clinicians to become more familiar with the signs and symptoms of their abuse and this chapter aims to highlight the important issues relating to the more commonly used opioid sparing analgesics. Substance use disorders are strongly associated with major causes of youth mortality and the recent rise in the prevalence of recreational abuse of drugs such as ketamine means that it is the clinician’s duty to be aware of their effects and treatment so appropriate management can be given.