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Published in final edited form as: Int J Drug Policy. 2025 Dec 2;147:105064. doi: 10.1016/j.drugpo.2025.105064

A Comprehensive Analysis of Jurisdiction-Specific Laws Related to Scheduling or Required Prescription Drug Monitoring of Gabapentin in the United States, 2016–2024

Katherine Gora Combs 1,2, Rachel Vickers-Smith 3, Collin Stewart 4, Daniel Wacker 5, Juan M Hincapie-Castillo 6,7
PMCID: PMC12676011  NIHMSID: NIHMS2122746  PMID: 41337803

Abstract

Gabapentin prescription use has increased across the United States since the late 2000s. Concerns of potential misuse and growing overdose involvement have led to the passage of jurisdiction-specific policies targeting gabapentin prescribing; however, the current legal landscape of these policies is not well documented or understood. We conducted a comprehensive, longitudinal analysis of policies related to scheduling or required prescription drug monitoring of gabapentin across 51 jurisdictions in the United States from January 2016 through December 2024. Across the study period, 25 jurisdictions (49%) enacted policies related to gabapentin scheduling or required prescription reporting. Eight (16%) jurisdictions classified gabapentin as a schedule V controlled substance and mandated reporting of gabapentin prescriptions in the jurisdiction’s prescription drug monitoring program (PDMP) and 17 (33%) jurisdictions required the reporting of gabapentin prescriptions to the jurisdiction’s PDMP but did not classify gabapentin as a schedule V controlled substance. Both scheduling and mandated reporting policies were largely concentrated between 2016 and 2019. Though policy changes were observed across the entirety of the continental United States, the majority of jurisdictions with policies were concentrated in the Appalachian and Eastern Midwest regions. Our results provide a strong basis for future research on the impact of gabapentin scheduling and prescription drug monitoring policies on prescribing, dispensing, health care utilization, and overdose involvement. Future discussions at the state and federal level can also be informed by this analysis of the current legal landscape of gabapentin prescribing policies in the United States.

Keywords: gabapentin, health policy, United States, prescription drug monitoring, controlled substance, drug scheduling

Graphical Abstract

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INTRODUCTION

Gabapentin is an orally administered medication used most commonly as an anticonvulsive or for the off-label treatment of neuropathic pain (Christo et al., 2007; Taylor, 1997). Gabapentin received United States Food and Drug Administration (FDA) approval for treatment of partial seizures in adults and pediatric patients in 1993 (Wallach & Ross, 2018) as short-term use showed promise in reducing the frequency of seizures in both populations (Panebianco et al., 2021). The drug later received FDA approval for postherpetic neuralgia in children age 2 to 17 in 2000 and for the same condition in adults in 2002 (Wallach & Ross, 2018).

Gabapentinoid consumption has increased globally. From 2008 to 2018, gabapentinoid consumption increased annually at an average of 17.2% across 65 countries (Chan et al., 2023). Since the late 2000s, the United States has seen a steady increase in gabapentin prescribing (Pauly et al., 2020; Zhou et al., 2020). With no new FDA-approved uses through this period, off-label use is likely the driving cause of this increase, with some estimates of off-label use as high as 83–95% (Hamer et al., 2002; Radley et al., 2006). Off-label uses span a wide variety of conditions, including postoperative pain, alcohol dependence and withdrawal, bipolar disorder, and neuropathic pain (Chouinard, 2006; Mack, 2003; Pauly et al., 2020; Radley et al., 2006). Though the evidence of gabapentin’s effectiveness varies by condition, recent recommendations from the International Association for the Study of Pain include gabapentin as a first-line pharmacologic treatment for neuropathic pain (Finnerup et al., 2015), emphasizing its usefulness in some clinical practice.

Reports of misuse and diversion have emerged alongside the growing off-label prescribing trends. Though the estimated lifetime prevalence of gabapentin abuse in the general population is low (estimates range from 1.1–2.1%) (Evoy et al., 2021; Kapil et al., 2014), evidence suggests that the potential for misuse is much higher among people who currently use, or who have a history of using, nonmedical opioids or benzodiazepines (Smith et al., 2016). Estimates of gabapentin misuse among these samples ranged from 15–22% (Smith et al., 2016). Gabapentinoid misuse has also been well documented across Europe, Australia, and the Middle East (Hägg et al., 2020).

Harms associated with gabapentin misuse, particularly when combined with opioids or benzodiazepines, are well-documented. Studies have demonstrated that healthcare utilization is elevated for individuals who misuse gabapentin (Peckham, Fairman, et al., 2018) placing additional strain on overburdened healthcare systems. Adverse events from the medication are also heightened with misuse (Vickers-Smith et al., 2020). Use of gabapentin with opioids or benzodiazepines also increases the risk of respiratory depression and overdose, potentially resulting in death (Olopoenia et al., 2022; Peckham, Fairman, et al., 2018). This is especially concerning given a study which found that 40% of all gabapentinoid outpatient encounters had an opioid co-prescription (St. Clair et al., 2020). Between 2019–2020, gabapentin was detected in about 10% (5,687) of all fatal overdoses (58,362) with documented toxicology across 23 states and the District of Columbia, and of these, about 90% also involved opioids (Mattson et al., 2022). Jurisdiction-specific analyses vary widely, with Kentucky (41%), North Carolina (20%), and West Virginia (15%) reporting the highest proportions of gabapentin-involved fatal overdose in the United States (Slavova et al., 2018). Gabapentin has been predominantly detected in overdose decedents who also tested positive for buprenorphine, methadone, and pharmaceutical opioids, and less so among heroin, cocaine, and methamphetamine positive decedents (Slavova et al., 2018). Overdose due to gabapentin alone is rarely documented (Klein-Schwartz et al., 2003; Middleton, 2011; Schauer & Varney, 2013).

Interventions to address gabapentin misuse and its associated harms have predominately involved regulations to curtail prescribing. In the absence of a federal mandate in the United States by the Controlled Substance Act (Controlled Substance Act, 2024), numerous jurisdictions, under their police powers, have classified gabapentin as a schedule V controlled substance or have mandated reporting of gabapentin prescriptions in jurisdiction-level prescription drug monitoring programs (PDMPs). Classification as a controlled substance is based on the drug’s accepted medical use and abuse or dependency potential. At the federal level, schedule V is reserved for drugs with the lowest potential for abuse and dependence (US Drug Enforcement Administration, 2018). Controlled substance classification places additional restrictions on how a drug can be prescribed and who can prescribe the drug (Preuss et al., 2024). PDMPs are electronic databases that maintain records of any controlled substance prescriptions or prescriptions for other drugs as mandated by the jurisdiction (Centers for Disease Control and Prevention, 2024). Studies have shown that such federal and jurisdiction-level regulations can be effective in decreasing prescribing (Allen et al., 2024; Li et al., 2019; Maierhofer et al., 2021, 2023; Sedney et al., 2021; Usmani et al., 2021). However, serious unintended consequences can also occur, including increased overdose risk following rapid opioid tapering (Agnoli et al., 2021), difficulty accessing medication among groups for whom it is clinically indicated (Maierhofer et al., 2023; Shen et al., 2021), and shifts to alternative treatments (Faryar et al., 2019) or an unregulated supply (Cook et al., 2025). Therefore, it is imperative that jurisdictions carefully consider all potential policy outcomes before enactment. In turn, thorough analysis of the impacts of these policies will be critical to inform future legislation in this area.

Understanding trends in medication prescribing and use over time requires a systematic examination of the evolving legal and regulatory frameworks that govern their prescription and dispensing. While previous studies have begun to provide this foundation (Campbell et al., 2021; Karavolis et al., 2022; Peckham, Ananickal, et al., 2018), none have utilized policy surveillance methodologies (Burris, 2014) to systematically track policies related to gabapentin scheduling or mandatory prescription reporting. This study addresses that gap by providing a comprehensive legal mapping of gabapentin-specific policies across all 51 United States jurisdictions from January 2016 through December 2024.

METHODS

We completed a longitudinal policy surveillance process to track policies related to gabapentin scheduling and mandated prescription reporting. Policy surveillance is “the ongoing, systematic collection, analysis, and dissemination of information about laws and other policies of health importance” (Presley et al., 2015) which allows for systematic approaches to measuring legal exposures in public health research (Chriqui et al., 2011). Specifically, we were interested in tracking jurisdiction-level laws that: A) newly added gabapentin to the list of schedule V controlled substances or B) newly required the reporting of gabapentin prescriptions for human consumption in the PDMP. Statutory law and administrative codes and regulations were tracked across 51 jurisdictions (50 states and the District of Columbia) during the time period (January 1, 2016 through December 31, 2024). January 2016 was selected as the starting date for this surveillance study to ensure capture of the earliest known policies of interest.

Data source and collection of legal text

We used Nexis Uni® (LexisNexis, n.d.) to identify which of the 51 jurisdictions had statutes and regulations related to scheduling or required prescription reporting. All 51 jurisdictions (100%) were redundantly reviewed to ensure that all relevant legal texts were collected. Any divergences between the legal text gathered were discussed and subsequently resolved. The search terms used to identify relevant policies were “gabapentin*” and its chemical name “1-(Aminomethyl)-cyclohexaneacetic acid”. The inclusion of the wild card character (*) allowed us to capture both texts that mentioned gabapentin as a specific medication, as well as its class, gabapentinoids. Only policies related to scheduling of gabapentin or reporting of gabapentin prescriptions were tracked. Laws related to gabapentin scheduling were defined as those that explicitly named gabapentin as a schedule V controlled substance in the jurisdiction’s controlled substance listing. Laws related to gabapentin mandated prescription reporting included: 1) explicit mention of a requirement for gabapentin prescriptions to be tracked in the jurisdiction’s PDMP, 2) a requirement to report schedule V substances for jurisdictions who classified gabapentin as a schedule V substance, or 3) a requirement to report under the general legal provisions of the PDMP (e.g. requirement to track all prescriptions or drugs of “concern”). We excluded other policies related to gabapentin, such as those focused on workers compensation, traditional Chinese or naturopathic medicine, or veterinary uses, because those laws were not explicitly related to scheduling or mandated prescription reporting in the medical setting.

To ensure that all relevant PDMP legal texts were accurately captured, we also collected and reviewed all general PDMP policies in effect during the study period for the 29 jurisdictions where no explicit gabapentin-related PDMP policy was initially found. This process yielded three additional jurisdictions that had not named gabapentin explicitly in the legal text, but gabapentin still qualified for the PDMP reporting requirement under the general legal provisions.

Information collected for each relevant legal text included the following: jurisdiction (state or the District of Columbia), effective date, valid through date, full legal text, and legal citation (session law for statutes and register for administrative code). The effective date was the date that the relevant section of the policy went into full effect which may or may not necessarily match the date of enactment or the implementation of the law in practice. The valid through date was the last day that the policy was in effect as reflected by the legal text, or the last date the researcher confirmed the law or policy was in effect during the study period (up to December 31, 2024). The legal text captured the full legal text relevant to the coding questions. Full text versions of the statutes and regulations were pulled directly from each jurisdiction’s legislative websites (i.e., unencumbered public sources) after their initial identification in Nexis Uni®.

Coding of legal text

For each jurisdiction-specific time period with relevant legal text, the following two questions were coded: 1) “Does the jurisdiction classify gabapentin as a schedule V controlled substance?” and 2) “Does the jurisdiction require reporting of gabapentin prescriptions for human consumption in the jurisdiction’s prescription drug monitoring program (PDMP)?”. Answer options for both questions were mutually exclusive, binary variables (Y/N). Records were coded and subsequently updated for each legal text amendment relevant to the questions of interest. MonQcle, a web-based software coding platform which allows for the organization and display of data gathered during policy surveillance processes (Center for Public Health Law Research - Temple University, n.d.), was used to compile the data. The final dataset included the following variables: jurisdiction, effective date, valid through date, legal citation, controlled substance (Y/N), PDMP requirement (Y/N), and attachments and caution notes (if applicable).

Quality control in coding

Redundant coding of each legal text by the researchers was completed in batches of 5 jurisdictions until the rate of divergence across coding questions was less than 5%. After coding the first 5 jurisdictions, the rate of divergence was 0%. As there were no divergences, no additional redundant coding was conducted. Any questions that arose in the coding process were discussed and resolved.

Data availability and documentation

The full dataset from this project, the research protocol, and the codebook are available for free download at LawAtlas (Center for Public Health Law Research at Temple University) (Gora Combs et al., 2025). Additional detail about the initial data collection and coding approach and any jurisdiction-specific considerations are listed comprehensively in the protocol document (Appendix A).

RESULTS

Across the study period, 25 jurisdictions (49% of all 51 jurisdictions in the United States) enacted policies related to gabapentin scheduling or required prescription reporting. Though policy changes were observed across the entirety of the continental United States, the majority of jurisdictions with policies were concentrated in the Appalachian and Eastern Midwest regions.

Classification as a schedule V controlled substance and required reporting to jurisdiction’s PDMP

Between January 1, 2016 and December 31, 2024, eight (16%) jurisdictions classified gabapentin as a schedule V controlled substance (Figure 1). Kentucky was the first jurisdiction to classify gabapentin in July 2017, followed by West Virginia and Tennessee in 2018 (Table 1). The majority of jurisdictions scheduled gabapentin between 2017 and 2019 with only one state scheduling after this period (Figure 2). All eight of these jurisdictions also required reporting of gabapentin prescriptions in the PDMP; four jurisdictions established this requirement prior to scheduling and four completed both actions concurrently. One of these eight jurisdictions (Michigan) scheduled and required reporting of gabapentin to the PDMP and then subsequently descheduled and removed the reporting requirement during the study period.

Figure 1. Status of gabapentin scheduling and required prescription reporting as of December 31, 2024, United States.

Figure 1.

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As of December 31, 2024, 7 jurisdictions classify gabapentin as a schedule V controlled substance and mandate reporting in the jurisdiction’s prescription drug monitoring program and 17 mandate reporting without a controlled substance designation.

Table 1.

Gabapentin scheduling policies in the United States between January 2016 and December 2024

State Effective Date Current Citation as of Dec. 31, 2024
Alabama November 18, 2019 Ala. Admin. Code. R. 420-7-2-A
Kentucky July 1, 2017 902 Ky. Admin. Regs. 55:015
Michigan January 4, 2019 Rescinded May 28, 2024
North Dakota April 9, 2019 N.D. Cent. Code, § 19-03.1-13
Tennessee October 3, 2018 Tenn. Comp. R. & Regs. R. 0940-06-01-.05
Utah May 1, 2024 Utah Code § 58-37-4
Virginia July 1, 2019 Va. Code § 54.1-3454
West Virginia June 7, 2018 W. Va. Code § 60A-2-212
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Each state’s effective date listed in this table is the effective date of the first statute or regulation that scheduled gabapentin. This may not be the effective date of the current citation as of December 31, 2024.

Figure 2. Timeline of gabapentin scheduling policies between January 2016 and December 2024.

Figure 2.

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This timeline shows the incremental increase of gabapentin scheduling policies between January 2016 and December 2024. A total of 8 jurisdictions classified gabapentin as a schedule V controlled substance during the time period. Jurisdictions are listed alphabetically during the relevant year. Note that Michigan (MI) scheduled gabapentin 2019 and subsequently descheduled gabapentin in 2024.

Required reporting to jurisdiction’s PDMP only

Between January 1, 2016 and December 31, 2024, 17 jurisdictions (33%) required the reporting of gabapentin prescriptions to the jurisdiction’s PDMP but did not classify gabapentin as a schedule V controlled substance (Figure 1). The first jurisdiction to do so was Minnesota in August 2016 (Minn. Stat. § 152.126, 2016). The number of jurisdictions requiring this reporting increased over time. Most jurisdictions passed PDMP-related policies between 2016 and 2019 with an average of 4.5 jurisdictions passing new policies per year during this period. The passage of newly enacted policies slowed between 2020 and 2024 with an average of 1.2 new jurisdictions per year (Figure 3). For all but one jurisdiction, the requirement to report gabapentin prescriptions to the PDMP was through the direct listing of gabapentin in the jurisdiction’s PDMP statute or regulation or through designation as a “drug of concern” or other similar term. One jurisdiction (Nebraska) has required reporting of all prescriptions in the state’s PDMP since January 2018 which includes gabapentin by default.

Figure 3. Timeline of policies related to mandated reporting of gabapentin prescriptions between January 2016 and December 2024.

Figure 3.

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This timeline demonstrates the new policies related to mandated reporting of gabapentin prescriptions that became effective between January 2016 and December 2024. A total of 25 jurisdictions mandated reporting of gabapentin prescriptions during the time period. Jurisdictions are listed alphabetically during the relevant year. Note that Michigan (MI) mandated reporting of gabapentin prescriptions in 2019 and subsequently removed that mandate in 2024.

DISCUSSION

Between January 1, 2016 and December 31, 2024, 49% of United States jurisdictions enacted policies related to gabapentin scheduling or required reporting. This represents an estimated 37% (US Census Bureau, n.d.) of the total United States population who lived in jurisdictions with these policies as of December 31, 2024. Both scheduling and mandated reporting policies were largely concentrated between 2016 and 2019 which aligns with the emergence of reports citing increasing gabapentin misuse among individuals with current or prior nonmedical use of opioids and benzodiazepines (Smith et al., 2016) and involvement in overdose fatalities (Slavova et al., 2018).

Despite more recent warnings from the Food and Drug Administration about serious breathing problems linked to gabapentin, particularly when combined with opioids (Food and Drug Administration, 2019a), and additional reports emphasizing the growing involvement of gabapentin in fatal overdoses (Mattson et al., 2022), new policies related to scheduling or mandated reporting have slowed, and in one case (Michigan), been rescinded. Adoption or rescinding of policies appears to be geographically motivated. Bordering states, particularly in the Appalachian and Eastern Midwest regions, tend to have similar policies related to gabapentin prescribing. In the case of Michigan, lack of scheduling among other states in the region was cited as a primary reason to discontinue scheduling (Shaltry, 2023).

Considering that half of US jurisdictions have enacted policies related to scheduling or mandated reporting of gabapentin, calls for scheduling at the federal level, led by a consumer rights advocacy groups (Public Citizen, 2022) and researchers (Peckham, Ananickal, et al., 2018) have gained traction. Policy changes at the federal level would preempt the current jurisdiction-specific variations in gabapentin policies, providing a more cohesive policy approach to the growing concerns of misuse and overdose involvement. Recent advocacy efforts at the federal level cite the classification of pregabalin, another gabapentinoid prescription medication, as a schedule V controlled substance at the federal level and harms associated with misuse as indicators for the need for federal policy change (Public Citizen, 2022). An additional factor is the growing evidence of the medication’s capability to potentiate the effects of opioids (Bao et al., 2021; Garza-Carbajal et al., 2024). Despite recent declines in overdose deaths, the majority continue to involve opioids (National Center for Health Statistics, 2025) making this potentiation concerning.

Two major federal institutions have circulated statements about the push for gabapentin scheduling in recent years. In 2023, the Food and Drug Administration denied a request (Public Citizen, 2022) to initiate proceedings to schedule gabapentin at the federal level. Their response highlighted other recent federal efforts, including updated warnings (Food and Drug Administration, 2019b) and media releases, to elevate concerns about respiratory depression related to the use of gabapentin and other central nervous depressants (Food and Drug Administration, 2023). That same year, the American Medical Association Council on Science and Public Health released a policy that actively opposed the scheduling of gabapentin but supported the continued research into the risk of concurrent gabapentin and opioid use and gabapentin withdrawal (American Medical Association, 2023a, 2023b). Additional pushes to schedule gabapentin at the national level will require stronger evidence and increased buy-in from federal leaders.

Rescheduling of gabapentin in the United States can be informed by international approaches to gabapentinoid misuse, though the estimated effect of these approaches has varied. In Saudi Arabia, the addition of pregabalin to their controlled substance listing was found to decrease pregabalin prescribing but increase gabapentin use (Althunian et al., 2022). Similarly, in France, additional prescription requirements for pregabalin decreased dispensing and increased gabapentin dispensing (Michel et al., 2025). In the United Kingdom, however, the reclassification of both gabapentin and pregabalin saw little change in gabapentinoid prescribing in the months immediately following the reclassification and no significant impact in pregabalin-related deaths (Ashworth et al., 2023; Nahar & Paterson, 2023). At the federal level, rescheduling of gabapentin should also be guided by the evidence provided by jurisdiction-specific policy changes. For example, state-level actions to classify carisoprodol products as schedule IV or require prescription monitoring ultimately led to a national schedule IV classification in 2012 (Fass, 2010; Li et al., 2019). Understanding the jurisdiction-level effects of gabapentin scheduling in the United States on prescribing and other clinical outcomes is critical prior to changes at the national level.

While drug scheduling may reduce prescribing, a growing body of evidence highlights its unintended consequences. For example, Cook et al. (2025) found that following scheduling in Kentucky, self-reported nonmedical gabapentin use actually increased among people who use drugs, and the primary source of gabapentin shifted from prescribers to unregulated sources (e.g., drug sellers). While deaths due to gabapentin alone have not been widely documented, these shifts pose serious risks including unknown exposure to potentially lethal substances as the unregulated drug supply becomes increasingly adulterated and the continued risk of respiratory depression when gabapentin is combined with other drugs (Peckham, Fairman, et al., 2018). In addition to increasing reliance on unregulated sources, scheduling gabapentin may also further limit treatment options for chronic pain where effective alternatives are limited. Gabapentin has often served as an alternative to opioids, particularly for neuropathic pain, due to its effectiveness and relatively favorable side effect profile (Dowell, 2022). Thus, while scheduling may raise awareness of potential harms, it is critical to evaluate potential downstream effects (Caulkins et al., 2021; Usmani et al., 2021) like unchanged rates of misuse, increased reliance on riskier sources, substitution with more dangerous substances, and reduced options for pain management. To anticipate and mitigate these unintended consequences, it is essential to incorporate the perspectives of people who use gabapentin into policy discussions.

Limitations

It is important to view our findings as valid only for the period between January 2016 and December 2024. Any policies that may have occurred prior to 2016 or after 2024 were not collected. In the spirit of open science, we provided our complete research protocol and coding materials in LawAtlas, so that the dataset can be updated in the future. Our comprehensive policy surveillance only tracked implemented policies in full effect; legislation that is currently in progress or legislation that was proposed but then failed was not tracked in our study. We also did not track variations in PDMP policies such as exemptions for certain prescribers, exemptions based on prescription quantity, or exemptions based on location of the dispensation. Additionally, policies related to PDMPs that do not serve the general population, such as PDMPs focused on long-term care populations, were not included. Finally, our analysis tracked the dates when policies were effective which may not fully encompass the true implementation date in practice. It is known that during the rollout of a new policy, the true implementation phase can span months around the official date due to behavior change in advance of an upcoming policy or due to delays in policy enforcement. The potential of premeditated or delayed implementations must be considered when using the results of this study for analysis of policy effects.

CONCLUSION

We conducted the first comprehensive, longitudinal analysis of United States policies related to the scheduling or required prescription monitoring of gabapentin from 2016 through 2024, systematically identifying 25 jurisdictions that have enacted policies. Our database can help ensure that the time-dependent presence or absence of gabapentin policies is correctly incorporated in interventional studies seeking to understand the policy’s effects, minimizing misclassification which can weaken causal inference (Schnake-Mahl et al., 2025). More research is needed to understand implementation and clinical outcomes related to these policies, such as potential changes in prescribing, dispensing, health care utilization, and overdose involvement. Future discussions at the state and federal level can also be enhanced by this analysis of the current legal landscape of gabapentin prescribing policies in the United States.

Supplementary Material

1

Supplemental Material Appendix A. Research Protocol: This document provides the full research protocol for the policy surveillance process, including additional details about the data collection, coding approach, and any jurisdiction-specific considerations.

Highlights.

  • Eight U.S. jurisdictions classified gabapentin as a controlled substance from 2016–2024.

  • 25 U.S. jurisdictions required gabapentin prescription reporting from 2016–2024.

  • Policy surveillance methods improve the understanding of health policy landscapes.

Acknowledgements:

The authors would like to thank the Center for Public Health Law Research at Temple University for their support of this project and for their willingness to publish its results for free on LawAtlas.

Funding:

This work was supported by the National Institute on Drug Abuse of the National Institutes of Health under award number R36DA062854. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Footnotes

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Declaration of interests

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:

Katherine Gora Combs reports financial support was provided by National Institute on Drug Abuse. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Contributor Information

Katherine Gora Combs, Department of Epidemiology, UNC Gillings School of Global Public Health, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, North Carolina, 27599-7435, USA; UNC Injury Prevention Research Center, 725 Martin Luther King Jr. Blvd, CB# 7505, Chapel Hill, NC 27599-7505, USA.

Rachel Vickers-Smith, Department of Epidemiology and Environmental Health, UK College of Public Health, 111 Washington Avenue, Lexington, KY 40536, USA.

Collin Stewart, Department of Epidemiology, UNC Gillings School of Global Public Health, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, North Carolina, 27599-7435, USA.

Daniel Wacker, Department of Health Behavior, UNC Gillings School of Global Public Health, 135 Dauer Drive, CB #7440, Chapel Hill, NC 27599-7440, USA.

Juan M. Hincapie-Castillo, Department of Epidemiology, UNC Gillings School of Global Public Health, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, North Carolina, 27599-7435, USA; UNC Injury Prevention Research Center, 725 Martin Luther King Jr. Blvd, CB# 7505, Chapel Hill, NC 27599-7505, USA.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

1
NIHMS2122746-supplement-1.pdf (262.1KB, pdf)

Data Availability Statement

The full dataset from this project, the research protocol, and the codebook are available for free download at LawAtlas (Center for Public Health Law Research at Temple University) (Gora Combs et al., 2025). Additional detail about the initial data collection and coding approach and any jurisdiction-specific considerations are listed comprehensively in the protocol document (Appendix A).

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