The misuse of narcotic drugs and psychotropic substances (NDPS), especially gabapentinoids such as pregabalin and gabapentin, has emerged as a major public health concern globally. While these drugs are recommended for neuropathic pain and epilepsy, rising off-label usage and diversion for recreational purposes have been reported in numerous countries (Evoy et al., 2021; Hägg et al., 2020; Chiappini and Schifano, 2016). Pregabalin, in particular, has shown substantial misuse potential due to its rapid onset of action and sedative–euphoric characteristics, especially when co-administered with opioids and benzodiazepines (Pharmacopoeia, 2013; Kurdi, 2021).

In response, several nations have introduced regulatory measures to restrict access to gabapentinoids. The United Kingdom reclassified pregabalin and gabapentin as Class C controlled substances in 2019 following a notable increase in fatalities associated with their use (UK Home Office, 2025). Similarly, France, Germany, and Sweden have tightened regulatory oversight through national databases or scheduling under controlled drug frameworks (Driot et al., 2019; Finklea et al., 2025). In the United States, over 22 states now apply restrictions on dispensing gabapentinoids, which must be reported to Prescription Drug Monitoring Programs (PDMPs) (Karavolis et al., 2022).

In Saudi Arabia, escalating misuse, particularly among young adults and individuals with psychiatric comorbidities, led to the reclassification of pregabalin and gabapentin as controlled drugs in 2017 (Alkhalaf et al., 2021; Althunian et al., 2022). To enhance prescription surveillance, the Saudi Food and Drug Authority (SFDA) implemented the Raqeeb platform, an integrated national electronic system that enables real-time monitoring of NDPS prescribing and dispensing across all healthcare sectors (Aldossari et al., 2025). Raqeeb is part of Saudi Arabia’s broader digital health transformation under Vision 2030, where platforms such as Seha support the integration of electronic health services and strengthen accountability in the handling of controlled substances (Al-Kahtani et al., 2022).

This initiative aligns with Saudi Arabia’s Vision 2030 strategy, which emphasizes the digital transformation of healthcare to improve transparency, safety, and regulatory compliance. Comparable systems, such as SafeScript in Australia and the Electronic Prescription Service (EPS) in the UK, have demonstrated improvements in medication safety and prescriber accountability (Goundrey-Smith, 2018; Sheikh et al., 2022). However, successful implementation depends heavily on the engagement and capacity of frontline providers, especially community pharmacists.

Community pharmacists in Saudi Arabia serve as gatekeepers in NDPS dispensing and are increasingly expected to integrate surveillance platforms like Raqeeb into their workflow. In a recent study, Alshahrani et al. (Alshahrani et al., 2021) highlighted that Saudi pharmacists play a growing role in pharmaceutical care, including medication review, counseling, and adherence to regulatory requirements. Their involvement is particularly critical given the widespread accessibility of community pharmacies and their expanded role in public health services (Khayyat et al., 2024).

Despite its potential, the implementation of Raqeeb has not been without challenges. Pharmacists have reported administrative overload, lack of integration with existing pharmacy software, inadequate training, and concerns about regulatory scrutiny (Aldossari et al., 2025; Yasmeen et al., 2023). These operational difficulties are consistent with international experiences involving digital surveillance systems, where usability issues and system alert fatigue often undermine long-term adoption (Karavolis et al., 2022; Sheikh et al., 2022; Alzahrani et al., 2024). In rural or under-resourced areas, poor internet connectivity and limited technical infrastructure further restrict optimal use (Pomerleau et al., 2017).

Moreover, many pharmacists express concern about the limited availability of low-dose formulations, the absence of automated decision support tools, delays in insurance-covered prescriptions, and inconsistent feedback from regulators when concerns are flagged through the system (Goundrey-Smith, 2018; Yasmeen et al., 2023). Such challenges may reduce confidence in using Raqeeb, contribute to delays in patient care, or even discourage appropriate dispensing due to fear of regulatory repercussions.

To ensure the continued success of Raqeeb and similar national initiatives, it is crucial to understand the real-world perceptions and experiences of community pharmacists. This study aims to examine pharmacists’ knowledge, attitudes, and challenges in engaging with the Raqeeb platform. Findings are expected to guide system refinements, training needs, and policy adaptations that support safe and efficient NDPS monitoring in Saudi Arabia.

The Raqeeb platform is a transformative leap forward in Saudi Arabia’s public health strategy to combat the misuse of narcotic drugs and psychotropic substances (NDPS), particularly gabapentinoids like pregabalin and gabapentin, which have seen rising recreational use globally and locally (Aldossari et al., 2025). As a cornerstone of Saudi Arabia’s Vision 2030, Raqeeb leverages digital innovation to enhance healthcare transparency, safety, and regulatory compliance through real-time monitoring of NDPS prescribing and dispensing (Aldossari et al., 2025; Al-Kahtani et al., 2022). This study provides new insights into community pharmacists’ engagement with Raqeeb, highlighting both strengths and practical challenges. Importantly, the findings position Raqeeb not only as a regional model but also as a system with global relevance if usability, integration, and training barriers are addressed.

Pharmacists’ robust awareness of Raqeeb’s purpose and its contribution to medication safety mirrors the success of Australia’s SafeScript program, which achieved a 20% reduction in opioid-related overdoses by enhancing prescriber accountability through real-time data monitoring (Alzahrani et al., 2024). Similarly, the UK’s Electronic Prescription Service (EPS) has improved dispensing accuracy by integrating digital prescribing tools across healthcare sectors, a goal Raqeeb aims to replicate (Goundrey-Smith, 2018; Sheikh et al., 2022). However, unlike international systems, Saudi-specific policy considerations must be emphasized. In particular, integration with Seha (the national digital health platform) and with insurance systems is essential to achieve seamless adoption and maximize utility for pharmacists and patients.

Challenges such as a complex interface and a lack of integration with existing pharmacy software align with global PDMP experiences. In the U.S., studies report that 35%–40% of pharmacists find PDMP interfaces cumbersome, leading to reduced adoption rates and workflow inefficiencies (Pomerleau et al., 2017; Haffajee et al., 2018; Alshehri et al., 2023; Lin et al., 2017). Raqeeb’s integration issues, noted by 44% of respondents, highlight the need for seamless interoperability. User-centered design principles should guide future upgrades to ensure the platform complements pharmacists’ workflows. In addition, previous studies have shown that electronic prescribing services (EPS) reduce medication errors and improve healthcare delivery, with 74% of patients preferring EPS over paper-based prescriptions (Shams, 2011). The integration of EPS with hospital information systems has led to reduced prescribing errors, as reported by physicians, pharmacy staff, and nurses (Shams, 2011). However, challenges persist, including missing electronic prescriptions and design-specific issues (Mozaffar et al., 2017). These parallels reinforce that usability must be a central design priority for Raqeeb, supported by a strong technical infrastructure.

The strong support for mandatory Raqeeb training (77.4%) and nationwide expansion (71.8%) reflects pharmacists’ recognition of its public health value, consistent with studies on Saudi Arabia’s Wasfaty system, where structured training boosted adoption (Yasmeen et al., 2023; Alzahrani et al., 2024). Internationally, pharmacists with comprehensive PDMP training were significantly more likely to use monitoring systems effectively (Lin et al., 2017). Raqeeb’s training gaps, with 40.7% citing inadequate preparation, underscore the need for robust, mandatory training programs. Adopting structured and continuous training initiatives—potentially linked with professional licensure or CPD requirements would enhance pharmacists’ ability to engage with Raqeeb confidently. Canada’s PharmaNet system, where training supported reduced inappropriate prescribing of opioids and benzodiazepines, provides a strong precedent (Pontefract et al., 2018; Fleming et al., 2014; Dormuth et al., 2012).

Operational challenges, including medication unavailability (51.1%) and workflow delays, echo issues observed in France’s gabapentinoid monitoring program, where supply chain gaps reduced dispensing efficiency (Driot et al., 2019). In Saudi Arabia, the specific causes of unavailability warrant further investigation to determine whether they are related to supply chain disruptions, regulatory restrictions, or technical limitations within Raqeeb. Addressing this gap is critical to ensure that controlled medications are accessible to patients without compromising regulatory oversight. Connectivity and infrastructure barriers, particularly in rural areas, may further compound adoption difficulties, consistent with national reports of e-health implementation challenges (Almuayqil et al., 2016; Martin et al., 2021). Fear of regulatory scrutiny, noted by 41.8% of Raqeeb users, parallels U.S. findings where pharmacists hesitated to dispense controlled substances due to legal concerns (Radomski et al., 2018; Cochran et al., 2016; Peckham et al., 2018; Coustasse et al., 2025). Australia’s Real Time Prescription Monitoring program addressed this by providing clear regulatory guidelines, reducing apprehension, and improving compliance (Dobbin and Liew, 2020). For Saudi Arabia, transparent legal frameworks and supportive communication from regulators could similarly reduce pharmacists’ concerns and promote confidence in dispensing practices.

To elevate Raqeeb’s efficacy, policymakers should prioritize user-centered design, integration with existing software, technical support, and medication availability. Visual decision-support features and dashboard summaries could further streamline workflows and facilitate rapid interpretation of controlled substance use patterns. Recent studies highlight the evolving role of pharmacists in global healthcare systems, emphasizing the need for advanced training and integration into primary care teams (Anderson et al., 2009; Wagner et al., 2023).

The Raqeeb platform represents a pivotal advancement in Saudi Arabia’s strategy to combat the misuse of narcotic drugs and psychotropic substances, aligning with Vision 2030s digital healthcare transformation goals. This study demonstrated that community pharmacists generally support Raqeeb’s role in enhancing medication safety and accountability, while also identifying practical barriers that may hinder its optimal adoption. Key challenges include system usability, insufficient training, and medication unavailability. Addressing these will require user-centered redesign, integration with existing pharmacy software, and comprehensive training programs, ideally linked with continuous professional development. In addition, ensuring reliable medication supply and providing clear regulatory guidance will be essential for strengthening pharmacists’ confidence in dispensing controlled substances. Even though international systems such as SafeScript and EPS provide useful lessons, the future success of Raqeeb depends on tailoring solutions to Saudi-specific contexts, including integration with Seha, collaboration with insurers, and engagement with local stakeholders. By implementing these targeted improvements, Raqeeb can progress from its current early stage to a global exemplar of digital prescription monitoring, reinforcing Saudi Arabia’s leadership in innovative, technology-enabled healthcare solutions.