Gabapentin

What is Gabapentin?

Gabapentin is an anticonvulsant medication used to treat nerve pain and seizures. It has relaxing and pain-killing effects similar to certain sedatives. While it is not a controlled substance, a growing number of people are reporting abuse and addiction to this medication.^[1]

Gabapentin is also known by the brand names Neurontin and Gralise, and is a prescription painkiller with its own drug class, gabapentinoids. It acts as an anticonvulsant and is commonly used to treat epilepsy, chronic pain, hot flashes, restless leg syndrome, diabetic neuropathy, fibromyalgia, partial seizures, and neuropathic or nerve pain.

It is considered to be a less addictive alternative to opioid painkillers. It is sometimes used to treat withdrawal symptoms from substances like cocaine and heroin. Gabapentin does carry some risk of abuse and addiction and can also have adverse side effects, such as suicidal thoughts, mood swings, and acute changes in behavior.

Gabapentin as an addiction treatment medication

Currently, there are only a handful of FDA-approved medications used to treat addiction withdrawal symptoms. Gabapentin is occasionally used to treat withdrawal but is considered an off-label alternative.

While many pharmaceutical companies have manufactured gabapentinoids for use in withdrawal treatment, it is still part of a wide range of medications, and some treatment facilities will prefer to use more recognized alternatives, depending on the addiction type and medical history. Some alternatives to gabapentin treatment include:

• Clonidine
• Other anticonvulsants, such as Tegretol and Lyrica
• Methadone and buprenorphine
• Naltrexone

Gabapentin abuse

Gabapentin abuse tends to occur in people who already have an addiction to opioids or other drugs. While gabapentin is not thought to cause people to get high, some people do report experiencing a sense of calm, euphoria, and effects similar to marijuana.^[1]

People who have had previous substance abuse problems with alcohol, opioids, cocaine, and other substances may be more likely to abuse gabapentin. According to the medical journal, The Annals of Pharmacotherapy, the rate of gabapentin misuse among the general population was only 1.1 percent while the rate of misuse in addiction treatment centers was 22 percent.^[4]

According to the 2017 National Survey on Drug Use and Health, 0.4 million Americans misused prescription sedatives like gabapentin in the past month. The FDA reports that in recent years, it has been encountered more regularly by law enforcement, has been documented in national crime lab reports, reported to poison control centers, and diverted for illegal use. Reports from law enforcement also indicate that it is being used as a cutting agent in illegal drugs such as heroin.

Gabapentin’s unique ability to address multiple ailments has made it one of the most popular prescription medications in the U.S. In May of 2019, GoodRx reported that it was the fifth-most prescribed drug in the nation. Despite its low abuse potential, its ability to be used in conjunction with other drugs causes widespread harm and addiction.

Is Gabapentin addictive?

Gabapentin abuse can often lead to someone developing an addiction, though they are not the same thing. Gabapentin abuse will often cause negative side effects to the user and in most cases requires help to overcome.

Like most forms of addiction, a person with a gabapentin use disorder will be diagnosed by a licensed professional using these 11 criteria, outlined by the DSM-5:^[4]

1. Hazardous use: You have used the substance in ways that are dangerous to yourself and/or others, i.e., overdosed, driven while under the influence, or blacked out.
2. Social or interpersonal problems related to use: Substance use has caused relationship problems or conflicts with others.
3. Neglected major roles to use: You have failed to meet your responsibilities at work, school, or home because of substance use.
4. Withdrawal: When you stop using the substance, you experience withdrawal symptoms.
5. Tolerance: You have built up a tolerance to the substance so that you have to use more to get the same effect.
6. Used larger amounts/longer: You have started to use larger amounts or use the substance for longer amounts of time.
7. Repeated attempts to control use or quit: You've tried to cut back or quit entirely, but haven't been successful.
8. Much time spent using: You spend a lot of your time using the substance.
9. Physical or psychological problems related to use: Your substance use has led to physical health problems, such as liver damage or lung cancer, or psychological issues, such as depression or anxiety.
10. Activities given up to use: You have skipped activities or stopped doing activities you once enjoyed in order to use the substance.
11. Craving: You have experienced an intense craving for the substance.

These criteria are measured by the negative impact the substance has on a person's life; including physical, psychological, and behavioral measures, and are classified as mild, moderate, and severe. The criteria are measured against the previous 12 months of substance use and a score of 2-3 is considered mild, 3-5 moderate, and 6 or more severe. ^[4] Even severe gabapentin addictions can be treated and overcome.

Signs of a gabapentin addiction

Gabapentin withdrawal symptoms

Treating a gabapentin addiction

Frequent and excessive use of Gabapentin can lead to a physical and psychological dependence on the drug. This is when someone becomes so accustomed to taking a drug that they need it to feel and function normally, and have trouble moderating and controlling their use of the substance. They may also become physically addicted to the medication and experience tolerance, cravings, and withdrawal.^[4]

Quitting a drug like Gabapentin cold turkey can be dangerous and induce withdrawal symptoms of varying severity. These include anxiety, insomnia, nausea, pain, and sweating. Quitting also increases one’s likelihood of having a seizure which can lead to personal injury or the development of medical problems and life-threatening emergencies. For these reasons, some people may need to detox from the medication in an inpatient detox or rehab facility.

Gabapentin FAQ

Here are some frequently asked questions about gabapentin: