Gabapentin is one of the most prescribed drugs in the U.S. In fact, in 2020, Gabapentin was the 6th most commonly prescribed drug in the country, with over 68 million prescriptions given. Gabapentin, an anticonvulsant which is often prescribed under the brand name Neurontin, is primarily used to treat seizures, neuropathic conditions, and neuropathic pain. At the same time, it’s noted as having a high risk for abuse and use by individuals with a substance use addiction. Additionally, Gabapentin is increasingly popular with recreational users, who abuse the drug on its own and with other street and prescription drugs like opioids to create intense (and dangerous) highs.
While Gabapentin is increasingly seen as dangerous, it remains popular for prescription use. This is largely because the drug is not necessarily heavily addictive on its own, although it does have a strong withdrawal profile. Instead, most users are already addicted to opioids and other drugs. Therefore, Gabapentin’s use and abuse are complex and often situationally related to the individual, their mental health, and their lifestyle.
If you or a loved one is using Gabapentin, on its own or in conjunction with other drugs, it’s important to learn about and understand it.
What does Gabapentin Do?
Gabapentin is the world’s most popular anticonvulsant drug. It’s normally prescribed to treat epilepsy, neuropathic pain, neuropathy, and restless leg syndrome. The drug is also often used to treat neural problems in diabetes, addiction treatment, hot flashes, complaints of itchiness, and anxiety – even though these off-label uses are not FDA approved.
Gabapentin works by interacting with the GABA receptors, the voltage-gated calcium channels, and by modulating enzyme production. As a result, Gabapentin sedates the body (similarly to the “down” effect of alcohol”), while causing the same mild euphoric effects as other GABA interacting drugs.
Neurontin – Gabapentin is most commonly prescribed as Neurontin, a brand name. It’s also available as Horizant, Gralise, Gabarone, and as a generic medication.
Addiction Treatment – Gabapentin is frequently used in the treatment of alcohol use disorders. This off-label use means that a doctor may prescribe Gabapentin for its GABA interaction. Users can take the drug to reduce alcohol withdrawal symptoms without continuing alcohol abuse – and then slowly taper off Gabapentin to make withdrawal safer and easier. Gabapentin should only be used to withdraw from alcohol in a detox setting, with medical monitoring.
Is Gabapentin Addictive?
Gabapentin shows a low addiction profile. This means that most users will not experience addiction from taking Gabapentin at recommended/prescribed doses, even over a longer period. However, Gabapentin does display a mild dependency profile. This means that users taking Gabapentin as prescribed over a mid-to-long-term will experience withdrawal symptoms when quitting the drug. This is exacerbated by increases in frequency or the size of dose.
In one study, it was shown that an estimated 40-60% of patients with a Gabapentin prescription abuse it in some way. However, 15-22% of total opioid users also abuse Gabapentin. This review, which included a systematic review of 23 case studies and 11 reports determined that, even without addiction, the likelihood of Gabapentin abuse for recreational or self-medication purposes was very high.
Additionally, many of the people abusing Gabapentin don’t have prescriptions. Instead, users are looking for a cheap and safer high than opioids. Therefore, Gabapentin abuse has become more prevalent as it becomes more difficult to purchase and use prescription opioids like oxycodone outside of a prescription.
One study suggests that individuals abusing Gabapentin could be taking doses 4 or 5 times in excess of the recommended 1,800-2,400 mg. This changes the effect of the drug from mild sedation to euphoria and sedation. The same study points out that as many as 20% of individuals seeking treatment for Gabapentin are addicted to opioids.
Be Brave. Get Help.
We know what it’s like to have a new chance at life. We want you to feel that, too.
Side Effects of Gabapentin
Gabapentin has a relatively mild side-effect profile, especially compared to opioids. These primarily include:
Fatigue
Dizziness
Somnolence
Swelling of the extremities
Involuntary eye movements
Loss of muscle coordination
Twitching
Erectile dysfunction
Respiratory depression (At high doses)
In rarer cases, gabapentin contributes to suicidal ideation, with some claimants citing a 40% increased risk of suicidal ideation.
Gabapentin Dependence
Gabapentin also contributes to chemical dependence and reliance. Here, the body adjusts to levels of Gabapentin in the brain, changing GABA production. Withdrawal symptoms typically occur between 24 and 48 hours of stopping the drug. They include:
- Agitation
- Confusion
- Disorientation
- Sweating
- Nausea and Diarrhea
- Tremors
- Irregular Heartbeat
- Hypertension
- Insomnia
- Seizures
These symptoms are very similar to those experienced by individuals taking other drugs which interact with GABA receptors, such as alcohol.
Gabapentin Overdose – While GABA shows a very low addiction profile, it does have a risk of overdose. Users taking very high amounts may show symptoms similar to alcohol overdose. These include heavily slurred speech, drowsiness, respiratory depression, sedation, blurred vision, and uncontrollable, jerking motions. Overdoses can result in a coma and eventually death if medical help is not found.
Gabapentin as a Recreational Drug
Gabapentin is quite different from many other recreational drugs. With only a limited addiction profile, it’s not a prime candidate for abuse. However, Gabapentin is uniquely available, relatively cheap, and was poorly controlled up until 2019. As a result, many people come to Gabapentin from other drugs. Because many pharmacists also see Gabapentin as safer and less addictive than other pain medication for neuropathy, it’s also relatively easier to get with any sort of neuropathic pain diagnosis.
Gabapentin and Other Drugs – Many people abusing Gabapentin don’t take the drug on its own. Instead, it’s frequently mixed with opioids and alcohol as a means of intensifying and prolonging the high. This can make Gabapentin more dangerous because its interactions with other drugs are poorly studied. Side effects and overdose may occur more easily in combination with other drugs.
Getting Help
If you or a loved one is abusing Gabapentin, it may be time to seek out help. Gabapentin is not high on the list of addictive drugs but it does cause chemical dependence, and this can, eventually, result in addiction. However, most users become addicted to other drugs and then move to Gabapentin, creating a psychological and behavioral dependence on the drug. If you think you or a loved one might be struggling with dependence and addiction, seeking out rehab, behavioral therapy, and counseling can help.
Gabapentin abuse and addiction has increased by over 90% since 2008. At the same time, therapies like CBT, effective drug detox programs capable of helping people to safely quit, and counseling intended to resolve underlying problems behind addiction have also grown in popularity. Going to rehab can be that crucial first step to learning how to live a happy life without drugs and alcohol, doing so safely, and getting your life back.
Matthew Beck B.A, M.A, LMFT 
