Gabapentin is a prescription anticonvulsant medication often sold under the brand name Neurontin. Gabapentin also has many off-label uses, including neuropathic pain, anxiety, manic-depressive disorders, and, more and more frequently, as a form of medication-assisted treatment (MAT) during opioid detox, as it is believed to have a much lower addiction potential.
While addiction treatment and recovery research on using gabapentin as a means of coping opioid cravings and withdrawal during detox is still very much an ongoing process, what has been learned is that gabapentin has significant potential to help people in recovery from opioid addiction get through detox and work toward maintaining abstinence.
Unfortunately, like many medications used in medical maintenance therapy for opioid addiction, it is not without risks. For someone already struggling with an opioid use disorder, gabapentin could, if misused, become a substitute and lead to the user abusing it and eventually becoming addicted.
Under the care and supervision of a medical detox professional and paired with other treatments like behavioral therapy, gabapentin can make it easier for someone to get through the opioid detox process, which, in turn, makes it more likely that they will continue with treatment and increase their chances of maintaining sobriety.
How Does Gabapentin Work?
The way gabapentin achieves its effects is extremely complex and still not fully understood. The drug is neither an opioid or a benzodiazepine, although it produces similar effects.
The medication has been observed and proven to calm brain activity by increasing certain brain chemicals that are also affected by benzos and opioids, like gamma-Aminobutyric acid (GABA), which regulates feelings of stress and anxiety in the central nervous system.
However, unlike these other drugs, gabapentin does not work by binding with GABA receptors to produce an excess of the chemical, so because of this, the mechanism used to create this effect remains unclear. But it does reduce electrical stimulation in the brain, which is what makes it so useful as an anticonvulsant for people with epilepsy. Aside from feelings of calm and anti-anxiety, gabapentin also causes drowsiness, dizziness, and a mild euphoric high that can lead users to abuse it to get the stronger high that they are used to experiencing through opioid abuse.
What Is Involved in Opioid Detox?
Medical detoxification is the process of removing all of the drugs, alcohol, and any associated toxins out of someone’s system to treat acute intoxication, get them mentally and physically stabilized, and stop any further damage that having these substances in their system may be causing.
Someone can’t move on to an addiction treatment recovery program if they are still intoxicated, as they need to be able to fully devote their focus on recovering from opioid addiction, which they cannot do without first going through detox.
Detox is also when someone is going to experience withdrawal symptoms, which is caused by their body and brain attempting to adjust to the lack of alcohol or drugs they’ve become dependent on. The intensity of the symptoms someone can expect to experience during detox will depend on the severity of their addiction, their physical and mental health, and the substance that they have been abusing.
In the case of opioids, the withdrawal symptoms associated with detox, while still extremely unpleasant and uncomfortable, are comparatively milder relative to depressants like benzos or alcohol, and usually include flu-like symptoms such as:
- Nausea and vomiting
- Runny nose
- Muscle pain
- Fever and chills
- Excessive sweating
- Difficulty concentrating
- Mood swings
- Intense drug cravings
While all of these symptoms can be difficult to deal with, cravings are among the most dangerous part of opioid withdrawal, as they can be so intense that it is extremely common for people to relapse mid-detox, especially if they are trying to do so on their own.
When someone chooses to detox at a professional detox treatment center, then they can be given detox medications to help prevent relapse and make for a smoother and successful detoxification process.
While the aim of opioid detox treatment is still to achieve sobriety, it is sometimes done a bit differently through the use of weaker opioids like methadone and buprenorphine. These are often employed to help ease these withdrawal symptoms and wean someone off the opioid they are addicted to in a way that is safe and less likely to result in relapse with the eventual goal being total abstinence. In terms of abuse and addiction, gabapentin is considered to be even safer to use than other common MAT methods.
However, even though gabapentin is considered to be even safer than those drugs because it is not an opioid, using gabapentin during opioid detox is still not completely without risk and remains a fairly controversial form of detox treatment.
Is Gabapentin Safe to Use During Opioid Detox?
While gabapentin is considered to have a comparatively low potential for abuse, it is still possible to become addicted to it as well as overdose. In recent years, as the opioid crisis has continued to grow, more people are turning to gabapentin because it is perceived to be a safer drug that can still provide them with the effects of an opioid as well as the fact that, since gabapentin is not classified as a controlled substance, it is much easier to get ahold of.
But because it is so much less potent than other opioids, users are actually at very high risk of overdosing on gabapentin since they need to take such a large amount of it to get an intoxicating high, usually exceeding 900 milligrams.
Symptoms of a gabapentin overdose include:
- Nausea and vomiting
- Intense drowsiness
- Slurred speech
- Blurred vision
- Muscle weakness
- Loss of control over body movements
And even taking gabapentin as directed can have risky side effects, including:
- Joint and back pain
- Appetite loss
- Depression and suicidal thoughts
Stopping gabapentin after a long period of heavy use can also lead to seizures because of overactivity in the central nervous system.
Nonetheless, gabapentin has been proven to be effective in controlled, restricted environments at easing the withdrawal symptoms associated with opioid withdrawal. To avoid relapsing or transferring an addiction to an opioid like heroin to gabapentin, it is vital that if gabapentin is utilized during the detox process, it is done so very carefully with a medical professional who can best weigh the benefits and risks of doing so for a given individual.