As the opioid epidemic continues its unceasing onslaught on the lives of thousands of Americans, doctors are scrambling to find alternatives to help patients deal with pain. One of those alternatives is gabapentin, the nerve pain medication.
Doctors have been prescribing gabapentin more and more for pain relief and other uses. This uptick in prescriptions has given people an opportunity to misuse the drug, which could create a secondary addiction crisis as an outgrowth of the opioid scourge.
For years, doctors have prescribed gabapentin to treat seizures, pain related to shingles, and nerve damage from diabetes. Because it is not an opioid, the presumption is that it is safer to take. What users don’t realize is that gabapentin possesses addicting effects of its own. It can also produce distressing withdrawal symptoms, enough to ensnare someone into a cycle of tolerance, dependence, and addiction. This outcome is even more likely when someone misuses this drug by smoking or snorting it.
One New England Journal of Medicine study stated that increased gabapentin use can cause patients to experience serious side effects such as sedation and dizziness. Also, when gabapentin is ingested with other central nervous system (CNS) depressants, the effects can be even more troubling.
Kentucky authorities indicate the significant rise in gabapentin abuse and have classified it as a controlled substance. An analysis of coroner data by a Louisville, Kentucky, media outlet revealed that gabapentin was found in nearly a quarter of all fatal overdose deaths in the state’s most populous county in 2016. It is worth noting that it is not classified as a controlled substance at the federal level under the U.S. Drug Enforcement Administration (DEA).
What all this points to is an emerging addiction trend that could prove dangerous, especially for users who take the gabapentin in ways not intended for normal use, by either smoking or snorting it.
Gabapentin: A History of Approved and Unapproved Uses
Gabapentin was introduced to the U.S. under the brand name Neurontin in 1994 and was approved by the U.S. Food and Drug Administration (FDA) as an anti-seizure medication. It is also sold under the brand names of FusePaq Fanatrex, Gaborone, Gralise, and Horizant.
Though gabapentin’s exact mechanism of action is unknown, it possesses a structure similar to gamma-Aminobutyric acid (GABA), the chemical responsible for inhibiting the central nervous system (CNS). However, gabapentin does not bind to the GABA receptors in the brain. Once it is absorbed in the small intestine, however, it aids in decreasing seizure activity within a user.
Gabapentin is available as a generic drug and comes as a capsule, tablet, and oral solution. It is also available at various dosage strengths.
In the late 1990s, Neurontin’s manufacturer aggressively marketed the medication to doctors to treat a variety of conditions including migraines, manic depression, and attention-deficit/hyperactivity disorder (ADHD).
A U.S. district court later determined that Pfizer, which acquired the company that originally manufactured Neurontin, was guilty of illegally marketing Neurontin for uses that were not approved by the FDA. It had to pay a fine of $430 million in 2004 and an additional $325 million to resolve claims that it defrauded insurers and health care providers over the unapproved use of the drug.
Currently, gabapentin and its various brand name formulations are employed to treat other conditions besides seizures, including neuropathic pain, hot flashes, and restless leg syndrome. Neurontin remains one of the most widely prescribed medications in the United States.
The Dangers of Gabapentin
Though gabapentin is not scheduled as a federally controlled substance, there is evidence of its use as a recreational drug. Users will display one of the hallmarks of a growing addiction by taking gabapentin in ways unintended, such as snorting or smoking it.
In addition to euphoria, users also reported that the drug endowed increased sociability and feelings of calm and relaxation, not unlike a Cannabis high. Nevertheless, some users said that when they snorted gabapentin, it gave them a stimulant effect.
There seems to be growing anecdotal evidence that gabapentin misuse is on the rise, particularly in the “Bluegrass State.” A study of more than 500 adults from the Appalachian area of Kentucky who used pharmaceuticals non-medically found that 15 percent of them use gabapentin to get high.
That number, according to the DEA, represented a 165 percent increase from the previous year and a 2,950 percent increase from 2008 from people within that same study. Nevertheless, whether users smoke or orally ingest gabapentin, it can produce some troubling effects, which include:
- Trouble sleeping
- Panic attacks
- Aggressive/violent behavior
- Suicidal thoughts
- Suicide attempts
- Unusual behavior/mood changes
In addition to those effects, there are adverse side effects that gabapentin abuse could cause, such as headaches, dizziness, uncontrollable shaking, unsteadiness, vomiting, heartburn, diarrhea, constipation, swelling of the hands, feet, ankles, or lower legs, weight gain, and fever.
When one user tried to stop using gabapentin, she experienced troubling withdrawal symptoms.
She wrote that “My gabapentin withdrawal symptoms included vertigo from the moment I woke up until about midday, hot flashes that rivaled menopause, daily migraines, and what I prefer to just call intestinal distress.”
Gabapentin’s effects can run the gamut. It can even produce overdose symptoms, even though these events are rarely fatal.
How a Gabapentin Addiction Grows
Any substance addiction begins when a user develops a tolerance, meaning they have to take more of the drug to experience the effects a smaller, previous dose yielded. When their bodies become used to the presence of the drug, any cessation of the substance produces withdrawal symptoms. At that point, they will have developed a dependence.
Finally, addiction occurs once a user displays compulsive behaviors around obtaining and using the drug. They will use the drug despite adverse effects like health, professional, and/or legal complications.
If you or a loved one has begun to experience these changes around gabapentin use, then your best course of action is professional addiction treatment.
Why Professional Treatment is Necessary with Gabapentin Addiction
If you took gabapentin to treat a seizure disorder but quit cold turkey, you will likely have more seizures when the drug leaves your system. This is a life-threatening effect that users experience when they attempt to quit gabapentin on their own without professional help.
The safest, most effective step you can take in ceasing your gabapentin use is by talking to your doctor.
If you are looking to put an end to your cycle of abuse, then professional addiction recovery offers the best solution. In professional addiction treatment, a medical team will determine the severity of your gabapentin abuse and withdrawal process.
They will determine whether you will need to undergo detox at a residential facility or safely participate in an outpatient detox program.
If your doctor recommends that you participate in detox while at home, then here are some steps you can take to avoid relapse:
- Contact your family and friends.
- Stay hydrated.
- Eat healthy foods.
- Make an exercise plan.
- Take small doses of over-the-counter painkillers.
- Make a list of people to call.
- Go to all doctors’ appointments and report new symptoms.
Gabapentin Overdose is Possible
Compared to other substances, gabapentin can produce relatively minor overdose symptoms, including double vision, drowsiness, slurred speech, and diarrhea. However, fatal overdoses involving gabapentin, particularly with other opioids, has become more common in areas such as Kentucky.
Overdoses occur when people substitute their non-medical use of opioids with drugs like gabapentin. They assume that it is safe to abuse.
One medical doctor told Healthline, “There has been an increase in the mentions of gabapentin toxicity in emergency rooms, including overdose deaths. These are likely due to a combination of gabapentin with another central nervous system depressant,” he said.
Startling Gabapentin Statistics
- As the 10th most prescribed medication in the U.S., 64 million gabapentin subscriptions were dispensed in 2016, up from 39 million in 2012.
- Between 2012 and 2016, gabapentin was detected in 168 fatalities and was the primary cause of death in 23 people.
- According to an official with the Kentucky Office of Drug Control Policy, gabapentin showed in an estimated one-third of all drug deaths across the state in 2016.