In recent years, legal and medical authorities have pushed back against the opioid epidemic, considered the deadliest drug scourge in American history. States and municipalities have filed lawsuits against the makers of opioid medications and doctors have been prescribing them less and less.

What about the people who rely on these medications, especially the ones who have become addicted to them? A growing number of those users, caught between unyielding need and diminished supply, have turned to alternative medications like gabapentin and kratom.

While each medication has a demonstrated ability to treat pain, they can produce euphoric, opioid-like effects in large enough doses. Those effects have been enough to bring on addiction in users. Also, there is persuasive anecdotal evidence that gabapentin use, for example, can be harmful. According to this report, almost one-fourth of all overdose deaths in Louisville, Kentucky, involved gabapentin.

As for kratom, the U.S. Food and Drug Administration (FDA) issued a warning about the medicinal herb, where it likened the plant to a narcotic opioid and stated that it has been responsible for at least 44 deaths since 2011.

People continue to use both substances to treat pain and other symptoms. When taken together in appropriate doses, they can help people who are going through opiate withdrawal. Recreational users have resorted to taking gabapentin with kratom to enhance the opioid-like effects, a practice that can be harmful, if not deadly.

What Is Gabapentin?

In the U.S., gabapentin was brought to market under the brand name Neurontin in 1994 and approved by the FDA as an anti-seizure medication. The substance is sold under the brand names of FusePaq Fanatrex, Gaborone, Gralise, and Horizant.

Sometime in the late 1990s, Neurontin was aggressively marketed to treat other conditions such as attention-deficit/hyperactivity disorder (ADHD), migraines, and manic depression. However, a U.S. district court invalidated those claims through a ruling that held the drug manufacturers liable for promoting Neurontin for uses not approved by the FDA. The manufacturer was later fined millions of dollars for defrauding insurers and healthcare providers.

Still, gabapentin remains one of the most commonly prescribed medications. Formulations of the drug have been used to treat conditions like fibromyalgia and neuropathic pain associated with diabetes and spinal injuries. Doctors also prescribe it for hot flashes, restless leg syndrome, and migraines. When users take it, it’s either in the form of a capsule, tablet, or an oral solution.

While gabapentin’s exact mechanism of action is unknown, it does possess a structure similar to gamma-Aminobutyric acid (GABA), the chemical responsible for inhibiting the central nervous system (CNS). Gabapentin does not bind to the brain’s GABA receptors. What it does is decrease seizure activity by lessening the excitement in the brain. Thus, gabapentin can produce a sedative effect in users. Some people who use it say it also produces a high similar to marijuana.

Because of these purported effects, gabapentin has found value as a street drug, particularly in states like Kentucky. Kentucky’s top drug control official said this about gabapentin: “People were seeking early refills, claiming they lost their prescriptions and openly conducting transactions in parking lots outside of drug stores.”

Users have resorted to taking kratom with gabapentin to enhance the latter’s effects. But what exactly is kratom?

What Is Kratom?

Kratom is a medicinal herb that belongs to the coffee family and grows in Indonesia, Malaysia, Thailand, and Papua, New Guinea. Though it has been used in traditional medicine since the 19th century, it was first introduced in the U.S. about a decade ago. People use kratom to treat pain, anxiety, and depression. They also use it to boost appetite or sexual desire.

Kratom operates similarly to opiates because it activates the brain’s opioid centers. The substance is comprised of two compounds — mitragynine and 7-α-hydroxymitragynine. When ingested, it can provoke feelings of pleasure and sedation. The mitragynine component acts as a caffeine-like stimulant capable of producing mild opioid effects, endowing a user with energy and alertness. The 7-α-hydroxymitragynine ingredient, however, is about 13 times stronger than morphine.

Many parties advocate kratom as a suitable alternative to opioids, so much so that when the U.S. Drug Enforcement Administration (DEA) moved to ban it, federal lawmakers around the country came together to stop the regulatory body from classifying the plant as a Schedule I controlled substance.

Still, there is no known evidence that kratom is an effective remedy to treat cravings and withdrawal symptoms caused by opioids, alcohol, or other substances. While the drug escapes regulation on a federal level, it is banned in seven states.

Is There a Safe Amount of Gabapentin?

Some users report no harmful effects when low doses of gabapentin are taken with kratom. To avoid harmful effects, one kratom use guide recommends that users carefully choose their dosages and avoid large amounts altogether. However, this same report recommends that they find the right dosage amount that works for them.

The Dangers of Gabapentin and Kratom

When gabapentin is smoked or swallowed, its recreational use can produce dangerous effects on its own, including:

  • Restlessness
  • Trouble sleeping
  • Anger
  • Anxiety
  • Restlessness
  • Panic attacks
  • Aggressive/violent behavior
  • Suicidal thoughts
  • Suicide attempts
  • Unusual behavior/mood changes

Other adverse effects from gabapentin use include headaches, dizziness, uncontrollable shaking, unsteadiness, vomiting, heartburn, diarrhea, constipation, swelling of the hands, feet, ankles, or lower legs, weight gain, and fever.

Kratom acts like an opioid and produces similar effects and symptoms as well. Users can experience effects that range from positive to negative, even life-threatening, such as:

  • High energy levels
  • Increased alertness
  • Talkativeness
  • Increased sociability
  • Ability to stay focused on a task
  • Nervousness
  • Insensitivity to emotional or physical pain
  • Constricted pupils
  • Nausea
  • Vomiting
  • Itching
  • Sweating
  • Foggy state of mind
  • Sudden sleepiness
  • Lethargy
  • Delusions
  • Aggressive behavior
  • Paranoia
  • Shakiness
  • Respiratory issues

Kratom has been proven to extend the opioid-like effects of gabapentin, though each substance acts differently in the body. Users take both at low doses to reduce pain and anxiety while avoiding potentially harmful interactions.

Still, when taken at high doses, users leave themselves prone to experiencing the exacerbated effects and potential interactions of both drugs, though much is still not known about kratom. What is known is that when someone takes an increased amount of gabapentin to supplement the kratom, he or she could experience acute intoxication.

Plus, a large enough dose of kratom has been known to cause respiratory depression, liver damage, seizures, and symptoms of psychosis. Some users suggest that lower levels of kratom combined with gabapentin are safe to use. Though rarely fatal, this combination can inflict significant physical and physiological damage in users.

If you or a loved one is abusing kratom and gabapentin, it is vital that you seek professional addiction treatment as both substances can produce dangerous withdrawal symptoms.

Professional Treatment Options

Even though kratom and gabapentin have milder effects than opioids and benzodiazepines, they still alter the brain and produce harmful effects. What’s more, taking kratom and gabapentin still qualifies as polysubstance abuse, which involves the misuse and possible addiction to two or more substances.

For such cases, professional treatment has been proven to remedy addictions rooted in polysubstance abuse.

Professional addiction treatment can help you accomplish a few things. It enables you to rid the body of both drugs through detox, which restores brain and body chemistry. It also provides targeted therapy and counseling that gets to the root of your addiction via outpatient or partial hospitalization programs, equips you with strategies to avoid relapse, and provides critical life skills and aftercare through an alumni program to help you remain sober.

Kratom/Gabapentin Abuse Statistics

  • The U.S, Centers for Disease Control and Prevention found a tenfold increase in calls about kratom to poison control centers over five years, from 26 in 2010 to 263 in 2015.
  • 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.
  • The American Kratom Association estimates that there are between 3 to 5 million kratom users in the United States.
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