Gabapentin Abuse and Addiction

Gabapentin is a nerve pain medication that has received national attention for its abuse potential. According to one study examining multinational misuse patterns, the prevalence of gabapentin misuse was 1 percent among the general population, 40-65 percent among patients with a prescription for gabapentin, and 15-22 percent among people who used opiates.

In America specifically, and in Colorado, gabapentin misuse is on the rise. One report indicated that gabapentin is the ninth most frequently prescribed drug in the country. Misuse and abuse of gabapentin is a growing issue, but treatment options are available in Colorado and across the country.

What Is Gabapentin (Neurontin)?

Gabapentin, which is the generic name of the brand-name drug Neurontin, is a neuromodulator, developed initially as an anticonvulsant. Gabapentin is used in the management of:

  • Restless legs syndrome
  • Bipolar disorder
  • Anger and agitation
  • Anxiety
  • Neuropathic pain
  • Cravings for ethanol (this use is only speculatory at this time)

Some side effects of gabapentin use may include:

  • Dizziness
  • Drowsiness and fatigue
  • Fever
  • Sedation
  • Viral infection
  • Peripheral edema
  • Blurred vision
  • Impaired coordination (ataxia)
  • Involuntary eye movements (nystagmus)
  • Double vision (diplopia)
  • Lazy eye (amblyopia)
  • Dry mouth (xerostomia)

Is Gabapentin Addictive?

Gabapentin is not a controlled substance, nor has it been typically used to achieve strong euphoric effects. There is a recent developing market for it, particularly in correctional facilities, where access to other drugs of abuse is more difficult. The effects which are sought include mild euphoria and anxiolysis, which are potentiated by a variety of other drugs.

The initial report of gabapentin abuse was noted in 2004 at a Florida correctional facility, where inmates were insufflating crushed gabapentin, for reportedly a cocaine-like high. Gabapentin has been primarily used to potentiate the effects of opiates. It is also used as an adulterant in heroin, to increase weight and volume, reducing dealer cost and maximizing profit.

Prescribers do not typically recognize gabapentin as a potential drug of abuse, and therefore may be more willingly prescribed, which can contribute to diversion and illicit sale.

Understanding Gabapentin Addiction

Gabapentin addiction can start with misusing the drug or intentionally abusing it. With gabapentin, a person should not take more than their directed dosage limit. Typically, the maximum daily dose of gabapentin is up to 3600 mg a day, but dosage may vary depending on a person’s unique needs.

Gabapentin Overdose

Gabapentin can be fatal if it is overdosed on. There is no specific antagonist for gabapentin. The potential for a fatal overdose is increased if the person uses several drugs at once.

Indicators of gabapentin overdose may include:

  • Double vision
  • Slurred speech
  • Drowsiness
  • Lethargy
  • Diarrhea

Gabapentin Withdrawal

When a person stops taking gabapentin, they will likely go through withdrawal. A literature review determined that gabapentin withdrawal can set in within 12 hours to seven days after the last dose of gabapentin.

Symptoms of gabapentin withdrawal may include:

  • Anxiety
  • Sweating (diaphoresis)
  • Irritability
  • Agitation
  • Confusion
  • Rapid heart rate (tachycardia)
  • An inability to move normally (catatonia)
  • Continuous grand mal seizures

Why Is Gabapentin Addictive?

Gabapentin is mildly rewarding and produces withdrawal symptoms upon cessation of use. Gabapentin’s addictive potential is minimal. Addictive drugs produce an intense reward, which leads to a compulsion to reuse. This activity is part of the dopaminergic reward system. Gabapentin does not work directly on dopamine; therefore, its reward potential is minimal.

In most cases, gabapentin abuse happens due to a person’s desperation and lack of available alternatives — not because it is addictive.

How Long Does It Take to Get Addicted to Gabapentin?

Gabapentin addiction timetables may depend on many factors, including:

  • How soon withdrawal symptoms set in
  • The dosage of gabapentin, or how much gabapentin a person takes regularly
  • How long someone has taken gabapentin

Gabapentin appears to be a drug of last resort for people rather than a substance of primary interest. The popularity of abused substances waxes and wanes along temporal and geographical lines due to a multitude of variables. Clinicians must stay current on substance abuse trends to be effective and offer high-quality care.

Need help for a gabapentin addiction? The Recovery Village at Palmer Lake offers comprehensive addiction treatment programs in a safe, supportive environment. Call us today to learn more about rehab for gabapentin addiction. “Gabapentin.” Last updated on Dec 21, 2018. Accessed April 2019.

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Quintero, G.C. “Review about gabapentin misuse, interactions, contraindications and side effects.” Journal of Experimental Pharmacology, 2017. Accessed April 2019.

Mersfelder, T.L., and Nichols, W.H. “Gabapentin: Abuse, Dependence, and Withdrawal.” Annals of Pharmacotherapy, 2016. Accessed April 2019.

Perrone, Matthew. “Drug Epidemic Ensnares 25-Year-Old Pill for Nerve Pain.” U.S. News, 2018. Accessed April 2019.

Pfizer. “Neurontin (Gabapentin) 10: Overdose.” Revised October 2017. Accessed April 2019.

Smith, R.V., Havens, J.R., and Walsh, S. L. “Gabapentin misuse, abuse, and diversion: A systematic review.” Addiction, 2016. Accessed April 2019.

Smith, R.V., Lofwall, M.R., Havens, J.R. “Abuse and Diversion of Gabapentin Among Nonmedical Prescription Opioid Users in Appalachian Kentucky.” The American Journal of Psychiatry, 2015. Accessed April 2019.

U, Bonnet, and N, Scherbaum. “How addictive are gabapentin and Pregabalin? A systematic review.” European Neuropsychopharmacology, 2017. Accessed April 2019.  

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