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Since its approval by the U.S. Food and Drug Administration (FDA) in 1993 under the brand name Neurontin, gabapentin has seen increased use across the United States. Many physicians prescribe this medication for its off-label use.1 That is, they use gabapentin to treat symptoms of disorders beyond the medication’s original purpose.
As the trend of prescribed off-label gabapentin use has grown, the rates of gabapentin misuse and addiction have risen as well.
How can you tell when your loved one is high gabapentin?
Start by understanding the intended medical purpose of prescription gabapentin.
Gabapentin: Prescribed Uses
Brand names for gabapentin include Neurontin, Gabarone, Gralise, and Horizant.1 Pay attention to how your loved one labels their medication. The use of street names such as “gabbies,” GABA, or other modifications to official names could indicate signs of misuse.
Gabapentin has structural similarities to a neurotransmitter called gamma-aminobutyric acid (GABA). Gabapentin was first used to manage certain types of seizures and pain. Today, prescribing physicians may recommend gabapentin for FDA-approved and non-approved purposes.
FDA-Approved Uses of Gabapentin:3
- Partial seizures.
- Restless legs syndrome.
- Pain associated with shingles or post-herpetic neuralgia.
Non-FDA (Off-label) Uses of Gabapentin:1,3,4
- Hot sweats.
- Nerve pain.
- Pain after surgery.
- Kidney-related concerns.
- Nerve damage associated with diabetes.
- Mood disorders.
- Bipolar disorder.
- Post-traumatic stress disorder.
- Substance use-related seizures.
Researchers have noted gabapentin’s success in fibromyalgia and chemical dependence treatment.1 Gabapentin’s pain-relieving effects also contributed to improved outcomes in sleep, depressed mood, work functioning, and quality of life.1
This medication comes in a variety of forms for oral use. These forms include capsules, tablets, and solutions. Dosages of gabapentin can increase to 1800 mg/day depending on your medical history, symptoms, and cause for treatment.3 The FDA recommends that children between the ages of 5 and 11 receive up to 35 milligrams a day per kilogram of the child’s weight.
Gabapentin Side Effects
Speak to your doctor about the side effects you might experience when taking gabapentin. They can explain the kinds of issues that can arise from taking this medication as prescribed. They can also tell you how to cope with side effects. Certain health concerns may put you at higher risk of experiencing side effects. Check the insert provided with this medication for more information.
Side effects of gabapentin include:1,3
- Fluid build-up in the body
- Rapid, involuntary eye movement
- Increased sensitivity to viral infection
- Hyperactive behavior
- Changes in thinking
- Increased heart rate
- Memory concerns
- Suicidal thoughts
Seek medical attention immediately for assistance with severe side effects. Seek support from emergency services if your loved one has thoughts of harming themselves or others. Reach out for support if their behavior places someone at risk.
If your loved one takes an opioid medication such as hydrocodone or morphine, monitor for any changes that occur when starting or stopping gabapentin use.3 Combining opioid medication and gabapentin can result in increased sedation or breathing issues. Careful consideration can help you manage gabapentin’s side effects.
If someone you love experiences intense side effects and continues to take the medication, they may be at a higher risk for misusing gabapentin.
With so many official and off-label uses, your loved one may want to use this medication for purposes beyond what their medical provider recommends. Severe pain and mental health disorders may increase your loved one’s risk of dependence or misuse. Pay attention to any changes in your loved one’s physical or mental health conditions. These changes can indicate that they may be at risk for misusing gabapentin.
If you notice your loved one taking more than the recommended dosage of gabapentin, running out of their medication early, or requesting multiple refills in a short period, talk to them about their potential misuse of this medication. If your loved one has a history of mental health or substance use concerns, some gabapentin side effects may pose a greater risk to their health.
The physical and mental effects of gabapentin taken at high dosages can contribute to the likelihood of the medication’s misuse.5 Some people reported sensations similar to benzodiazepines, hallucinogens, and opioids even when using gabapentin at recommended doses.
Prescribers may offer gabapentin for a wide range of medical concerns, including as an alternative to opioid medication.6 Research has shown that people with a history of a substance use disorder may have a higher risk of becoming dependent on gabapentin.5
Misuse of gabapentin means taking more than prescribed or taking it for non-prescribed purposes. People who misused gabapentin reported taking it for the following purposes:7
- Improved social connection
- Better mood
- Improved sleep
- Physical sensations
- Increased empathy
The effect of gabapentin on the central nervous system and the brain’s reward system can make misuse seem appealing. Taking proper precautions and using gabapentin as prescribed can protect you and your loved ones from the harmful effects of this medication.
Some people rely on the internet or non-medical dealers to obtain gabapentin for misuse. Others may exaggerate or inaccurately describe their symptoms to obtain gabapentin. These patterns of obtaining and using gabapentin can increase your loved one’s risk of developing a dependence on the medication. Using gabapentin for its intoxicating effects also places your loved one at risk for dependence.
Becoming dependent on gabapentin means that a person may struggle to function when they stop taking the medication. Dependence can result in increased tolerance for the substance or symptoms of withdrawal when cutting back on use.8
Tolerance means that you need more of the substance to achieve the same or desired effect that earlier use provided.8 If the effects of gabapentin begin to wear off, your loved one may express cravings or urges to seek out the medication. Research indicates that a person may experience withdrawal symptoms if they use gabapentin to manage withdrawal from other substances.3 Symptoms of withdrawal can include disorientation, confusion, and agitation.
Overdose can occur when your loved one has taken too much gabapentin. Signs of overdose include:3
- Slurred speech
- Low energy
- Impaired vision
If an overdose on gabapentin occurs, the FDA recommends seeking medical attention or contacting a poison control center. If your loved one misuses this medication, look out for any of the following changes:9
- Changes in walking ability
- Altered mood
- Feeling drunk
- Incoherent speech
Gabapentin as Treatment for Addiction
Gabapentin has seen increased use in the treatment of addiction and substance use disorders.4 Each treatment facility may have different policies regarding the use of gabapentin. Some programs may request patients to taper off or slowly reduce their use throughout treatment. Some may actively employ gabapentin to support the addiction treatment process.
These differences highlight the challenges prescribers face when managing addiction treatment. If your loved one has physical pain and experiences a substance use disorder, your doctor may want to discuss the risks and benefits of continuing a gabapentin regimen.4
Though many patients receive these medications for legitimate purposes, the risk of diversion and misuse persists.4 Some professionals note that gabapentin misuse could indicate an early sign of relapse.
Some patients may even rationalize their misuse, describing their experience as a “freelapse.”10 Some clinicians reported that people who received substance use treatment might misuse gabapentin to:4,10
- Manage symptoms of distress
- Cope with symptoms of withdrawal
- Cope with boredom
- Respond to peer influences
- Avoid testing positive on a urinalysis
Each person has their own unique needs in treatment. Addressing the reality of addiction can help you or your loved one manage the risk of relapse on gabapentin.
Ways to Address Gabapentin Misuse with a Loved One
Understanding the intended purpose of gabapentin can give you a better idea of what appropriate use looks like. Have open conversations with your loved one about prescription medication. Creating a safe space for you and your loved one to connect can help them stay honest about their medication use.
Unclear or incomplete advertising practices can create the perception that gabapentin use holds little to no risks. Utilize information available through the FDA or your local government websites to make informed decisions about care for you or your loved one. Remember that gabapentin side effects and dependence can occur even with prescribed usage.
- Acknowledge your loved one’s physical or mental health concerns
- Have compassion for the suffering they may experience
- Be frank about the risks and side effects of gabapentin use
- Openly discuss changes you may have noticed in their mood and behavior
- Monitor dosages taken
- Account for dependence or addiction to other substances
- Prompt your loved one to seek substance use disorder treatment as needed
Different prescribing practices can create a confusing picture for safe gabapentin use. Tell your doctor about any concerns for misuse or diversion of medication that you may have. If your loved one needs treatment for substance use concerns, discuss these concerns with your loved one’s established treatment team.
Treatment for Gabapentin Abuse or Addiction
Substance use treatment professionals can help you or your loved one overcome addiction and gabapentin misuse. Therapy and case management services can help your loved one maintain substance use recovery. The relationships offered in recovery-focused communities can offer role modeling and support.
Individual therapy can offer tools and guidelines for managing chemical dependence and creating a healthier lifestyle. Talking to a qualified addiction treatment specialist can help you and your loved one to understand best practices when using prescribed medication.
Residential or inpatient treatment can provide a safe, structured environment for your loved one to recover from substance use and mental health concerns.
Many residential treatment programs employ a combination of medical and social interventions to promote recovery. The changes in behavior and thinking introduced in early recovery programs can shape and motivate commitment to lasting health.
If these aren’t viable for your loved one, outpatient rehab is also an option that provides more flexibility and the ability to continue a somewhat normal routine. Call 800-926-9037 (Who Answers?) to find a rehab center for you or your loved one today.
Community support groups, such as Narcotics Anonymous, can offer relationships that promote sobriety. They can help your loved ones understand how addiction has impacted their life.
Early recovery poses unique and sometimes overwhelming challenges. Recognize your limits and get help when you need it. Qualified treatment specialists can help you get started with the process of recovery. Call 800-926-9037 (Who Answers?) today to discuss the best treatment options for you or your loved one.
- Nguyen, T., Li, Y., & Refua, S. (2017). Gabapentin: a surprising drug with many uses. Journal of Pharmacy Practice & Research, 47(4), 304–307.
- Associated Press (2019, December 23). Nerve drugs gabapentin, pregabalin linked to breathing problems, FDA warns. NBCNews.com.
- (2017). Prescribing information for Neurontin.
- Buttram, M. E., Kurtz, S. P., Ellis, M. S., & Cicero, T. J. (2019). Gabapentin prescribed during substance abuse treatment: The perspective of treatment providers. Journal of Substance Abuse Treatment, 105, 1–4.
- Smith, R. V., Havens, J. R., & Walsh, S. L. (2016). Gabapentin misuse, abuse and diversion: A systematic review. Addiction, 111(7), 1160–1174.
- Peckham, A., Evoy, K., Ochs, L., & Covvey, J. (2018). Gabapentin for off-label use: Evidence-based or cause for concern? Substance Abuse: Research and Treatment, 12.
- Evoy, K., Covvey, J., Peckham, A., Reveles, K. (2021). Gabapentinoid misuse, abuse and non-prescribed obtainment in a United States general population sample. International Journal of Clinical Pharmacy.
- American Psychiatric Association. (2013). Substance-related and addictive disorders. In Diagnostic and statistical manual of mental disorders (5th ed.).
- Vickers-Smith, R., Sun, J., Charnigo, R. J., Lofwall, M. R., Walsh, S. L., & Havens, J. R. (2020). Gabapentin drug misuse signals: A pharmacovigilance assessment using the FDA adverse event reporting system. Drug and Alcohol Dependence, 206, 107709.
- Buttram, M. E., & Kurtz, S. P. (2020). A qualitative examination of gabapentin misuse inside of treatment and recovery settings. Journal of Studies on Alcohol and Drugs, 81(5), 681–686.