Gabapentin Abuse

  1. Table of ContentsPrint
  2. Side Effects
  3. Does Gabapentin Get You High?
  4. Can You Overdose on Gabapentin?
  5. Gabapentin Abuse Treatment

Hand holding out Gabapentin pills

Gabapentin (Neurontin) is an anticonvulsant that comes in a capsule, tablet, and oral solution. It is used to manage certain seizure disorders, as well as the neuropathic pain phenomenon known as post-herpetic neuralgia (lasting nerve and skin pain caused by an attack of shingles).2,9 An extended-release formulation of gabapentin (Horizant) is used to treat restless leg syndrome (RLS).9

Concerns have arisen in recent years over increasing instances of gabapentin abuse.4 According to the Drug Abuse Warning Network (DAWN), the number of emergency room visits involving nonmedical use of gabapentin increased by 90% in the United States since 2008.6  

On the street, gabapentin is sold under various nicknames including “gabbies.”4 One study found that gabapentin is used as a cutting agent in street heroin, increasing the potential for abuse and the development of dangerous health effects.4

Nonmedical use of gabapentin may be fueled by:4

  • The fact that gabapentin is not currently scheduled as a controlled substance.
  • The fact that escalating doses are recommended.
  • The potential for euphoria when combined with opioids like hydrocodone.

There are numerous reports of off-label and unapproved uses of gabapentin.1 This is partly because the manufacturers of gabapentin promoted the drug for at least 10 off-label medical conditions, including:1

  • Bipolar disorder.
  • Neuropathic pain.
  • Diabetic neuropathy.
  • Complex regional pain syndrome.
  • Attention deficit disorder.
  • Migraine.
  • Seizures from alcohol withdrawal.

In 2001, Gabapentin sales totaled $1.77 billion, which was a 57% increase from 2000 when the drug sold $1.13 billion. The drug’s manufacturer acknowledged that more than 78% of these gabapentin sales came from prescriptions written for unapproved use. That is, the company promoted the drug’s sales without reported safety and effectiveness of gabapentin for off-label use.10


Side Effects

Gabapentin can result in a number of physical and psychological effects, including suicidal thoughts and behaviors.

If you or a loved one is taking gabapentin, be aware of warning signs of suicide, such as:7

Talk:

  • Talking about being a burden to others.
  • Talking about having no reason to live.
  • Talking about killing themselves.

Behavior:

  • Using more drugs and alcohol.
  • Acting recklessly.
  • Calling people to say goodbye.
  • Withdrawing from activities.

Mood:

  • Depression.
  • Rage.
  • Anxiety.
  • Loss of interest.
  • Irritability.

Other Side Effects

Other gabapentin side effects that may intensify when you take too much or take it when you don’t need it include:2

  • Dizziness.
  • Difficulty speaking.
  • Lack of coordination.
  • Temporary loss of memory (amnesia).
  • Tremor.
  • Sleepiness.
  • Coordination problems.
  • Double vision.
  • Unusual eye movement.
  • Jerky movements.
  • Restlessness.
  • Agitation.
  • New or worsening irritability or anxiety.
  • Panic attacks.
  • Insomnia.
  • Acting on dangerous impulses.
  • Mania.
  • Depression.
  • Aggressive, violent, or angry behavior.

 


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Does Gabapentin Get You High?

Gabapentin is not a controlled substance. When taken alone and as prescribed, there is little potential for abuse or addiction. However, when a person takes gabapentin with other medications, such as muscle relaxants, opioids, or anxiety medications, it can produce a high.

The effects of gabapentin intoxication have been variously described as:4

  • Relaxation/sense of calm.
  • Euphoria.
  • A high similar to that of marijuana.

A study of illicit gabapentin users found that:3

  • 56% were taking gabapentin with an opioid.
  • 27% were taking gabapentin with an opioid, muscle relaxant, or anxiety medication.
  • 8.6% were using gabapentin with other illicit substances.

The FDA warns that mixing gabapentin with alcohol or other drugs can make you sleepy or dizzy, or increase these symptoms.2


Can You Overdose on Gabapentin?

Like opiates, you can fatally overdose on gabapentin.4 However, unlike opiates, there is no antidote that you can administer in the case of an overdose. Because of the drug’s long half-life, immediate medical attention is necessary to manage the complications associated with a toxic amount of this drug.4

Although most overdoses occur as a result of combining gabapentin with other substances, a study published in 2011 found that an individual committed suicide by intentionally overdosing on gabapentin.5

Man taking gabapentin pills and alcohol

Overdoses involving 49 grams or more of gabapentin have been reported by the FDA. Signs of gabapentin overdose include:2

  • Ataxia (decreased muscle coordination).
  • Labored breathing.
  • Diarrhea.
  • Ptosis (drooping upper eyelid).
  • Hypoactivity.
  • Excitation.
  • Double vision.
  • Marked sedation.
  • Slurred speech.
  • Drowsiness.
  • Lethargy.

If a person has overdosed on gabapentin, the drug can be removed from their system in the emergency room through a process of hemodialysis (kidney dialysis).2

What to Do in Case of Gabapentin Overdose

If you are near someone who has overdosed, check the person’s airway, breathing, and pulse. If the person is unconscious, call 911. You can also perform these steps:8

  1. Roll the person toward you on their side.
  2. Bend the top leg so that the hip and knee are at right angles.
  3. Tilt the head back to keep the person’s airway open.
  4. Try to keep the person calm.
  5. Stay with the person until help comes.


Gabapentin Abuse Treatment

Abruptly stopping gabapentin can increase the likelihood of seizures, so it’s important to seek help when looking to quit.4 If you are getting treatment for a gabapentin abuse problem, you will likely start with detox so that you can slowly eliminate the drug from your body in a controlled manner. After completing detox, you will need medical clearance before transitioning into an inpatient or outpatient treatment program. There are a number of gabapentin addiction treatment options available, including:

  • Detox: After long or heavy use of gabapentin, your body becomes dependent on the drug and needs it in its system to function and avoid a potentially perilous withdrawal syndrome. Getting medical detox helps you to slowly wean off gabapentin while under medical supervision.
  • Inpatient Treatment: If your gabapentin addiction is severe or you have co-occurring mental health or medical issues, an inpatient program can provide you with intensive care. Inpatient treatment requires that you live at the facility for the entire duration of your treatment. These programs provide a high level of structure and a safe environment that minimizes triggers to use gabapentin. Before you begin treatment, medical professionals will assess your situation and your addiction in order to create a tailored treatment plan. This may include individual and group therapy, family counseling, relapse prevention classes, support groups and aftercare planning.
  • Residential Treatment: A residential program can provide a high level of care, structured environment, and 24/7 medical monitoring while you treat your gabapentin addiction. If you require a longer stay and intensive services, a residential facility is a great option. There is a wide range of residential programs available, including facilities that offer dual diagnosis treatment, nutritional counseling, family therapy, and aftercare treatment options.
  • Outpatient Programs: After completing detox and/or inpatient treatment, you may move on to an outpatient treatment. You might also start in an outpatient program if your addiction hasn’t progressed to the point of requiring intense inpatient care. When you seek treatment on an outpatient basis, you will live at home and visit the facility for a set number of hours per week to work with a therapist and engage in group therapy.
  • Support Groups: Before, during, or after treatment, you may attend 12-step meetings like AA/NA or other support groups. When you go to a support group you will be welcomed by people who know what you’ve been through because they’ve gone through it too. Feeling accepted can make a huge difference in your recovery because you will create a new support network of sober individuals and learn from people who have been abstinent from drugs for a longer period of time.
  • Aftercare: In rehab, you will prepare for your transition out of treatment by creating an aftercare plan. This will look different for every person and may include transitioning into a sober living facility, locating a counselor or therapist outside of treatment, and regularly attending 12-step meetings or other support groups. After you leave treatment, it is important that you stay involved with some sort of care to prevent relapse.


References:

  1. Mack, A. (2003). Examination of the evidence for off-label use of gabapentinJournal of Managed Care Pharmacy9(6), 559-568.
  2. Food and Drug Administration. (2011). Neurontin.
  3. K. Quigley, V. Adhlakha, P. Reddy, A. Miller. (n.d.). Prevalence of Gabapentin Abuse Among Clinical Patients. Presentation Abstract.
  4. Smith, B. H., Higgins, C., Baldacchino, A., Kidd, B., & Bannister, J. (2012). Substance misuse of gabapentin. The British Journal of General Practice62(601), 406–407. http://doi.org/10.3399/bjgp12X653516.
  5. Middleton, O. (2011). Suicide by gabapentin overdoseJournal of forensic sciences56(5), 1373-1375.
  6. Medscape. (2015). Gabapentin New Drug of Abuse?
  7. American Foundation for Suicide Prevention. (n.d.). Risk Factors and Warning Signs.
  8. U.S. National Library of Medicine. (2016). Drug use first aid.
  9. U.S. National Library of Medicine. (2011). Gabapentin.
  10. Curtiss, F. R. (2002). Managing care via prior authorization (PA) programs? Journal of Managed Care Pharmacy, Vol. 8(4), 296. 
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