Gabapentin: The Drug You Need to Know About

Gabapentin is an FDA-approved prescription drug and an anticonvulsant that is primarily used to alleviate the conditions of epilepsy, neuropathic pain, hot flashes, and restless leg syndrome. Despite its widespread use in the field of medicine, it is classified as a Schedule V Controlled Substance in several states in the United States. This is primarily because Gabapentin abuse and addiction have become common in many patients today.

Gabapentin has a chemical structure, which is like Gamma-Aminobutyric Acid (GABA). It is a chemical produced in the brain and influences the body’s nervous system. GABA stimulates the sense of calmness and relaxation, helping relieve the symptoms of anxiety, pain, or poor sleep.

So, is Gabapentin used as a medication to alleviate nerve pain and epilepsy, or opening new avenues for drug abuse and misuse? Let’s understand in more detail here.

What is Gabapentin?

Gabapentin belongs to a class of prescription drugs known as anticonvulsants. It contains a special brain chemical that helps calm the excitability of neurons during seizures or pain. This helps alleviate the symptoms and provides relief. And this calming effect of Gabapentin is the primary reason why there is a growing incidence of drug abuse today.

Taking Gabapentin

Gabapentin is approved by the Food and Drug Administration as a ‘non-controlled substance’ in some states for the following uses:

Control and prevent partial seizures: The medication is commonly used in children above 3 years and adults who experience partial seizures or convulsions.

Relieve post-herpetic neuralgia in patients with shingles: In patients who have had shingles, nerve pain like that of stabbing or burning is common. Gabapentin is used to alleviate the symptoms of post-herpetic neuralgia, relieving nerve pain.

Helps control cancer pain: Combined with other opioid pain relievers, Gabapentin can help relieve pain and improve the quality of life for patients with cancer. However, this use is rare.

Helps prevent the conditions of restless legs syndrome: Gabapentin is often prescribed to provide effective treatment for moderate to severe restless legs syndrome.

What is restless legs syndrome?

Restless legs syndrome is a condition that causes an irresistible urge to move the legs. This is often accompanied by a crawling, itching, or tingling feeling in the legs. The condition generally worsens with age and can lead to insomnia and daytime fatigue. Gabapentin can help relieve the symptoms of restless leg syndrome and improve sleep quality.

Is the Use of Gabapentin Illegal in the United States?

The FDA presumes Gabapentin to be safer as a proven treatment to relieve neuropathic pain.

At the federal level, it is a non-controlled substance that is mostly prescribed for partial seizures and post-herpetic neuralgia (PHN). Gabapentin is also frequently prescribed to relieve the symptoms of diabetic neuropathy and restless legs syndrome.

Nevertheless, Gabapentin has its characteristic potential of drug abuse. Though it is still not considered a controlled substance in many states, its potential of addiction is being investigated. However, some states where this medication has been classified as a controlled substance are Alabama, Kentucky, Michigan, North Dakota, Tennessee, Virginia, and West Virginia.

States that have made Gabapentin reporting mandatory are Connecticut, Washington DC, Indiana, Kansas, Massachusetts, Minnesota, Nebraska, New Jersey, Ohio, Oregon, Utah, and Wyoming. Other states that are initiating mandatory reporting of this drug as a controlled substance are Delaware, New York, and Wisconsin.

Hence, Gabapentin use is not illegal in the United States because it mostly falls under the purview of Schedule V of controlled substances in only some states. Schedule V classification means the medication has a low potential of drug abuse and is currently approved for medical use in some treatments.

What are the Side Effects of Gabapentin?

Since Gabapentin often works by calming the nerves, it can cause temporary side effects such as:

Dizziness
Feeling tired
Nausea and vomiting
Headache
Fever
Memory loss
Difficulty speaking
Weight gain
Double vision or unusual eye movements
Movement or coordination problems, tremors, unsteadiness, jerky movements
Recurring infections

However, there are some serious side effects of using this drug. If you experience such symptoms, consult your physician right away. These include:

Changes in behavior or mood swings, including irritability and anxiety, depression, panic attacks, trouble sleeping, suicidal thoughts, feeling impulsive, inability to concentrate, or increase in activity.
Signs of allergic reactions like itching, peeling of skin, skin rashes, hives, wheezing, swelling of the face, etc.
Symptoms of kidney anomalies include trouble urinating, blood in the urine, swelling of feet and legs, weight gain, etc.
Symptoms of liver anomalies like dark urine, yellowing of the skin, vomiting, light-colored stools, unusual bruising, or bleeding, etc.

Warnings

In patients who already have a breathing disorder, Gabapentin can cause serious breathing troubles. If you experience extremely slow breathing, seek medical attention immediately. Changes in mood swings may happen and therefore, it is important to stay alert to avoid behavior changes or suicidal thoughts.

Avoid doing hazardous activities or driving until you know what side effects Gabapentin has. Drowsiness and dizziness are common side effects of using this drug, and may cause severe injuries, falls, and accidents.

Gabapentin Interactions with Other Substances and Medications

The drug can interact with other over the counter and prescription medications, herbal supplements, and vitamins. If you are using any medication or supplement, tell it to your physician before you take Gabapentin. Following are the primary substances that interact with this medication and may cause potential side effects:

Losartan, a drug used for high blood pressure
Caffeine found in cola, tea, and coffee
Mefloquine, an antimalarial medication
Magnesium oxide, which is used as an antacid and mineral supplement
Ethacrynic acid, a diuretic
Phenytoin, a drug used to control seizures
Morphine, an opioid-based medication for pain

Before you take the following types of medications, it is important that you tell your physician if Gabapentin is causing drowsiness or sleepiness in you:

Antidepressants
Anti Anxiety medications
Muscle relaxers
Antihistamines
Sleeping pills
Narcotics used for pain

Gabapentin for Recreational Use

At a federal level, FDA does not consider Gabapentin as a controlled substance. However, there has been a recent upswing in its recreational use. In 2016, a study was conducted on patients from addiction and pain centers in the United States. Surprisingly, a whopping 70 out of 323 patients were found to be using Neurontin – a type of gabapentinoid – without any prescription. And more shockingly, most of them were using it with an opioid, anxiety medication, or muscle relaxant.

Users of Gabapentin report a feeling of calmness, relaxation, and euphoria – and perhaps that is the reason why it is being increasingly used for recreational purposes. Some adverse effects of using this drug are “feeling high,” hallucination, increased energy or feeling doped up. Many users have reported experiencing “marijuana-like high,” which calms the senses. However, these effects primarily happen when someone takes Gabapentin beyond FDA’s recommended dosage.

Extended-release and its dosage

These types of forms are more prone to abuse as compared to their other forms. Gabapentinoids are water-soluble and have a short half-life, which makes them easily available for injection after crushing the pills. People who abuse Gabapentin report that they either snort it or mix it with water and inject it. Some people also mix Gabapentin with other drugs to increase its potency.

As FDA reports, recreational users of Gabapentin take 300-5000mg daily, which is more than 49 grams than the daily recommended dose. The prescribed dosage for long-term patients should not exceed 1800-2400mg per day, suggests FDA. But recreational users are consuming much higher dosages than this.

Most recreational users take the pill, while other ‘parachute’ them. It is a term used when pills are crushed and placed inside a tissue paper to swallow. Users have reported a stronger and faster high in this method. Snorting is another method of Gabapentin abuse, wherein the pills are crushed or grinded and then inhaled through the nose. Since the drug enters the bloodstream quickly in this method, it causes a faster high and increases the chances of addiction.

Owing to a significant rise in recreational use of Gabapentin, many states have classified it as a controlled substance or mandated reporting of its use.

Can I Mix Gabapentin With Other Substances?

Gabapentin misuse, dependence, and abuse are rising in the United States – primarily because it is not listed as a controlled substance by the FDA. Recreational users or addicts commonly take this drug in pill or powdered form. However, many users also combine it with other drugs and substances, such as cannabis, alcohol, baclofen, lysergic acid diethylamide, serotonin reuptake inhibitors, gamma-hydroxybutyric acid, and amphetamine.

Using Gabapentin in combination with other drugs as mentioned above can cause serious side effects, including severe breathing problems. Physicians often use this drug in combination with other medicines to relieve the symptoms of neuropathy pain. However, the use is restricted only to the recommended dosage and considered safe by the physicians. When used in combination with drugs that cause decreased awareness or sleepiness, it can cause serious breathing troubles and other health hazards.

When used in combination with these drugs (with or without alcohol), Gabapentin may increase the risks of overdose and even death in some cases.

Am I Addicted to Gabapentin? Common Gabapentin Misuse & Addiction Symptoms

When used in combination with these drugs (with or without alcohol), Gabapentin may increase the risks of overdose and even death in some cases.

Look out for these signs or behavior changes to understand if you are addicted to Gabapentin:

Personality changes, like saying or doing things that you would normally not do
Acting secretive, and moving away from family and friends
Less attention towards school or work
Visiting multiple doctors to get Gabapentin prescribed, stealing, or acting restless unless you get the drug
Poor grooming and personal hygiene habits
Lying to the doctor about addiction symptoms
Not quitting taking the drug despite financial, legal, or social problems
Additionally, signs of overdose include:
Slurred speech
Ataxia or loss of coordination
Ptosis or the upper eyelid drooping
Labored breathing
Tremors
Low or high blood pressure
Drowsiness and dizziness
Double vision
Excitedness and irritability
Diarrhea
Rapid heartbeat
Slow heart rate
Lethargy

If you are experiencing these symptoms in the long run, you may be addicted to Gabapentin.

Managing Gabapentin Withdrawal Symptoms

Gabapentin withdrawal occurs mostly in users who have an addiction or dependence on the drug. Over continued usage, a human body gets dependent on a drug and sudden withdrawal from the same may cause severe symptoms. Typically, these symptoms arise after 12 hours from taking the last dose. And they can be extremely serious if adequate help and support are not taken.

Some common symptoms include:

Surviving Gabapentin withdrawal can be challenging for both long-term abusers and people who have medication sensitivity. Mere willpower is not going to help; rather, it is important that you reduce the dosage gradually. It is crucial to seek consultation from an experienced practitioner who specializes in managing Gabapentin withdrawal.

Seek Expert Help to Manage Gabapentin Addiction

If you think you are addicted to Gabapentin, it is important to seek expert help immediately. There are proven ways to address Gabapentin addiction and withdrawal, usually starting with a detox program. It is a method to eliminate the drug from your body safely. Throughout the process, you will receive dedicated medical supervision. Later, you can consider getting comprehensive treatment through inpatient, outpatient, or residential approaches.

Long-term abusers or severe addicts may start with in-patient or residential treatment programs. They are safe, address individual needs, and provide continuous medical supervision – even for co-occurring health problems. Outpatient treatment is an ideal choice in the recovery phase.

However, it is more important to find someone trustworthy and experienced who you can talk to and who will stay with you throughout the journey of recovery.

Look for a Gabapentin addiction treatment center that offers comprehensive care and follow-up support. With the right help, you can overcome Gabapentin addiction and lead a healthy, drug-free life.

If you are struggling with Gabapentin addiction, don’t hesitate to reach out for help. There are many resources and treatments available to help you overcome addiction and lead a healthy life. Gabapentin addiction is a serious issue, but it is one that you can overcome with the right help.

Conclusion

In this Gabapentin article, we discussed what Gabapentin is, some of the signs and symptoms of Gabapentin addiction, and how to manage Gabapentin withdrawal symptoms. We also encourage you to seek expert help if you think you may be addicted to Gabapentin. Gabapentin addiction is a serious issue, but it is one that you can overcome with the right help. If you or someone you know is struggling with Gabapentin addiction, don’t hesitate to reach out for help. There are many resources and treatments available to help you overcome addiction and lead a healthy life.