Gabapentin Effects, Addiction, & Treatment
In This Article
What is Gabapentin?
Gabapentin is an anticonvulsant, or anti-seizure, medication. While it is most commonly used to treat chronic neuropathic (or nerve) pain, gabapentin has other uses, such as fibromyalgia and hot flashes.
It's also used to treat alcohol use disorder. One study found that gabapentin effectively treated alcohol dependence as well as relapse-related symptoms.11
Gabapentin works in the nervous system by suppressing nerve impulses making their way to the brain.
More specifically, it does this by interacting with the ion channels found on the outside surface of nerve cells. These channels modulate if and how fast these cells are able to communicate an electrical message, such as a pain signal.
Although gabapentin is quite effective at reducing nerve pain, the use of this drug is not without serious side effects or risks. Gabapentin misuse can lead to addiction.
Side Effects of Gabapentin
The therapeutic potential of gabapentin is somewhat offset by a range of side effects that can result from its use. These side effects can range from mild to very serious, even fatal.
The most common side effects of gabapentin include:
- Visual problems (including myopathy)
- Suicidal ideations
- Self-harm behaviors
- Allergic reactions
- Respiratory depression
- Respiratory failure
Two side effects that pose a particular risk are diarrhea and vomiting. These conditions cause the body to lose a lot of water quickly. A person's blood pressure can drop dramatically, which can lead to heart failure. This is much more likely to happen when someone tries to quit gabapentin “cold turkey.”
How Addictive is Gabapentin?
The likelihood of gabapentin addiction has traditionally been considered low compared to other drugs. For that reason, the Drug Enforcement Agency currently does not consider it a controlled substance.
There has been a move in recent years to change that classification, and some states have already made gabapentin a controlled substance.
These states include:
- West Virginia
- North Dakota
Despite being less addictive than opioids, gabapentin use can still lead to addiction and withdrawal symptoms.
There are several characteristic symptoms of gabapentin addiction, including changes in mood and behavior, as well as physical signs.
Some of these symptoms include:
- Poor coordination
- Muscle tremors
Other signs of gabapentin addiction include:
- Taking more than prescribed
- Using it in an unintended way (e.g., crushing to snort it)
- Deficits in school or work performance
- Changes in social circles
- Engaging in secretive behaviors
The most prominent symptom of gabapentin addiction is physical dependence. This is characterized by withdrawal symptoms upon cessation of drug use.
Symptoms can include:
- Light sensitivity
Other Risks of Gabapentin
Due to its extensive side effects, gabapentin use (even when legally prescribed by a physician) is risky. For instance, side effects such as diarrhea and vomiting can be dangerous if not taken seriously.
In one study conducted in the Appalachian region of the U.S., 22% of those who died of a fatal drug overdose had gabapentin in their system. In that same study, gabapentin was also listed as a “contributing factor” on 40% of death certificates in Kentucky and 57% in North Carolina.9
In another study involving patients prescribed opioids, treatment regimens including gabapentin were associated with a significant increase in the risk of opioid-related overdose and death.10
One contributing factor is time. When people take gabapentin for a long time, they become dependent on it. However, some people abuse gabapentin recreationally for its sedative and psychoactive effects.
If someone is addicted to gabapentin and stops taking it, they will experience withdrawal symptoms, as described above. These withdrawal symptoms can be dangerous, even deadly. This is why it is very important to have medical supervision when going through gabapentin detox.
The safest way to quit using gabapentin is to go to an inpatient treatment facility. There, people go through the detox process under constant medical supervision. There are many treatment facilities throughout the country.
The following can be done on either an inpatient or outpatient basis (depending on addiction severity):
- Therapy and counseling
- Mutual support groups
- Additional support (vocational rehab, case management services, and occupational therapy)
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- Bastiaens, Leo, Galus, James, Mazur, Cherise. “Abuse of gabapentin is associated with opioid addiction.” Psychiatric Quarterly. 2016.
- Gomes, Tara, et al. “Gabapentin, opioids, and the risk of opioid-related death: a population-based nested case–control study.” PLoS Medicine. 2017.
- Hellwig, Thaddeus R, Hammerquist, Rhonda, Termaat, Jill. “Withdrawal symptoms after gabapentin discontinuation.” American Journal of Health-System Pharmacy, 2010.
- Kukkar, Ankesh, et al. “Implications and mechanism of action of gabapentin in neuropathic pain.” Archives of Pharmacal Research. 2013.
- Mason, Barbara J, et al. “Gabapentin treatment for alcohol dependence: a randomized clinical trial.” JAMA Internal Medicine. 2014.
- Quintero, Gabriel C. “Review about gabapentin misuse, interactions, contraindications and side effects.” Journal of Experimental Pharmacology. 2017.
- Straube, Sebastian, et al. “Single dose oral gabapentin for established acute postoperative pain in adults.” Cochrane Database of Systematic Reviews. 2010.
- Wiffen, Philip J, et al. “Gabapentin for chronic neuropathic pain and fibromyalgia in adults.” Cochrane Database of Systematic Reviews. 2014. Slavova, Svetla et al. “Prevalence of gabapentin in drug overdose postmortem toxicology testing results.” Drug and alcohol dependence vol. 186 : 80-85. doi:10.1016/j.drugalcdep.2018.01.018 Gomes, Tara et al. “Gabapentin, opioids, and the risk of opioid-related death: A population-based nested case-control study.” PLoS medicine vol. 14,10 e1002396. 3 Oct. 2017, doi:10.1371/journal.pmed.1002396
- Anton, Raymond F et al. “Efficacy of Gabapentin for the Treatment of Alcohol Use Disorder in Patients With Alcohol Withdrawal Symptoms: A Randomized Clinical Trial.” JAMA internal medicine vol. 180,5 : 728-736. doi:10.1001/jamainternmed.2020.0249