What is Gabapentin?
Gabapentin, a gamma-aminobutyric acid analog drug, has been used since 1993 as a seizure treatment. In 2004 generic forms were authorized. The drug has been used to treat pain (as the chemical makeup of Gabapentin mimics that of opioids and cocaine). According to a study by the University South Carolina School of Medicine, there was no objective evidence that this drug reduced pain. Still, the pharmaceutical industry widely promoted its off-label use. It is categorized in some states as a controlled substance, but not all.
Gabapentin is best known as Neurontin, Gralise, or Horizant, but these brands are not interchangeable. The drug is available in several forms: tablets, oral solutions, capsules, and extended-release tablets. It is used for various medical issues, from essential tremors, mood disorders, anxiety, interstitial cystitis, social phobia, PTSD, etc. Ninety-five percent of Gabapentin prescriptions today are for off-label use.
Gabapentin mirrors the effects of naturally occurring GABA on neurons in the brain; however, it does not attach to the GABA neurons. Because of the ability to calm excited neurons, Gabapentin is prescribed for people suffering from alcohol and substance abuse. But there is growing evidence that Gabapentin, when used by someone suffering from alcoholism or substance abuse, or a combination of the two, can lead to abuse and addictive behavior. The likelihood of misuse increases significantly with those individuals who abuse alcohol and substances compared to the general population.
Common Side Effects of Using Gabapentin
- Feeling tired
- Nausea and vomiting
- Difficulty speaking
- Recurring infections
- Memory loss
- Weight gain
- Movement problems: coordination problems, being unsteady, tremors, jerky movements
- Eye problems: unusual eye movements, double vision
Generally, using opioids in combination with Gabapentin can lead to hospitalization.
Serious Side Effects
More severe side effects can include:
- Skin rash
- Bluish-color or tinted skin: lips, fingers, toes
- Trouble breathing
- Suicidal thoughts
- Liver abnormalities: Yellowing of the skin, whites of the eyes, dark urine, bruising
- Kidney abnormalities: Trouble urinating, blood in urine, swelling of legs and feet
Whether taking Gabapentin for medical issues or using it in conjunction with other drugs, emergency help will be required if the individual has the following:
- Suicidal thoughts
- Acting on dangerous impulses
- Acting angry or violent
- Worsening depression or anxiety
- Talking excessively
- Engaging in manic activity
Growing Number of People Taking Gabapentin
How frequently is Gabapentin prescribed? According to a study conducted in 2018, prescribing this drug increased by 64% from 2012-2016! “US commercial insurance claims database found a direct relationship between all-cause and drug-related inpatient hospital and emergency department utilization and increasing degrees of gabapentin overuse. Patients with prolonged overuse of concomitant Gabapentin and opioids were significantly more likely to experience an all-cause or drug-related inpatient hospital stay and, more specifically, an inpatient hospital stay or emergency department visit for altered mental status or respiratory depression.”
Sadly, Gabapentin has been targeted at older adults with numerous medical issues and who have more than one opioid or benzodiazepine prescription. With the increase in prescribing Gabapentin off-label, there has also been an increase in the rates of adverse effects. The withdrawal symptoms of the drug can be worse for older adults.
Long-term consequences of taking Gabapentin may include:
- Respiratory failure
- Memory loss
- Weakened muscles
People who use drugs recreationally or addictively believe that the combination of Gabapentin and other drugs intensifies the high. There is a greater chance of more severe side effects from arbitrarily combining illegal and legal drugs. For example, snorting Gabapentin increases the risk of addiction and overdose. Snorting increases the risk of overdose because the drug bypasses the digestive system and goes directly to the bloodstream. When people snort the drug, they lose track of how much they have consumed, which leads to a higher risk of overdose.
Sometimes withdrawal symptoms from Gabapentin will be attributed to benzodiazepines or ethanol. One or more of these drugs will be reintroduced to minimize the withdrawal symptoms. However, withdrawal symptoms will not cease until Gabapentin is prescribed. Then, the client must go through tapering off the Gabapentin but will still go through withdrawal. The medical staff needs to monitor the discontinuation of the drug. There are no approved treatments for withdrawal from Gabapentin other than a slow reduction of dosage. Abruptly stopping the medication can lead to seizures.
“It is becoming increasingly evident that Gabapentin may be subject to abuse in particular populations. Case reports describe gabapentin misuse in patients with prior histories of substance abuse and dependency, either to deal with cravings or abstinence symptoms or as a substitute for substances such as cocaine. Drug users seeking pleasurable effects (e.g., euphoria) abuse gabapentin at various doses.” Users also know that Gabapentin will not show up on a standard urine test, especially those testing for cannabis or heroin.
Researchers are now writing about the potential for abuse with Gabapentin, even its use in treatment facilities. While it is true that some addicts can be helped through the withdrawal of drugs and alcohol using Gabapentin, others cannot. Researchers are calling for a re-evaluation of the drug and its addictive qualities. According to some researchers, Gabapentin abuse is a marker toward relapse, especially for those with a substance abuse history.
Best practices suggest a medically supervised detoxification as a necessary step toward recovery. Medical staff and clinicians in a licensed detox facility will evaluate the client’s needs and develop a withdrawal treatment plan while closely monitoring the client. All plan adjustments will then be made in an appropriate medical and clinical manner.
Once a client completes detox, he/she/they should move immediately (recommended) into a treatment program (inpatient or outpatient). In the treatment facility, a personalized treatment plan will be implemented, which usually includes but is not limited to the following:
- Group therapy
- Individual counseling
- Family therapy
- Medication management
- Life Skills
- Career Exploration
- Alternative treatments (yoga, meditation, etc.)
If you or a loved one suffers from Gabapentin (Neurontin, Gralise, Horizant) abuse or a combination of drug addictions, call us today! We can help you or your loved one form a solid foundation for recovery.