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Gabapentin is not a controlled substance, but the drug still has the potential for abuse. Often, people abuse this drug because it can make them feel intoxicated or “drunk.” Reports show that gabapentin abuse is becoming increasingly common in Ohio and throughout the country.
This uptick in gabapentin abuse rates has made many people wonder about what the drug is, whether it’s addictive and what the risks of abusing it may be.
The brand name of gabapentin is Neurontin. It is used as a treatment for seizures caused by epilepsy, and it can also treat pain related to neuropathy. It also has a number of off-label uses. An off-label use is when a medication is used in a way that is not approved by the Food and Drug Administration (FDA).
Gabapentin commonly comes in capsules, but it is also available as a liquid formulation. Some of the formulations are also made as tablets, which are similar to the capsule formulation. The extended-release version is called Gralise and only needs to be taken once daily.
Gabapentin is believed to work by calming overactivity in the brain. When someone takes gabapentin, it may increase the brain’s gamma-aminobutyric acid (GABA) activity. GABA is a natural neurotransmitter in the central nervous system.
When you’re feeling stressed out or anxious, GABA is responsible for calming nerve impulses and helping promote a sense of calm. With the use of gabapentin, the calmed neural activity can reduce pain and cause relaxation.
Gabapentin does not bind directly to GABA receptors, which is probably the main reason its addictive potential is low. It seems to make the receptors more sensitive to the GABA that is already present in the system. This mechanism is similar to how alcohol or benzodiazepines work.
Gabapentin is primarily removed from the body via the kidneys. If you are prescribed gabapentin, your doctor will measure your kidney function to ensure you receive the correct dosage.
Gabapentin does have the potential to be addictive. Although gabapentin isn’t as addictive as opioids, anytime a drug changes the activity of neurotransmitters in the brain — particularly dopamine receptors — it can lead to abuse and addiction.
Factors that play a role in whether someone becomes addicted to gabapentin or how quickly an addiction forms include:
The question of how long it takes to get addicted to gabapentin is difficult to answer because everyone’s physical and psychological composition is different. One person may use gabapentin and never become addicted. Another person may use it briefly and become addicted.
The vast majority of people will not become addicted to gabapentin, so it is not considered a controlled substance. Someone would likely need to abuse gabapentin for a very long time to become addicted.
Gabapentin is available in several different formulations, including capsules, tablets and a liquid formulation. Regardless of the formulation a person uses, the dosages are equivalent. For example, 300 mg of gabapentin in capsule form is equal to 300 mg in liquid form. An exception is the extended-release formulation, which is designed to last for 24 hours. Gralise cannot be converted equally to immediate-release gabapentin.
Common dosages for immediate-release and liquid gabapentin include:
These values will be different for people with kidney disease.
Gabapentin is a mild depressant that causes nervous system cells to activate more slowly. As a result, side effects are related to slower vital signs and mental function. Typically, the side effects are worse when starting gabapentin and when increasing the dose. Common side effects include:
Gabapentin by itself rarely causes overdoses, and only a few cases are known in medical literature. When a person takes higher and higher doses of gabapentin, it does not mean more gets into their system. The protein transporter in the small intestine becomes “saturated” with gabapentin, and there is a ceiling effect.
Unfortunately, combining gabapentin with other substances — particularly opioids — is dangerous. The combination increases the risk of an overdose because gabapentin and opioids are both central nervous system depressants. Using multiple substances simultaneously can also increase the risk of developing a polydrug addiction.
Research on people who died from drug overdose found that 22% had gabapentin in their system. This does not necessarily mean that gabapentin caused the overdose, but the drug is associated with one in five overdose deaths in the United States.
Symptoms of a gabapentin overdose can include:
If you suspect that you or someone else is overdosing on gabapentin, call 911 for emergency services. You should also call the Poison Center at 1-800-222-1222.
Gabapentin is frequently used with opioids because gabapentin increases the effects of opioids and creates a stronger high. Gabapentin is also much more widely available than opioids because it’s not a controlled substance. This increased level of availability means gabapentin is inexpensive, making it even more accessible.
In 2020, researchers conducted a study where they asked 250 former inmates in the United States about their history of prescription drug abuse. Approximately 16% reported abusing gabapentin in the past. If an inmate had an opioid use disorder, the risk of gabapentin abuse was over six times greater.
Gabapentin abuse can be hard to detect since it is more common among people who abuse other substances. If people take opioids, it will mask the symptoms of gabapentin abuse because the opioid-related symptoms would be more pronounced. Signs and symptoms of gabapentin abuse can include:
Gabapentin is addictive because it affects GABA production in the brain. When this happens, someone may experience feelings of euphoria or pleasant relaxation. Those pleasurable feelings can cause the brain’s reward response to be activated. The activation of the reward cycle in the brain can lead to the development of addiction.
Addiction (substance use disorder) is a pattern of behavior where a person continues to seek out a drug even when it affects their life in a negative way. Addiction can severely impact a person’s finances, relationships and job.
Someone addicted to gabapentin will show signs of abuse as well as a number of behavioral signs. The behavioral signs might be more obvious to a friend or family member. Examples include:
Along with addiction, physical dependence on gabapentin can develop. Dependence indicates that a person may experience withdrawal symptoms if they suddenly try to stop using gabapentin.
Withdrawal symptoms happen because the body is good at adjusting to foreign substances. Since gabapentin increases the effects of GABA, the body responds by decreasing GABA receptors. When someone stops taking gabapentin after they are dependent, they suddenly do not have enough receptors for their body’s needs. This situation leads to withdrawal.
Withdrawal symptoms typically start one to two days after stopping gabapentin without a taper. The symptoms are reported to be similar to alcohol or benzodiazepine withdrawal.
Gabapentin withdrawal is similar to alcohol withdrawal because both substances work in similar ways. As a result, a person can expect the same type of withdrawal symptoms with either substance. These include:
When a person is detoxing from a drug, their body is working to return to normal function. The process involves eliminating the drug from the system and then restoring normal receptor levels. In the case of gabapentin, GABA receptors will be too low after stopping it, and the body will need to make more.
The timeline of gabapentin detox is not clear because abuse and addiction are less common. The entire detox process can range from days to months, depending on the person and their usage level.
Gabapentin has a half-life of five to seven hours, meaning that half of the drug will be eliminated from the body in that amount of time. After 25 to 35 hours — or five half-lives — almost all of the drug will be gone. However, symptoms can last much longer than this as the body recovers.
Rather than quitting “cold turkey,” a person should consider undergoing medical detox during withdrawal. During medical detox, a team of addiction professionals can monitor and ease withdrawal symptoms. The most dangerous symptom of gabapentin withdrawal is a seizure, and medical detox can prevent this.
After medical detox, a person may choose to continue addiction treatment. Addiction treatment has different levels based on severity, including outpatient, intensive outpatient (IOP) and inpatient/residential programs.
For those in the Orlando area, The Recovery Village is a great option for addiction treatment. Our facility is staffed with trained and certified professionals who can help you throughout your recovery journey. You’ll also have access to our onsite exercise facility, pool, yoga, fire pit and many other amenities during your stay.
If you or someone you care about is struggling with gabapentin addiction, The Orlando Recovery Center can help. Contact us today to learn more about gabapentin detox and addiction treatment programs that can work well for your situation.
The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.