Few prescription drugs are abused more commonly than prescription sedatives. Although Gabapentin is considered a safer sedative and analgesic compared to opioids, it still carries the potential for abuse. Recent drug use trends suggest gabapentin is involved in numerous fatal overdoses. Understanding the mechanism and signs of Gabapentin addiction can help avoid problematic abuse and identify early signs of addiction.
What is Gabapentin?
Gabapentin is primarily an anticonvulsant although it has powerful pain-numbing and sedative effects as well. It is a gabapentinoid, which means it works on the inhibitory neurotransmitter GABA in the brain. The drug mimics GABA in order to control motor function, cortical function, and vision. This is how it reduces the activity of the central nervous system, making it a key drug to treat conditions characterized by excessive nervous system activity including epilepsy, neurological pain, and anxiety disorders.
It is also prescribed to treat opioid withdrawal because it alleviates the physical symptoms of withdrawal. This means that it’s often taken by people with a history of addiction, making it more likely that gabapentin will also be abused. Though it is safer than other opioids, it can also cause a state of euphoria like dangerous opioids when taken at extremely high doses.
Though it can be very useful for people needing to regulate their motor activity or anxiety, the feelings of sedation and relaxation the drug produces can lead to abuse of the drug. The effect has been compared to the effects of marijuana, which can motivate people to use gabapentin outside of prescribed dosages. Though it is considered safe when used as directed, taking higher doses can lead to physical dependence and withdrawal, which makes addiction harder to overcome.
Like any prescription drug, gabapentin can have some adverse side effects. Typically, the likelihood and severity of the symptoms depend on how high the dose is and how frequently it is taken. These effects include:
- Drowsiness
- Nausea
- Vomiting
- Dry mouth
- Heartburn
- Tremors
- Blurred vision
- Abnormal or jerky eye movements
- Mood changes
- Depression
- Impaired coordination
- Anxiety
- Impaired speech
- Diarrhea or constipation
When taken at extremely high doses, typically outside of prescribed use, there may be more serious side effects including:
- Impaired memory
- Suicidal thoughts or impulses
- Swelling of hands and feet
- Exacerbated medical problems such as kidney and respiratory function
- Gabapentin toxicity, which can be fatal
Gabapentin toxicity is more common among people with kidney disease, because that can affect the rate of metabolization, leading the drug to stay in the body longer than usual. As a result, toxic amounts of gabapentin build up in the body over time.
Most drug panels do not screen for gabapentin, so gabapentin addiction may easily be obscured. Knowing the behavioral signs of gabapentin addiction is helpful in identifying problematic abuse or addiction.
Some behavioral signs of gabapentin abuse and addiction include:
- Intense cravings for gabapentin
- Spending more time obtaining, using, or recovering from gabapentin use
- Continued gabapentin use despite its social and financial consequences
- Decreased interest in hobbies and other enjoyable activities in favor of gabapentin use
- Taking higher or more frequent doses than prescribed
- Failed attempts to quit using gabapentin
- Tolerance, which means more and more of the drug is needed to achieve the same effect
- Withdrawal symptoms which occur if gabapentin use is discontinued
Gabapentin overdose
Gabapentin overdose is not highly likely but it is possible, especially when it is taken concurrently with other drugs and substances such as opioids or alcohol. People who have a history of abusing opioids may use gabapentin to enhance the effects of those drugs. Compared to illicit opioids, gabapentin is also relatively easy to obtain. It’s not a controlled substance, and prescriptions for it are common.
Overdose can occur with gabapentin and other drug use because the drugs can cause a synergistic effect which is more powerful as the effects of each drug are compounded when taken together. Gabapentin’s most dangerous drug interactions occur with other nervous system depressants, which have the same effect as gabapentin. At high doses, multiple nervous system depressants can lead to dangerously slowed heart rate or respiratory depression, which can cut off oxygen to the brain.
Gabapentin withdrawal occurs when the body is physically dependent on the substance. With continued use, especially excessive use, the body becomes accustomed to having gabapentin in the body. The drug takes over certain functions in the brain, which means that the nervous system can no longer function normally without it. If gabapentin is suddenly withdrawn, the body experiences a series of uncomfortable symptoms as the body begins to readjust. Withdrawal can begin within half a day after gabapentin use is discontinued, and symptoms may last for a week or more.
During this period, common symptoms of gabapentin withdrawal include:
- Anxiety
- Nausea
- Vomiting
- Excessive perspiration
- Inability to fall asleep or stay asleep
- Pain
- Seizures or tremors
The withdrawal period may be difficult to overcome without help. In cases of severe withdrawal, medical detox is recommended. During medical detox, a person’s vitals are monitored and their withdrawal symptoms treated to ensure that they are comfortable and to reduce the possibility of relapse. Detox alone is not enough to treat gabapentin abuse, but it is an important step in the recovery journey.
Gabapentin abuse and addiction is often present in conjunction with other substance abuse issues. This underscores the need to personalize addiction treatment so that a person’s individual needs and severity of addiction can be addressed. In the case of polysubstance use, the most dangerous drugs are prioritized in treatment. During detox, all substances are typically eliminated simultaneously.
Following detox, the focus of addiction treatment turns to underlying psychological or mental health issues that lead to or exacerbate substance abuse. Treatment is guided by a treatment plan, which can be individualized to address a person’s most pressing issues, whether that is mental illness, trauma, or difficulty coping with stress. Behavior therapy is held on a one-on-one basis with an individual therapist, but group therapy also plays an important role in addiction treatment. Through peer groups, individuals can develop long-lasting relationships with supportive and understanding people who can help them maintain sobriety.
The goal of therapy is to empower individuals to take their recovery into their own hands by learning and practicing skills and relapse-prevention strategies that can be maintained even after inpatient addiction treatment concludes. The most successful individuals stay involved in their recovery by attending therapy or peer group meetings on a continuous basis.
Gabapentin Addiction FAQs
Is gabapentin addictive if used as directed?
Gabapentin use, even medically regulated use, can lead to physical or psychological dependence. It’s important to be aware of symptoms of addiction and work with your primary care doctor to ensure that its use does not become problematic.
What makes gabapentin safer than opioids?
Opioids bind to opioid receptors, creating a far more powerful high that is characterized by deep relaxation and feelings of euphoria. Gabapentin only mimics GABA but does not bind to opioid receptors in the brain, so it does not create the powerful euphoric high.
Can I quit using gabapentin cold turkey?
Doctors warn against quitting gabapentin cold turkey because it will cause more severe withdrawal. It is always advised to slowly taper off use according to medical guidance. This makes withdrawal safer and easier.
