Is Gabapentin Addictive
Is Gabapentin Addictive?
Gabapentin is a prescription anticonvulsant pain killer most used to treat epilepsy, restless leg syndrome, fibromyalgia, and nerve damage. It is also used to help ease alcohol and drug withdrawal symptoms as part of a detox and supports relapse prevention. However, although there is a long history of gabapentin being effective in aiding all these conditions, due to the way that the drug interacts with the brain. As a result, there needs to be careful monitoring of patients taking gabapentin, especially those easily susceptible to addiction and may be taking gabapentin as part of substance abuse treatment. So then, is gabapentin addictive?
Let us begin by examining the history of gabapentin, how it works and why it is an effective medicine. It is a relatively new drug, first used in the 1990s and approved for US use by the FDA in the early 2000s. It is now one of the most widely prescribed medications in the country. Typical doses consist of 300 -1200mg taken in tablet form. It works as gabapentin has a similar chemical structure to Gamma-Aminobutyric Acid (GABA), which is the brain chemical that affects the nervous system.
As a result, gabapentin can impact the body’s nervous system by altering the body’s calcium channels and so ease seizures and reduce pain. It also induces feelings of calmness, relaxation, and pain relief; all of which are also beneficial to the treatment of nerve conditions and nerve pain. Its use in the treatment of substance addiction also relies on the calming effect on the nervous system, as it eases withdrawal symptoms such as agitation and anxiety.
Although gabapentin is used mainly to treat alcohol addiction when used to treat substance abuse, it is speculated that it may also be effective in patients detoxing from marijuana and benzodiazepines. However, there is not enough research yet to prove its usefulness for marijuana or benzodiazepines. Patients prescribed gabapentin are monitored carefully by their doctor through the time that they are taking it, as an addiction to gabapentin is increasingly common.
It seems ironic that a drug so widely used to help combat addiction is also one that patients can so easily become addicted to. Frequent use of gabapentin, as with any drug, can lead to dependency, and because gabapentin mimics GABA, which occurs naturally in the brain, this dependency is even easier to achieve. Although it is generally not considered an addictive drug by some medical professionals, as it does not react with the opioid receptors in the brain but targets the GABA neurotransmitters instead, it is possible to get withdrawal symptoms once someone stops taking gabapentin. Gabapentin provides users with a high as it calms the body, which is concerning as gabapentin is classed as a sedative.
As a result of being a sedative which provides a high, the likelihood of psychological as well as a physical addiction to gabapentin is higher, though still considered a substance with a low risk of addiction.
Signs of gabapentin addiction
Physical signs of gabapentin abuse include drowsiness, tremors, depression, suicidal ideation and behaviors, dizziness, forgetfulness, anxiety, coordination issues, fever, blurry vision, disorientation, respiratory failure, and inability to communicate or speak. Abusers of it, like those who abuse other prescription medications, will often “doctor shop” to get multiple prescriptions for gabapentin and make sure that no one notices what they are doing and spend too much money on medication.
While we have discussed the ways that users bend the above board medical system to obtain the gabapentin needed to feed their addictions, it is also important to discuss the use of it on the black market. On the street, it is increasingly popular, often referred to as “morontin”, “gabbies”, “johnnies”, or “rotties”. Users of gabapentin have noted that it has a similar effect to cocaine when crushed and snorted. We have discussed that it is not an opioid, but it is taken in conjunction with opioids such as cocaine and heroin, and which heightens the effect of such opioids, in turn, increasing the resulting high.
In recent years, it has been discovered that it is often “cut” with heroin, as it makes heroin doses cheaper, and emphasizes the effect of the heroin. As well as gabapentin heightening opioids’ effects on users, it also makes them dangerous. Both gabapentin and all opiates are drugs that sedate the user, slowing the central nervous system, which once impeded to a certain level, also triggers the respiratory system to slow, and therefore overdose.
Once the respiratory system slows enough – the heart is in jeopardy and, in the worst scenario, can stop. Similar effects result from the mixing of gabapentin and alcohol, where each drug will increase the potency of each in the body, increasing the toxicity within the bloodstream. The combination of substances can impair motor skills and cause blackouts, as well as other common symptoms of abusing both these substances individually.
Gabapentin on the brain
While gabapentin is a tool in treating alcoholism and drug abuse, it is also a medication that can become addictive easily, and can heighten the effects of alcohol or opiates, as well as provide a high of its own. The use of gabapentin has increased over recent years, both in the frequency of medical prescription and the rate of purchase illegally on the street. Given the ease with which gabapentin can affect neurotransmitters in the brain, mimicking a naturally occurring brain chemical, it is very easy to see how someone can become dependent on it.
Quick dependency is especially easy, and especially dangerous, as it is a sedative that provides users with a high in the same way many recreational drugs do. Due to these facets of the medication, it is only natural to conclude that gabapentin is addictive, emphasized in how it is used recreationally, mixing with and boosting other substances. The ease with which gabapentin creates dependency is even more concerning considering that one of its uses as a medication is to treat addiction withdrawal, and so being provided to already susceptible patients. Regardless of how else it is used, research and evaluation of its risks and benefits as a detox medication are needed.
References: Gabapentin Addiction
- Petroff OA, Hyder F, Rothman DL, Mattson RH. Effects of gabapentin on brain GABA, homocarnosine, and pyrrolidinone in epilepsy patients. Epilepsia. 2000;41:675–680. [PubMed] [Google Scholar]
- Gee NS, Brown JP, Dissanayake VU, Offord J, Thurlow R, Woodruff GN. The novel anticonvulsant drug, gabapentin (Neurontin), binds to the alpha2delta subunit of a calcium channel. The Journal of biological chemistry. 1996;271:5768–5776. [PubMed] [Google Scholar]
- Radley DC, Finkelstein SN, Stafford RS. Off-label prescribing among office-based physicians. Archives of internal medicine. 2006;166:1021–1026. [PubMed] [Google Scholar]
- Hart CL, Ward AS, Collins ED, Haney M, Foltin RW. Gabapentin maintenance decreases smoked cocaine-related subjective effects, but not self-administration by humans. Drug and alcohol dependence. 2004;73:279–287. [PubMed] [Google Scholar]
- Voris J, Smith NL, Rao SM, Thorne DL, Flowers QJ. Gabapentin for the treatment of ethanol withdrawal. Substance abuse. 2003;24:129–132. [PubMed] [Google Scholar]
- Roberge RJ, Francis EH., 3rd Use of naloxone in valproic acid overdose: case report and review. The Journal of emergency medicine. 2002;22:67–70. [PubMed] [Google Scholar]
- Larance B, Degenhardt L, Lintzeris N, Winstock A, Mattick R. Definitions related to the use of pharmaceutical opioids: extramedical use, diversion, non-adherence and aberrant medication-related behaviours. Drug and alcohol review. 2011;30:236–245. [PubMed] [Google Scholar]
- Hakkinen M, Vuori E, Kalso E, Gergov M, Ojanpera I. Profiles of pregabalin and gabapentin abuse by postmortem toxicology. Forensic science international. 2014;241:1–6. [PubMed] [Google Scholar]
- Spiller HA, Dunaway MD, Cutino L. Massive gabapentin and presumptive quetiapine overdose. Veterinary and human toxicology. 2002;44:243–244. [PubMed] [Google Scholar]
- Drug Enforcement Administration Department of Justice. Schedules of controlled substances: placement of pregabalin into schedule V. Final rule, Federal register. 2005;70:43633–43635. [PubMed] [Google Scholar]
- Tran KT, Hranicky D, Lark T, Jacob N. withdrawal syndrome in the presence of a taper. Bipolar disorders. 2005;7:302–304. [PubMed] [Google Scholar]