Gabapentin belongs to its own drug class, the Gabapentinoids. It is a medication used to treat epilepsy and is also used to relieve neuropathic or nerve pain resulting from disorders such as shingles, diabetes, or trigeminal neuralgia. Gabapentin is also used to treat migraines. The medication comes in tablet, capsule, or liquid format and is available on prescription. Gabapentin is also used as an alternative to opioids as it is considered less addictive.
Gabapentin works by changing the messages (or neurotransmitters) being sent to your brain by the nerves. When a nerve is not functioning well or something presses on it a false message can be sent to the brain. The brain believes the body is hurt when it is not, and you experience pain. By altering nerve messages, Gabapentin relieves pain. A similar process occurs in epilepsy where Gabapentin is used to calm nerves. It produces a feeling of relaxation and calm which helps reduce anxiety, nerve pain, and sleep disorders.
Gabapentin is involved with the GABA neurotransmitter, blocking nerve messages to the brain and relieving pain but does not appear to affect the nerve transmitters linked with benzodiazepines and opioids. For this reason, it is considered less addictive than other drugs but problems can still occur. The drug is also used to treat alcoholism and therefore has connections to dependence on substances. Gabapentin is not on the USA list of controlled substances. However this medication has effects similar to intoxication.
Gabapentin produces mild euphoria in a similar way to cannabis and also increases sociability and a feeling of calm. On the street, Gabapentin is known as gabbies or morontin. Drug users frequently mix it with other drugs to get an enhanced effect.
Although Gabapentin is considered a lower risk for addiction than some other opioids it can produce unpleasant withdrawal effects. The high experienced from Gabapentin can be addictive, leading people to use it more or combine with other narcotics. It can sometimes be seen as the first step on a downward spiral with drugs so stepping in early to stop dependence is crucial.
If someone is experiencing an excess of Gabapentin they will experience a range of symptoms that include:
The affected person may have most or just a few symptoms as each person will vary with how they report problems.
Clinicians or family members may identify a range of clinical signs that can indicate Gabapentin addiction. These may include all or some of the following behaviors:
Other signs there could be a problem with a Gabapentin dependence are multiple pill bottles lying around, or a sense of chaos in a home. Recognizing these signs and symptoms is vital because there is a potential risk to safety and to health. At a high dose of 800mg or more a person experiences a state of euphoria which does not reveal itself in drug screening. Typically, a Gabapentin abuser combines this drug with opiods to give an even stronger high. It is also possible to overdose fatally both with Gabapentin as a singular drug and in combination with others. There is no antidote to Gabapentin, unlike with opioid toxicity.
Anyone in a semi-comatose or comatose state suspected of taking Gabapentin should be taken to hospital. Call 911 for the paramedics and place the patient in the recovery position to ensure their airway does not become blocked.
In 2016 Gabapentin was the 10th most commonly prescribed medication in the USA with 64 million prescriptions dispensed. . Research shows that Gabapentin prescribing has doubled in recent years and is an ongoing public health concern in North America. The study by Pauly et al (2020) examined an insured population in the USA and found that prescribing had increased in almost every state, particularly in the Southern states. Women and those in age group 55-62 were more likely to be prescribed Gabapentin. They also identified the patients in the study had a higher level of mental health issues, diabetes, and seizures and were also being co-prescribed opioids. Data on USA drug use use shows that while drug costs to patients have lowered, the number of Gabapentin prescriptions has increased.
A further study on Gabapentin toxicity also found prescribing to be increasing. The study identified 74,175 Gabapentin exposures over 5 years (2013-17) a 73% increase. The researchers found the links to toxicity and increase in prescribing concerning, recommending care is taken when these are prescribed for patients. A Cochrane Review found Gabapentin to reduce pain by 50% in around 15% patients, thereby opening up potential for co-prescribing.
Work by Mersfellder et al (2016) indicated that 1.1% of the adult American population had a history of Gabapentin abuse with 22 percent of those attending an addiction support facility having had exposure to the drug. Increased prescribing of the drug is giving concern that this is linked to increases in other opioid drug prescriptions.
It takes courage to realize and acknowledge something is wrong and you may be suffering from Gabapentin abuse. Many people try to manage the situation themselves, hoping the problem will simply go away. It rarely does, and this is due to the lack of support that person has by trying to go it alone. People withdrawing from drugs like Gabapentin often need emotional support in addition to helping manage the physical effects of quitting the drug. Many people who go it alone do not succeed as they don’t have the support behind them or the helpp to manage side effects. This leads to a revolving door situation where they go back taking Gabapentin again.
Withdrawal symptoms from Gabapentin can be unpleasant. They include palpitations, flu-like symptoms,and rebound pain. Many of the people taking Gabapentin do so for a clinical reason and their underlying condition will need to be managed as they withdraw from the drug to ensure they do not experience complications from diabetes, epilepsy or their other medical problems.People withdrawing from Gabapentin have an increased risk of having a seizure which can place them in danger. By joining a rehabilitation program to support withdrawal from the drug, the process can take place in a structured manner. Most importantly, you will get the support you need to take this next step with your health.
Dependence on Gabapentin occurs when someone requires it to function normally. This situation can emerge after prolonged and excessive usage. Quitting by going cold turkey on Gabapentin can be dangerous so it is vital to enter a program so withdrawal can take place in a planned way. This reduces the chance of complications such as seizures. There are currently no FDA approved drugs for withdrawal from Gabapentin so most of the process is symptom management and supportive care.
A rehab center is an effective way of getting support to overcome Gabapentin addiction. The staff are trained to deal with these issues, and will ensure that any underlying medical problems are monitored in addition to treating the effects of Gabapentin withdrawal. They are skilled in teaching and supporting behavior change which will give you simple methods of self managing and avoiding further problems with drug abuse or addiction. By learning new techniques you will be in a better place to support yourself and avoid dependence on Gabapentin. Staff will also be able to help with anxiety and emotional support you may need when undergoing withdrawal from Gabapentin.
Withdrawal can take 10 days to 2 weeks to achieve but many people experience effects for months afterwards. Being monitored by a rehab center will help with this and support you in avoiding Gabapentin dependence in future. The professional staff in the rehabilitation center will liaise with other physicians involved with your care such as a diabetologist or neurologist to ensure that any care is joined up and they are aware of the issues experienced around Gabapentin.
Your therapist at the rehabilitation center will work out a recovery plan with you. This does not just include physical withdrawal from Gabapentin itself but includes plans for a longer recovery of your self-esteem, health, and well-being. Your plan will include goal setting which encompasses what you want to achieve and how to get there. It will include managing symptoms and using techniques such as distraction therapy to help you get through difficult and challenging moments. You will be encouraged to look at staying healthy and as well as possible in addition to your withdrawal from Gabapentin. If you require an alternative way of managing your pain for the reason you were prescribed Gabapentin in the first place, this will be reviewed alongside your treatment plan. In summary, your recovery is concerned with the short term challenge of Gabapentin withdrawal but you will also be supported to plan for the longer term so you avoid dependence on drugs of this nature.