Gabapentin misuse means taking gabapentin (brand names include Neurontin) in a way other than prescribed, such as taking extra doses, using someone else’s pills or combining it with opioids or other drugs to increase a high. Gabapentin is often seen as low-risk, but misuse can lead to dependence, withdrawal and dangerous slowed breathing, especially when mixed with opioids. The U.S. Food and Drug Administration (FDA) has warned about serious breathing problems in people who take gabapentin with opioids or other sedating drugs.
If you or someone you care about has been using gabapentin in ways that feel out of control, you are not alone, and help is available. This guide covers why gabapentin misuse happens, the risks, what withdrawal looks like and how treatment works.
What Is Gabapentin?
Gabapentin is a prescription medicine. According to MedlinePlus, it is used to treat certain seizures, nerve pain after shingles (postherpetic neuralgia) and restless legs syndrome, and it is also used for diabetic nerve pain and hot flashes. A StatPearls review of gabapentin notes it is also prescribed off-label for conditions such as anxiety, fibromyalgia, migraine prevention and alcohol withdrawal.
Because it is so widely prescribed, many people assume gabapentin cannot be misused. But StatPearls points out that gabapentin can increase the euphoria caused by opioids, and it does not show up on standard urine drug tests. Those two facts help explain why some people misuse it.
Is Gabapentin a Controlled Substance?
Not at the federal level. StatPearls notes that gabapentin is not classified as a federally controlled substance, but several states have moved it to Schedule V, the lowest level of control. Rules vary by state, so ask your pharmacist or prescriber about the rules where you live.
Why People Misuse Gabapentin
People start taking more gabapentin than prescribed for different reasons, and many do not set out to misuse it at all. Common patterns include:
- Taking more than prescribed to get more pain relief or calm
- Combining it with opioids to boost their effects
- Taking pills not prescribed to them
People with an opioid use disorder face special risk. The FDA noted growing misuse and abuse of gabapentinoids together with opioids when it issued its 2019 warning. Learn more about opioid addiction and its treatment.
Warning Signs to Watch For
It is not always easy to tell when gabapentin use has crossed a line. Signs that use may be becoming a problem include:
- Taking larger or more frequent doses than prescribed
- Running out of a prescription early or asking for early refills
- Getting gabapentin from friends, family or other sources
- Using it together with opioids, alcohol or other sedating drugs
- Seeming very drowsy, dizzy or unsteady, or having slurred speech or double vision, which MedlinePlus lists as possible overdose symptoms
- Feeling anxious, sick or unable to sleep when a dose is missed
If several of these sound familiar, it is worth talking with a doctor or an addiction specialist. Reaching out early can prevent more serious harm.
Risks of Gabapentin Misuse
Dangerous Slowed Breathing
The FDA warns that serious breathing difficulties can happen with gabapentin in people who also use opioids or other central nervous system depressants, people with lung problems like COPD, and older adults. StatPearls adds that reports of slowed breathing and heavy sedation, occasionally fatal, have come from people taking gabapentin with opioids.
Overdose Deaths
A CDC report looking at overdose deaths in 23 states and Washington, D.C., in 2019 to 2020 found gabapentin in 9.7% of deaths. Among deaths where gabapentin was detected, 85% to 90% also involved opioids. Closer to home, the Pennsylvania Department of Health reported that fatal overdoses involving gabapentin among Pennsylvania residents rose from 19 in 2017 to 290 in 2020, while deaths involving gabapentin alone were rare (about 1%). In other words, gabapentin is most dangerous in combination with other drugs.
Mood Changes and Other Side Effects
MedlinePlus warns that gabapentin can cause unexpected mood changes, including suicidal thoughts, in a small number of people (about 1 in 500 in clinical studies). StatPearls lists common side effects such as dizziness, sleepiness, trouble with coordination, fatigue and impaired driving.
Signs of a Gabapentin Overdose
The FDA advises getting medical help right away for:
- Slowed, shallow or difficult breathing
- Extreme sleepiness or confusion
- Not responding
- Bluish lips, fingers or skin
Call 911 if you see these signs. If opioids may be involved, give naloxone (Narcan) if you have it. StatPearls notes there is no antidote for gabapentin itself, but naloxone can reverse the opioid part of an overdose. Learn how to use Narcan.
Gabapentin Withdrawal
Stopping gabapentin suddenly can cause withdrawal. According to MedlinePlus, symptoms can include:
- Anxiety
- Trouble falling or staying asleep
- Nausea
- Pain
- Sweating
For people who take gabapentin for seizures, stopping suddenly can cause more frequent seizures. StatPearls advises that doctors lower the dose gradually rather than stopping all at once to help prevent withdrawal seizures. MedlinePlus says not to stop taking gabapentin without talking to your doctor.
If you also use alcohol, benzodiazepines or opioids, be especially careful. Withdrawal from alcohol or benzodiazepines can be life-threatening and needs medical supervision. Talk with a medical provider before stopping anything. Our guide to medical detox explains when it is needed.
Treatment for Gabapentin Misuse
Treatment looks at the whole picture: the gabapentin misuse, any other substance use and the pain, anxiety or sleep problems that may have led to it. A good plan often includes:
- A medical review and a safe, supervised plan for coming off gabapentin
- Treatment for opioid use disorder when needed, including medication-assisted treatment (MAT)
- Cognitive behavioral therapy (CBT) and other talk therapies
- Care for co-occurring anxiety, depression or trauma
- Relapse prevention and peer support
Frequently Asked Questions
Can you get addicted to gabapentin?
Gabapentin can be misused, and stopping it suddenly can cause withdrawal. The risk of harm is highest when it is combined with opioids or other sedating drugs.
Why is gabapentin dangerous with opioids?
Both can slow breathing. The FDA warns that taking them together can cause serious breathing problems, and CDC found opioids in most overdose deaths where gabapentin was detected.
Does gabapentin show up on a drug test?
StatPearls notes that gabapentin does not appear on standard urine drug tests.
Where can I get help right now?
If you are having thoughts of suicide, call or text the 988 Suicide & Crisis Lifeline. For a medical emergency, call 911.
Get Help for Gabapentin Misuse in Lancaster, PA
At The Ranch Pennsylvania Outpatient Services, we treat prescription drug misuse alongside opioid use, anxiety, depression and other co-occurring conditions. Our partial hospitalization program (PHP) offers full-day care five days a week, and our intensive outpatient program (IOP) fits around home and work. Treatment includes psychiatric evaluation, medication management, CBT and group and family therapy, and MAT may be available when clinically appropriate. If medical detox is needed first, it can be coordinated with residential care at The Ranch Pennsylvania. Explore prescription drug addiction treatment, read about Adderall addiction, or verify your insurance. Our admissions team is available 24/7, and calls are free and confidential.
