Problems with Gabapentin Misuse are a Sign of Improper Prescribing: Report

Gabapentin problems with misuse and abuse are increasing, with overdoses often involving the use of opioid medications as well, researchers found.

Overdose deaths linked to the epilepsy drug gabapentin have increased in recent years, often involving combined use with opioid pain medications, according to the findings of a new report that suggests the problems with gabapentin must be addressed by more diligent prescribing practices.

Gabapentin is a prescription medication commonly used to treat epilepsy and nerve pain. It is a member of a class of anti-seizure drugs known as gamma-aminobutyric acid (GABA) analogs. GABA is a neurotransmitter produced by the body. Gabapentin is a derivative that is used to reduce nerve activity.

However, the drug is also often used off-label for other conditions, including pain management, depression, bipolar disorder, and other psychological conditions. Common brand names include Gralise, Horizant, Neurontin, and Neuraptine.

In a new report published last week in the Journal of the American Medical Association (JAMA), researchers warn that the growing problem with gabapentin off-label use appears to be linked to misuse and abuse.

Researchers indicate that misuse and overdoses involving gabapentin often also involve opioid medication, such as Vicodin and OxyContin. The JAMA report also indicates that many of the gabapentin problems involve the synthetic opioid fentanyl.

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Earlier this year, the U.S. Centers for Disease Control and Prevention (CDC) warned about the growing problems with gabapentin abuse, indicating that from 2019 to 2020, it was the cause of 3,000 deaths, and that gabapentin was involved in 10% of fatal overdoses across 23 states.

In the first quarter of 2019, 57% of fatal gabapentin overdoses also included illicit opioids. By the fourth quarter of 2020, that number rose to 69%.

Gabapentin on its own can cause severe breathing difficulties, but those side effects are exacerbated when used with other central nervous system depressants like opioids and antidepressants.

Early Signs of Gabapentin Problems

Research published in 2017 indicated many users began to misuse gabapentin after receiving a prescription for off-label uses, such as treatment of pain, detox or anxiety.

The consumer safety organization Public Citizen called for the drug to be classified as a schedule V controlled substance, indicating that users often take the medication to get high, which leads to increased rates of addiction, abuse and overdose.

The JAMA report warns the problem of gabapentin misuse and abuse is growing, and is greatly connected to the ever-worsening opioid epidemic. The authors of the report argue the drug should not be banned or “demonized” along with drugs like opioids. Instead, they call for a personalized approach to patient care.

Doctors should have a clear plan for how long the drug will be used, how to determine if it’s helping, what will lead them to stop prescribing it and other safeguards to help reduce the number of users being hooked on a drug that is leading to a growing problem of overdose deaths, researchers concluded.

28 Comments

  • CareyNovember 5, 2022 at 8:51 pm

    I’m going to need a lot of help from my daughters in a few more years and will probably end up living with one of them. While on Gabapentin since somewhere around 2013, couldn’t breathe, so was put on 3 different types of breathing meds, 4 times a day as well as to types of nose sprays. Almost died last October, now I’m left with of course breathing issues, 2 heart valves leaking, congesti[Show More]I’m going to need a lot of help from my daughters in a few more years and will probably end up living with one of them. While on Gabapentin since somewhere around 2013, couldn’t breathe, so was put on 3 different types of breathing meds, 4 times a day as well as to types of nose sprays. Almost died last October, now I’m left with of course breathing issues, 2 heart valves leaking, congestive heart failure, fluid on the lungs, terrible memory loss, plus a lot of eye issues. Just got my glasses this past August and I already need another exam, but Medicare only pays for one exam per year, so have to wait till August, I’m also left with cataracts in both eyes. Was diagnosed the year before in 2020 and this last exam they told me they r growing way to fast, so I’m no longer allowed to drive at night. Almost died from all this last October, when my gastroenterologist took me completely off Gabapentin. The cops and my daughters found me passed out for 3 days when my liver stopped functioning as well as my kidneys. So now they’re both damaged!! Please if u don’t want to end up like me, think very hard before u agree to take!!! I was placed on the max dose of 4800 mlgs per day, yes, 4800!! My memory has gone pretty quick and so far it’s not coming back. Forget Dr appointments, forget to pay certain bills, and somehow my daughters tell me I’m being mean to them and I don’t remember what i said and sometimes don’t remember even talking to them. I tell them I’m sorry if o said anything wrong today, if I did and if I talked to you!!! Never thought in my life at 60 I would end up this way!!!

  • BillOctober 8, 2022 at 11:21 am

    This stuff messed with my head. I felt like I was high and not in a fun way. I never want that feeling again.

  • MargaretOctober 6, 2022 at 5:28 pm

    I have been on gabapentine for 15 years. Started with 100 then went to 2 800s 3 times a day. My aprn decided I was over medicaid. Now I'm back to 100 2 times a day. I really wish for 1 week they could live in my body. Maybe they could understand.

  • MokaSeptember 29, 2022 at 12:33 pm

    I was on 1600 mg since 2014 just recently my Dr weened me off I had never damage in my back, neck and down my legs you name it I had pain. Wasn't on any Opioids I know it makes you gain weight but tget decided I needed a break for me it was mostly to help my headaches and it did help I guess your Dr has to be very competent to not overdose you.

  • ShaiSeptember 27, 2022 at 8:25 pm

    Speaking as a former opiate addict, the fact that there are increasing reports of gabapentin involved in overdoses with OTHER illicit opioids is not indicative that gabapentin is the problem, just that it is more commonly available. People who are on the opioid path are always going to be curious about any pill that even has a hint that it'll get them high in another way. I've yet to see a study t[Show More]Speaking as a former opiate addict, the fact that there are increasing reports of gabapentin involved in overdoses with OTHER illicit opioids is not indicative that gabapentin is the problem, just that it is more commonly available. People who are on the opioid path are always going to be curious about any pill that even has a hint that it'll get them high in another way. I've yet to see a study that gabapentin alone or even in combination with less powerful opiates is responsible for overdoses. I've been off and on gabapentin 300mg, taken twice daily, for three years for anxiety and depression, and it's VERY hard to abuse. All the positive feelings I get from it are really not multiplied much if I take more of it. Yes, it's a slightly better feeling, but not anywhere near worth running out the prescription. It's been an extremely helpful drug for me, and I actually try to save normal dose amounts for tough days by taking less from time to time, not more.

  • NancySeptember 23, 2022 at 7:28 am

    I take one 300mg.of Gabapentin before bed and do not get woken up with restless legs. It really works as I was getting restless legs every night and gaba. has been a blessing.

  • PeggySeptember 16, 2022 at 7:28 pm

    I've taken Gabapentin for years. It has helped with my nerve pain from spine problems. I have never felt any type of high taking this medicine. It's the illicit drugs that cause the over dose not gabapentin.

  • TanyaSeptember 15, 2022 at 7:04 pm

    I’ve been on gabapentin for about 3-4 yrs now and I take opioids and I’m an ex drug addict but it doesn’t make me want to overtake it or get me high or anything like that! It helps with the severe pain that I have and not once have I had any intention of over taking the meds or anything! If there are people out there dying on this medication it’s because they are doing it to themselves cause this [Show More]I’ve been on gabapentin for about 3-4 yrs now and I take opioids and I’m an ex drug addict but it doesn’t make me want to overtake it or get me high or anything like that! It helps with the severe pain that I have and not once have I had any intention of over taking the meds or anything! If there are people out there dying on this medication it’s because they are doing it to themselves cause this medicine has been out for a while but I mean there are people trying to get high on laundry detergent for the love of god stop blaming everything on the medicine because people are stupid! Not the medicine fault it’s the human taking it at fault! I’m so sick of everything being blamed on the medicine cause now they are making it almost impossible for people who really need it to be able to get it because of people wanting someone to blame because their loved ones couldn’t control themselves on it!

  • MikeSeptember 15, 2022 at 4:17 pm

    I have taken this drug for years in higher & higher doses. If anyone reading this actually believes there is any sort of "high" associated with gabapentin, they will be terribly disappointed. The only feel able affect is that of being tired and mentally foggy. If the person is actually high it is because of other drugs, not the gabapentin.

  • FrancesSeptember 15, 2022 at 4:10 pm

    I don’t understand the previous comments. I have been on gabapentin for 5 years now. I don’t have brain fog nor have I ever been high or had lung trouble. I have severe leg and foot pain and gabapentin takes 80% of the pain away. The neurologists like the medicine because it soothes the spine. I need something for the last 20% and the only thing they’ve come up with so far is the synthetic tramad[Show More]I don’t understand the previous comments. I have been on gabapentin for 5 years now. I don’t have brain fog nor have I ever been high or had lung trouble. I have severe leg and foot pain and gabapentin takes 80% of the pain away. The neurologists like the medicine because it soothes the spine. I need something for the last 20% and the only thing they’ve come up with so far is the synthetic tramadol which I take sparingly. But because of other peoples problems my doctor is reluctant to continue the script. I’m fine with something else if they can find something that works. Maybe the aforementioned people have something else going on.

  • KevinSeptember 15, 2022 at 1:10 pm

    I been taking gabapentin for years to help with my nerve pain of pins and needles type pain. It is working and I don’t take any opioids.

  • CindySeptember 15, 2022 at 10:36 am

    Can you mix gabapenten with parablin? I get gaba from VA. When I run out I fill in with parablin

  • MikeSeptember 15, 2022 at 7:56 am

    I have been in a non VA hospital for treatment after being taken off 1800 mg of gabapentin. I was cut cold turkey. Now they are saying I should have been slowly removed from its use. Was sent home. Could not find out what happened to me. Now on home care.

  • ElizabethSeptember 15, 2022 at 6:19 am

    I’ve been taking Gabapentin for 23 years. I take 3200mg per day. It calms the intense nerve pain in my back and legs. I would simply go crazy without it. The best way I can describe the pain is the feeling you get when you start to get sick with a fever and your skin starts to creepy-crawl- imagine that all the time.

  • ShawnSeptember 15, 2022 at 3:36 am

    I have been on it for years off and on. I take it for anxiety and depression. Personally I don't think it does anything to help but I'm also on Wellbutrin and hydroxyzine as well as effexor for my diagnosis. My breathing is horrible and I always feel tired.

  • EarleneSeptember 14, 2022 at 10:00 pm

    A few years ago a doc put me on 3600 mg a day as was going through chemo and had nerve damage. I was a frigging zombie and had such brain fog. My eye doc took me off it as said it was destroying my vision. Haven’t taken it since and do ok.

  • EricSeptember 14, 2022 at 9:45 pm

    Gabapenton is not the problem. It's taking them with the opiates that's bad. Gabapenton treats my neuropathy in my legs and I have no issues. I take as directed. This article is mis leading. Blaming gabapentin is stupid. It's still the opiates. You lead with gabapentin overdoses but then add "with illicit drugs". That's the real problem. Dr's prescribe them when they prescribe opiates. People like[Show More]Gabapenton is not the problem. It's taking them with the opiates that's bad. Gabapenton treats my neuropathy in my legs and I have no issues. I take as directed. This article is mis leading. Blaming gabapentin is stupid. It's still the opiates. You lead with gabapentin overdoses but then add "with illicit drugs". That's the real problem. Dr's prescribe them when they prescribe opiates. People like me that need them will be screwed over.

  • SheilaSeptember 14, 2022 at 6:16 pm

    I have been taking 1200 mg 3 times a day for a number of years for anxiety and nerve pain. I also take an antidepressant. I’ve only experienced a problem when I’m running low and take less than prescribed, mostly hightened anxiety. I take it on time 3 times a day with an alarm set on my phone. Without it I would have severe back and neck pain.

  • VickiSeptember 14, 2022 at 4:52 pm

    My husband was prescribed Gabapentin 900 mg per day. His whole body swelled and he began hallucinations. Basically, detoxed in the VA where it was prescribed.

  • VeronicaSeptember 14, 2022 at 4:29 pm

    I was on gabapentin for many years for chronic pain. The memory loss I have is awful. I was on the max dose of gabapentin and it was the worst thing I’ve ever taken. I so wish I could have my memories back, that is a dangerous dangerous drug.

  • RitaSeptember 14, 2022 at 3:44 pm

    I am taking Gabapentin for a pinched nerve in my back and the pain goes down into both legs as well. Gabapentin has helped but I'm a bit leary of the dosage. I take 400 MG a day but it does help.

  • AndySeptember 14, 2022 at 2:43 pm

    If been on gabapentin for 3 years I only take it at night to let me have a good night sleep I have osteoarthritis plus I had two cancers metistatic stage 3 melinoma plus stage 3 luekimia I also take 4 to 5 oxicodones daily plus the gabapentin I need them for all the pain but I don't use them for fun they are ok to use but only for patients that need them not for a kid out drinking at the bar I [Show More]If been on gabapentin for 3 years I only take it at night to let me have a good night sleep I have osteoarthritis plus I had two cancers metistatic stage 3 melinoma plus stage 3 luekimia I also take 4 to 5 oxicodones daily plus the gabapentin I need them for all the pain but I don't use them for fun they are ok to use but only for patients that need them not for a kid out drinking at the bar I was a bartender for years in Vegas when coke was the main party toy plus drinking now the party is pills that real patients need GROW UP AMERICA

  • ArleneSeptember 14, 2022 at 1:48 pm

    My husband died Thanksgiving morning 2021 with lung problems. He was a VA patient on Gabapentin for several years. He went from 300mg to 600mg. Why would he be prescribed Gabapentin when it causes lung problem?

  • SandySeptember 14, 2022 at 1:32 pm

    This is the only thing that takes care of the nerve pain that I have in my back. I do not abuse it but need it. I was on 16 pills before they gave me this one. Two pills a day is great. I feel like a human and want to live . Compared to the 16 I was on and hurt like I did . There is going to people that abuse everything. Instead of punishing them it’s always the innocent that gets hurt in the lon[Show More]This is the only thing that takes care of the nerve pain that I have in my back. I do not abuse it but need it. I was on 16 pills before they gave me this one. Two pills a day is great. I feel like a human and want to live . Compared to the 16 I was on and hurt like I did . There is going to people that abuse everything. Instead of punishing them it’s always the innocent that gets hurt in the long run I’m not addicted I only take when real pain hits and I can’t move

  • AlfredSeptember 14, 2022 at 11:16 am

    I've been on this drug for many years and I don't think that it does anything for pain and they have me on 2000 mg a day as well as a opioid for Sevier pain and also now have a heart condition and I wonder if so is not caused from the gabapenton

  • katgySeptember 14, 2022 at 10:19 am

    I was on it for almost 2 yrs for debilitating osteo arthritis knee pain. It caused severe brain fog everyday. yes it temp helped nerve pain but the brain fog side effect was horrible. I gradually got off of it.

  • DavidSeptember 14, 2022 at 9:15 am

    The Dr has had me on this medication for almost 2years I have been prescribed 75 mg and I take 2 every for hours last month my pharmacy had them on back order and I went like 5-6 days without the meds and I got so sick I thought I was gonna die I guess it is the same as Pregabalin that’s what I’m prescribed

  • JustinaSeptember 14, 2022 at 9:14 am

    I live in Massachusetts an my son is a drug addict. He was prescribed Gabapentin for two years . He overdosed numerous times . I called the doctor an told him not to give it to him cause he’s using it with opioids. All my son had to do was call the doctor on the phone an he would send it to the cvs. I called the doctor an told him he was doing drugs an not to give it to him anymore an the next tim[Show More]I live in Massachusetts an my son is a drug addict. He was prescribed Gabapentin for two years . He overdosed numerous times . I called the doctor an told him not to give it to him cause he’s using it with opioids. All my son had to do was call the doctor on the phone an he would send it to the cvs. I called the doctor an told him he was doing drugs an not to give it to him anymore an the next time my son called he told him not to tell his mother. His friend died from taking Gabapentin with opioids from another doctor an my son says he’s still giving it out but only with cash.

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