Gabapentin is a prescription medication used to manage medical conditions. Despite its therapeutic uses, individuals sometimes misuse the drug by taking it in ways not directed by a healthcare provider. This misuse can lead to various effects and health risks.
Understanding Gabapentin
Gabapentin is a gamma-aminobutyric acid (GABA) analog; its exact mechanism of action is not fully understood. It is believed to work by affecting neurotransmitter activity in the brain and nervous system, particularly by modulating calcium channels. This action helps calm overactive nerve signals, reducing pain and preventing seizures.
The U.S. Food and Drug Administration (FDA) has approved gabapentin for conditions including postherpetic neuralgia (a type of nerve pain following shingles), as an adjunctive therapy for partial seizures in adults and children with epilepsy, and for moderate-to-severe primary restless legs syndrome.
How Gabapentin is Misused
Misuse often involves taking gabapentin in ways other than prescribed, such as consuming higher doses. Some individuals take it more frequently than directed or without a valid prescription. While typically taken orally, some reports indicate crushing tablets for snorting or injecting, though oral administration remains the most common route.
A common practice is combining gabapentin with other substances, particularly central nervous system depressants like opioids, benzodiazepines, or alcohol. This combination can enhance the desired effects of these substances or produce a distinct “high.” Recreational users might consume dosages far exceeding therapeutic levels, sometimes ranging from 1,600 mg to 4,800 mg per day, compared to typical prescribed doses rarely exceeding 1,800 mg daily.
The Effects of Misuse
When misused, individuals may seek specific effects. These include euphoria, relaxation, or a sense of calm. Users may report an improved mood or a “sedative-like” high, particularly with high doses or when combined with other substances. Onset of these effects can vary, often appearing within a few hours.
Despite desired effects, misuse can also lead to immediate adverse side effects. Common issues include dizziness, drowsiness, and impaired coordination. Users might experience blurred vision, slurred speech, or confusion, impacting daily tasks. In severe cases, especially when combined with other central nervous system depressants, misuse can contribute to respiratory depression, where breathing becomes dangerously slow or shallow.
Risks of Misuse and Dependence
Misusing gabapentin carries risks, including physical and psychological dependence. Prolonged misuse can lead to the body adapting to the drug, meaning abrupt cessation can trigger withdrawal symptoms. These symptoms may include anxiety, insomnia, nausea, increased pain, and in severe cases, seizures, necessitating medical supervision for discontinuation.
Overdose risk is a serious concern, particularly when gabapentin is combined with other central nervous system depressants like opioids. This combination can synergistically depress the respiratory system, leading to severe respiratory depression, coma, or death. Increasing rates of gabapentin co-prescribing with opioids have raised alarms about this heightened overdose risk.
Beyond health consequences, obtaining or possessing gabapentin without a valid prescription can have legal implications. While not a federally controlled substance in the U.S., several states have classified gabapentin as a Schedule V controlled substance due to growing concerns about its misuse. This scheduling means unauthorized possession or distribution can result in legal penalties, reflecting its potential for abuse.