Gabapentin, commonly sold under brand names like Neurontin, Gralise, and Horizant, is a prescription medication primarily used to manage certain neurological conditions. While it serves legitimate medical purposes, there has been a noticeable increase in its non-medical use. Understanding the reasons behind this growing misuse is important for public health. This article explores why individuals might abuse gabapentin and the potential risks involved.
What is Gabapentin and Its Legitimate Uses?
Gabapentin is classified as an anticonvulsant medication, also known as a gamma aminobutyric acid (GABA) analogue. It functions by mimicking the effects of GABA, a neurotransmitter that helps calm excited nerve cells in the brain, which play a role in seizures and pain signal transmission.
The medication is legitimately prescribed for several conditions. It is approved to prevent and control partial seizures in adults and children aged 3 and older. Gabapentin also helps relieve nerve pain following shingles. It is used to treat moderate-to-severe restless legs syndrome. Gabapentin is a controlled substance in some states due to its potential for misuse.
Reasons for Gabapentin Abuse
Recreational use is a primary reason for gabapentin misuse, as individuals seek a “high” or feelings of euphoria, relaxation, and calm. Users report effects similar to marijuana, cocaine, or alcohol, including increased sociability or a “drunk” feeling. These experiences vary depending on the user, dosage, and other factors.
Individuals may also self-medicate with gabapentin to alleviate symptoms such as anxiety, insomnia, or withdrawal from other substances. This is common among those with a history of substance abuse, who might use gabapentin to manage withdrawal symptoms from opioids or alcohol. Its mild sedative properties contribute to this appeal.
Another motivation is to enhance the effects of other drugs, especially opioids or benzodiazepines. When combined with these central nervous system depressants, gabapentin can potentiate their euphoric effects, leading to a more intense “high.” This combination significantly increases safety concerns due to compounded side effects.
The perception that gabapentin is a “safer” or less addictive alternative to illicit drugs or opioids also contributes to its misuse. As a legally prescribed medication not federally classified as a controlled substance, some believe it carries fewer risks or is easier to obtain. This accessibility, along with diversion through sharing or multiple prescriptions, makes it readily available for non-medical use.
Effects and Risks of Abuse
Abusing gabapentin can lead to immediate and long-term effects on the body and mind. Physical effects include pronounced drowsiness, dizziness, and problems with coordination and balance, sometimes resulting in slurred speech. These effects become more severe when gabapentin is taken in higher doses or combined with other substances.
A significant risk, particularly when mixed with alcohol or other central nervous system depressants like opioids, is life-threatening respiratory depression. Sudden cessation after prolonged abuse can also trigger withdrawal symptoms, including anxiety, insomnia, agitation, pain, nausea, sweating, and seizures. These symptoms are challenging to manage without medical supervision.
Psychological effects of gabapentin abuse include mood swings, impaired judgment, confusion, and increased anxiety or depression. Prolonged misuse can lead to dependence, where the brain adapts to the drug’s presence, causing withdrawal symptoms if use is stopped. This dependence can progress to addiction, characterized by compulsive substance use despite negative consequences.
While a gabapentin overdose alone is rarely fatal, the danger increases substantially when combined with other substances, especially opioids or alcohol. Overdose symptoms include severe drowsiness, double vision, slurred speech, diarrhea, and in rare cases, coma, particularly in individuals with kidney failure. Legal consequences may also arise from illicit use, possession, or diversion of the medication.
Recognizing Abuse and Seeking Help
Recognizing gabapentin abuse involves observing behavioral and physical changes. Behavioral signs include “doctor shopping” for multiple prescriptions, lying about symptoms for higher doses, or seeking early refills. Individuals might also exhibit secretive behavior, neglect responsibilities, or withdraw socially.
Physical symptoms of abuse include extreme drowsiness, unsteadiness, slurred speech, tremors, and memory problems. As tolerance develops, individuals may require higher doses to achieve desired effects. The appearance of withdrawal symptoms, such as anxiety, insomnia, or nausea, when gabapentin use is reduced or stopped, also signals dependence.
Professional help is advised for anyone suspected of gabapentin dependence, as safe withdrawal requires medical supervision. Abrupt cessation can lead to severe withdrawal symptoms, including seizures, making a gradual tapering off under medical guidance important. Treatment options involve medical detoxification, followed by behavioral therapies such as cognitive-behavioral therapy.
Inpatient rehabilitation programs provide a structured environment with intensive therapy and medical monitoring. Outpatient programs offer flexibility for individuals to live at home while attending counseling sessions. Support groups and aftercare programs are also available to help individuals maintain sobriety and address any co-occurring mental health disorders. Consulting a healthcare professional or addiction specialist is the first step if concerns about gabapentin abuse arise.