A Guide to Gabapentin Abuse

The Growth of Gabapentin Addiction in the US

Many substances in our society are deemed “legal” and yet they’re addictive and even dangerous when misused. These include alcohol, nicotine, and even some prescription medications that users can develop a tolerance to, and dependence on. This is exactly the case with Gabapentin abuse.

What is Gabapentin or Neurontin?

Gabapentin (a.k.a., Neurontin) is a prescription painkiller and anticonvulsant. It belongs to its own class of drugs known as Gabapentenoids. These medications are typically used in treating epilepsy and neuropathic pain. Some other anticonvulsant medications you may have heard of include Clonazepam, Diazepam, and Valium.

Other conditions for which Gabapentin is prescribed include detoxing from alcohol and cocaine, diabetic neuropathy, and fibromyalgia. The reason it’s prescribed for these conditions is that researchers have discovered that it alters calcium channels in such a way that it’s capable of easing nerve pain.

Why do Doctors Prescribe Gabapentin So Frequently?

Doctors frequently prescribe Gabapentin because it’s less addictive than Opioids, but many patients still abuse and become addicted to Gabapentin. This is because the medication has a similar structure to Gamma-Aminobutyric Acid (GABA) which is the chemical in your brain that affects your nervous system, making it feel calm and relaxed. Therefore, Gabapentin is known to help people with nerve pain, anxiety, and insomnia.

It’s important to look at GABA interactions in the brain. While GABA is very important for your health, too much of it negatively affects your central nervous system. This can result in conditions like epilepsy, seizures, and mood disorders. Additionally, when you don’t have enough brain activity you can develop hypersomnia or daytime sleepiness.

Gabapentin is one of those chemicals that promote GABA interactions. It happens when GABA attaches to your brain’s GABA receptors. Many people enjoy the calming feeling this can create. However, it’s important to understand that this is addictive.

What is Gabapentin Used to Treat?

Besides the uses that were already mentioned (e.g., epilepsy, neuropathic pain, anxiety, insomnia, detoxing from alcohol and cocaine, diabetic neuropathy, fibromyalgia) there are a variety of other reasons why doctors prescribe this medication. These include:

• Restless leg syndrome
• Hot flashes
• Controlling partial seizures (a.k.a. convulsions)
• Nerve pain after herpes
• Essential tremors
• Acute pain after an operation
• Partial seizures
• Herpes virus
• Shingles

Is Gabapentin a Controlled Substance?

Gabapentin is considered an alternative to opiates; therefore, you may think that the federal government would regulate it. This is something that they frequently do with controlled substances to prevent people from abusing or misusing them. Currently, they don’t consider Gabapentin a controlled substance. However, different states treat it differently:

• States that classify Gabapentin as a controlled substance include Alabama, Kentucky, Michigan, North Dakota, Tennessee, Virginia, and West Virginia.
• States that have mandated reporting include Connecticut, Indiana, Kansas, Massachusetts, Maine, Nebraska, New Jersey, Ohio, Oregon, Utah, Wyoming, and Washington DC. This means that these states track certain prescriptions, like Gabapentin, to flag those who may be misusing it or putting themselves at risk of overdosing.

Alternative Treatment Modalities for Pain

Today there are many ways of managing pain without opioids. While some people will choose to turn to Gabapentin for relief there are also holistic treatment modalities available. These include things like over-the-counter medications (e.g., Acetaminophen, Ibuprofen, Naproxen), exercise, physical therapy, massage therapy, counseling, acupuncture, and treating the areas with heat.

There are foods to help boost GABA production such as soy proteins, fermented yogurt, kefir, citrus fruits, walnuts, almonds, spinach, broccoli, sweet potatoes, lentil beans, and brown rice.

What are the Short-Term Effects of Gabapentin?

Doctors prescribe Gabapentin for both short-term and long-term treatment. Just how long you’re prescribed this medication depends on what condition you’re being treated for. Regardless of how it’s prescribed, there are some serious risks that you should know about.

When You Suddenly Stop Taking Gabapentin

You should never stop taking Gabapentin suddenly, especially if it’s been prescribed for seizures. Suddenly stopping this medication may result in a medical emergency known as epilepticus. This is a condition in which you’ll have short or long seizures for at least 30 minutes which is why doctors taper patients off Gabapentin. Typically, this will take at least one week to accomplish.

When You Miss a Dose or Don’t Take Gabapentin as Prescribed

In this case, Gabapentin won’t work as you expect. It may even stop working altogether since you need to always have a certain amount in your body for it to work properly. If you do happen to miss a dose, you should take Gabapentin as soon as possible.

When you remember this a few hours before you’re to take your next dose, make sure you only take one dose. You shouldn’t attempt to “catch up.” Doing so will cause the deceleration of your body’s symptoms resulting in muscle weakness, lethargy, drowsiness, and drooping eyelids

What Happen When You Take Too Much Gabapentin?

When you take too much Gabapentin it may result in you having dangerous levels of this drug in your body. Some of the symptoms you may notice include:

• Double vision
• Tiredness
• Slurred speech
• Loose stools

If you or someone you love has taken too much Gabapentin, you should contact your doctor or the local poison control center immediately. For severe symptoms, either call 911 or go to the nearest emergency room immediately.

Common Slang Terms for Gabapentin

Gabapentin has a few different brand names and a variety of street names. Its brand names include Neurontin and Gralise. Its street names include “Gabbies,” “Johnnies,” and “lady gaba.”

What are the Signs of Gabapentin Abuse?

It’s important to recognize the signs and symptoms of Gabapentin abuse. These effects can be detrimental not only to your health but also to your livelihood and safety. They include:

• Coordination problems
• Forgetfulness
• Drowsiness
• Changes in mood
• Anxiety
• Depression
• Suicidal thoughts/behaviors
• Tremors
• Dizziness
• Difficulty speaking

Unfortunately, while you may think someone is in recovery it’s possible to still see these signs because many people in early recovery from cocaine and alcohol will use high doses (800+ mg) to get a euphoric-like high. This works because Gabapentin is an opiate potentiate which means that it increases the high that you feel when you take it with opioids (e.g., heroin, fentanyl, oxycodone, morphine, codeine, hydrocodone). When a client abuses Gabapentin it doesn’t show up on drug screens which is why so many people can get away with it for quite a while.

Unfortunately, those who can hide their addiction for a while are putting themselves at higher risk of overdosing and dying. This is because the combination of opioids and Gabapentin frequently result in depressed breathing. If you already have chronic obstructive pulmonary disease (COPD) or you’re part of the elderly population, you’re at an even greater risk of overdose from this deadly combination.

Can you Overdose on Gabapentin?

It’s important to note that the National Institute on Drug Abuse states that the number of overdose deaths caused by this medication are steadily increasing. Part of this is because when an overdose occurs there isn’t an antidote that can be administered like with Opioid overdoses.

Typically, someone who abuses Gabapentin does so while also taking Opioids (e.g., heroin, Vicodin) so they get their desired high so these overdoses look similar to those that happen with Opioids. The main difference is that there isn’t an antidote available to block the substance from affecting the brain when someone overdoses on Gabapentin.

If someone shows signs of an overdose (e.g., drowsiness, lethargy, sedation, droopy eyelids, muscle weakness) you need to get them medical attention immediately. They’ll do everything they can to immediately treat any life-threatening symptoms but even still it’s possible that you may suffer from permanent damage to your body or brain. Sometimes this means giving activated charcoal to the patient to absorb the excessive levels of Gabapentin in a patient’s body.

What are the signs of overdose that you should watch for when someone is using Gabapentin? They include:

• Abnormally slow heart rate
• Depression of the respiratory system
• High or low blood pressure
• Lloss of control of body movements)
• Rapid heartbeat
• Slurred speech
• Double vision
• Tremors
• Dizziness

However, the biggest threat is lack of oxygen to your brain. This is because the central nervous system becomes depressed and breathing either slows down significantly or ceases. When your brain doesn’t get enough oxygen, rapid cell damage occurs resulting in brain damage. This is one of the main reasons why it’s so dangerous when illegal distributors don’t think twice about mixing Gabapentin with heroin. Since heroin users don’t know this is happening, they’re more likely to die from an overdose.

What do Gabapentin Withdrawals Feel Like?

Although there isn’t a high rate of addiction among Gabapentin users, those who do abuse it will suffer from withdrawal symptoms. Some of the most common withdrawal symptoms include:

• Mood swings
• Rebound pain
• Anxiety
• Sweating
• Cravings
• Flulike symptoms
• Pain
• Nausea
• Insomnia
• Suicidal thoughts and/or behaviors

These symptoms are nothing to “play” with. If you’re addicted to Gabapentin you’ll need help getting clean. A medical detox program is highly recommended due to the drug’s unpredictable and potentially serious withdrawal symptoms.

Medically supervised Gabapentin detox programs are both safe and effective, especially if you’re also abusing other drugs at the same time as you’re abusing Gabapentin – something that commonly happens as people seek to enhance Gabapentin’s affects. Gabapentin detox also reduces the likelihood of relapse, and is something we are expert in dealing with at Icarus Behavioral Health.

The Gabapentin Withdrawal Timeline

Anticipating the Gabapentin withdrawal timeline looks different for everyone depending on the following factors:

• Were you using Gabapentin for recreational or medical purposes?
• How much were you taking?
• Were you using any other drugs simultaneously?
• What is your medical background (e.g., age, lifestyle, overall health, genetics, mental health)?

Here is a general idea of what you can expect.

Week One

Withdrawal symptoms begin appearing within 12 hours of your last dose. Initially, these symptoms will be minor but they’ll start escalating on the second day. Fortunately, they’ll let up somewhat near the end of the week. Here’s a look at what you can expect and when you can expect it:

• The first 12 – 24 hours: anxiety, hand and body tremors, heart palpitations, seizures, sweating, headaches
• Day 3: rapid heart rate, fever, confusion, disorientation, agitation, restlessness, hallucinations, trembling
• Day 4 and 5: agitation, increased confusion, light sensitivity, anxiety

Week Two

This week will typically start with difficult, but you’ll begin feeling some improvement by its end. The risk of seizures, delirium, photosensitivity, headaches, cardiovascular hyperactivity, tremors, and diarrhea will reduce. The symptoms that remain are rarely fatal unless you have a pre-existing issue. Some of the symptoms you may experience during this week include:

• Strong Cravings for Gabapentin
• Increased Sensitivity to Light
• Increased Irritability or Aggression
• Increased Anxiety
• Depression
• Fatigue and Lethargy
• Insomnia
• Headaches
• Constant sweating
• Tremors or Shaking
• Muscle Pain
• Diarrhea, Nausea, and Stomach Pain
• Increased heart rate
• Hypertension

Week Three and Four

Physically you should feel better now, but psychologically you may still feel not quite, ‘100%’. These symptoms may feel more intense since you’re no longer distracted by the physical symptoms. Fortunately, these symptoms will improve by the end of the fourth week. However, you should expect to deal with the following throughout this time:

• Cravings for Gabapentin
• Increased Irritability
• Diaphoresis (constant sweating)
• Moderate Anxiety
• Depression
• Fatigue and Lethargy
• Insomnia

How is Gabapentin Abuse Treated?

When you frequently take excessive amounts of Gabapentin you’ll develop both a physical and a psychological dependence on the drug. This is because your body grows so accustomed to taking this drug that you need it just so you can feel and function normally.

Therefore, you should never quit cold turkey. Doing so can be dangerous and induce several severe withdrawal symptoms including sweating, anxiety, insomnia, pain, and nausea. Quitting cold turkey can also increase your likelihood of having a seizure which can be life-threatening. For all these reasons, you need to seek medication-assisted treatment for Neurontin, whether at the medically supervised detox setting we offer at Icarus Behavioral, or elsewhere.

Is Long-Term Recovery from Gabapentin Abuse Possible?

The short answer to this question is “yes.” However, just like with any other disease, it’s important to take your treatment seriously. There are several factors that play into your likelihood of remaining in sobriety.

Treatment Modalities for Gabapentin

Gabapentin abuse needs to be taken seriously. In other words, you should seek treatment for it like you’d seek treatment for any other substance abuse disorder. This means starting with detox in a controlled environment to slowly eliminate the substance from your body.

From there you’ll want to transition into either an inpatient or outpatient treatment program. Here are some facts that you need to know about each of these programs so you can choose what’s right for you.

Inpatient Treatment (a.k.a., Residential Treatment)

Anyone with a severe Gabapentin addiction or a co-occurring health issue should go inpatient to receive the intensive care they need. This means living at the facility where you’ll not only receive a high level of care, but you’ll also have a safe environment in which to live so you aren’t triggered to relapse. While at our facility you’ll have a schedule to follow which will include various types of groups and individual therapy.

Outpatient Treatment

Depending upon your needs you may be referred to an outpatient treatment program instead of going inpatient or you may be referred to one after leaving our residential program at Icarus. Throughout the duration of this program, you’ll live at home and be required to visit our facility for a set number of hours each week. While here you’ll engage in both individual and group therapy.

Creating an Aftercare Plan

Make sure that you also create an aftercare plan. This will enable you to remain committed to your sobriety. Some of the things you should take into consideration here include therapy and support groups (AA/NA). Being involved in these things is an important part of your recovery.

Having people around you who understand what you’re going through will allow you to grow and mature. It’ll also help you build a new group of friends who share your commitment to sobriety so you aren’t tempted to return to your previous friends who may have been using with you. This is a great way to ensure you remain committed to your own long-term recovery from Gabapentin abuse.

The Path to Recovery Begins at Icarus Behavioral Health

Regardless of the length of time, you’ve been using Gabapentin, with or without other drugs or alcohol, our treatment team and facilities are second to none at Icarus.

Our clinicians will provide you with medication to offset any symptoms you’re continuing to experience through withdrawals and help establish a firm foundation for recovery. We will also facilitate the management of any other medical problems you may have developed from detoxing from this drug. With the help of Icarus, long-term recovery from Gabapentin abuse is possible, and achievable. Reach out now to discuss your situation with our compassionate Admissions staff today, and end the cycle of addiction once and for all!