What is Gabapentin?
Gabapentin is a prescription medication known as a gamma aminobutyric acid (GABA) analogue. Gabapentin capsules, tablets, oral solutions are used, and other medications to help control certain types of seizures in people with epilepsy. It is also used to relieve the pain of postherpetic neuralgia (PHN; the burning, stabbing pain or aches that may last for months or years after an attack of shingles).
Gabapentin extended-release tablets (Horizant) are used to treat restless legs syndrome (RLS; a condition that causes discomfort in the legs and a strong urge to move the legs, especially at night and when sitting or lying down). The drug’s known street names are “Gabbies” or “Johnnies.”
According to the National Institute of Health (NIH) , Gabapentin is in a class of medications called anticonvulsants. This medication treats seizures by decreasing abnormal excitement in the brain. It relieves the pain of PHN by changing the way the body senses pain. It is not known exactly how Gabapentin works to treat restless legs syndrome. Brand names of gabapentin include Horizant, Gralise, and Neurontin.
What is Gabapentin approved for?
Gabapentin is used to:
- Control and prevent partial seizures. Gabapentin can be used in adults and children age three and older who have partial seizures.
- Relieve nerve pain following shingles in adults. Shingle is a painful rash that develops many years after someone has chickenpox. The virus that causes chickenpox stays dormant in a portion of the spinal nerve root called the dorsal root ganglion. For whatever reason, this otherwise dormant virus gets reactivated — usually by stress — causing a shingles rash. Nerve pain following a case of shingles is called postherpetic neuralgia (PHN).
- Treat moderate-too-severe primary restless legs syndrome. The branded gabapentin products Neurontin and Gralise are approved for partial seizures and PHN. In addition, the branded gabapentin product Horizant is approved for restless legs syndrome and PHN.
Physiological dependence on Gabapentin
Certain prescriptions and illegal drugs may lead to the development of physical dependence in individuals who use them for more than a few weeks. Taking this drug regularly, a person’s body adapts to and essentially starts to expect a substance to be present and will rely on it to operate normally. When a dependent individual stops taking the drug or significantly reduces the amount of the drug they have been using on a regular basis, they will likely soon experience the onset of withdrawal.
Physiological dependence frequently develops in pair with tolerance, in which a person’s system does not react to the drug in the same way it did before. The individual must take higher and higher doses to achieve the effect they experienced when they first started using.
Dependence vs Addiction
Physiological dependence is often mistakably confused with addiction. However, the two are not the same thing. For example, a person using a medication to treat a chronic condition may develop some physical dependence on the drug. But if they continue to safely use the drug according to its prescribed purposes and under the supervision of their doctor and do not display other signs of compulsive misuse, they would not be considered to be addicted to it. Addiction involves a compulsion to seek out the drug and use it, with such drug use negatively interfering with other areas of the person’s life.
Significant dependence is more likely to develop in people who intentionally misuse or use gabapentin recreationally. However, maladaptive patterns of gabapentin abuse may also develop in people who initially were prescribed the drug but began to misuse it. If you or someone you care about is abusing the drug, speak with your doctor or seek out the help of a rehabilitation program or addiction professional.
According to the National Center for Biotechnology Information (NCBI) , A recent police report indicates the increasing tendency to use gabapentin as a ‘cutting agent’ in street heroin, further adding to the abuse and danger potential. Gabapentin abuse and addiction tend to happen in individuals who already have an addiction to Opioids or other drugs. Like opiates, Gabapentin is deadly in overdose; unlike opiates, there is no remedy, and the long half-life entails the need for prolonged, intensive management of overdose. The effects of Gabapentin intoxication have been described as a sense of euphoria, calm, and a high similar to cannabis.
One study found that of the 503 participants reporting illicit drug use, 15% reported using Gabapentin in addition to other drugs to get high in the previous 6 months. Another study, working with a sample of participants meant to represent the national population, found almost a quarter of patients with co-prescriptions of Gabapentin and opioids were getting more than 3 times their prescribed amount to supply their addiction.
Individuals taking Gabapentin without a prescription is a growing concern in many areas. Due to the drug’s legal status, this is tough to address from a policing perspective. States, where Gabapentin abuse is becoming more common, are starting to classify the drug as a more strictly regulated substance.
Gabapentin’s special ability to address multiple ailments has made it one of the most prevalent prescription medications in the US. In November of 2021, it was reported that it was the sixth-most prescribed drug in the nation. Unfortunately, despite its low abuse potential, its ability to be used with other medications causes widespread harm and addiction.
Effects Of Gabapentin Addiction
According to the National Center for Biotechnology Information (NCBI) , in the latest guidance report for pain treatment, the Centers for Disease Control and Prevention (CDC) identified gabapentin as a first-line medication for treating chronic pain. Since its market release in 1993, this medication was presumed to have no abuse potential, which has likely led to its extensive off-label prescribing (it is estimated that between 83–95% of all Gabapentin prescriptions are for a non-approved use). However, individuals taking this medication should be aware of the drug’s abuse liability and effects that may accompany its use.
Effects of extreme Gabapentin use include:
- Coordination problems
- Suicidal thoughts/behaviors
- Changes in mood
- Difficulty speaking
It is necessary to try to recognize these symptoms and to be mindful of other signs and symptoms, such as the existence of a lot of pill bottles. These effects can be damaging to one’s health, livelihood, and overall safety. Many Gabapentin users in early recovery abuse Gabapentin because, at high doses (800mg or more), they may experience a euphoric-like high that does not show up on drug screens. Gabapentin abusers normally take the drug in combination with Opioids to produce their desired high, a treacherous and potentially fatal combination.
Signs Of Gabapentin Addiction
- Lying about or exaggerating symptoms to doctors
- Changes in social habits and/or circles
- Seeking out multiple doctors to get extra doses
- Switching doctors after the original doctor refuses to continue prescribing the medication
- Refusal to quit despite social, financial, or legal consequences
- Changes in personal hygiene and grooming habits
- Unease at the thought of the drug being unavailable
- Failed attempts to quit
Can someone overdose on Gabapentin?
It is possible to fatally overdose on this medication, both on its own or in combination with other drugs. However, there is currently no cure that can be administered to someone in the case of a Gabapentin overdose as there is with Opioid overdoses.
Because of Gabapentin’s long half-life, quick medical attention is essential to manage the complications linked with a toxic amount of this medication. Although most overdoses happen as a result of mixing gabapentin with other substances, it was found that some individuals have committed suicide by intentionally overdosing on this drug .
Signs of Gabapentin Overdose
Signs of gabapentin overdose include:
- Labored breathing
- Ataxia (decreased muscle coordination)
- Ptosis (drooping upper eyelid)
- Double vision
- Marked sedation
- Slurred speech
If a person has overdosed on gabapentin, the drug can be removed from their system in the emergency room through a process of kidney dialysis.
What to Do in Case of Gabapentin Overdose
If you are near someone who has overdosed, check the person’s airway, breathing, and pulse. If the person is unconscious, call 911. You can also perform these steps:
- Roll the person toward you on their side
- Bend the top leg so that the hip and knee are at right angles
- Tilt the head back to keep the person’s airway open
- Try to keep the person calm
- Stay with the person until help comes
Does Gabapentin have a withdrawal Symptom?
Even individuals who take Gabapentin as prescribed may develop some physical dependence. However, those who abuse or misuse it recreationally may undergo significant levels of dependence and withdrawal symptoms when they try to stop or slow its use. There are reported cases of withdrawal symptoms in individuals who took daily doses between 400mg to 8000mg for at least three weeks.
The gabapentin withdrawal symptom may resemble some of the symptoms of benzodiazepine and alcohol withdrawal. This resemblance may be due to the fact that gabapentin and these other substances all act on gamma-aminobutyric acid, or GABA, which is an inhibitory neurotransmitter in the brain.
The primary withdrawal symptoms associated with gabapentin use include:
- Sensitivity to light
- Irregular heartbeat
In addition, individuals who are taking this medication for seizures and suddenly quit taking it may encounter a rebound in or increased frequency of seizure activity, including uncontrollable, continuous seizures (status epilepticus).
Withdrawal from this drug commonly occurs within twelve hours to seven days after quitting the medication. Though a withdrawal timeline hasn’t been clearly documented, some studies have noted symptoms that last up to ten days.
Factors that can affect withdrawal include:
- Length of use
- Medical or mental health problems
- Concurrent use of other drugs or alcohol
In some cases, individuals who are at risk of or are already displaying severe withdrawal symptoms may require intensive inpatient treatment and monitoring and medical withdrawal management if complications emerge.
Specialists recommend slowly and smaller doses of Gabapentin to comfortably and safely wean a person off the medication. Such tapering schedules are commonly used with medications like gabapentin that have the potential to produce adverse withdrawal effects when being discontinued.
Gabapentin use can be phased out over a period of one week, but the exact schedule will depend on the person’s particular situation. Slower tapers may allow for safer discontinuation of the drug. Experts recommend reducing the daily dose at a maximum rate of 300mg every four days.
How To Safely Withdraw From Gabapentin?
The secret for safely withdrawing from this medication is to not completely stop taking it, but to slowly wean off it (a taper). Talking to a doctor, or seeking the services of a treatment center, will help people consistently stick to slowly decreasing doses of gabapentin. This will produce the best possible possibilities for withdrawal while ensuring that the other conditions that the gabapentin treated receive proper attention.
Gabapentin should be tapered over a minimum of one week. The exact tapering schedule will depend on the person’s mental and medical health status, their likelihood of sticking to the tapering instructions, and factors such as:
- The condition for which gabapentin was prescribed.
- The current dose and regimen.
There may also be other factors that affect the taper, which is why you should always work with a doctor to determine the right schedule for you. For instance, some people may not respond well to the typical timeline and may need to adjust the dose.
If you have been prescribed gabapentin and would like to quit using it, talk to your physician about a taper. If you are abusing gabapentin and want to stop, consider Gabapentin detox and substance rehabilitation—especially if you are abusing it with other drugs or alcohol. These programs can help you taper off gabapentin and teach you skills to modify your lifestyle and prevent a relapse.
Gabapentin Detox and Addiction Treatment
Suddenly discontinuing Gabapentin can boost the probability of seizures, so it’s vital to seek assistance when looking to quit. Suppose you are getting treatment for a gabapentin addiction problem. In that case, you will likely begin with a medically-assisted Gabapentin detox so that you can slowly eradicate the drug from your body in a controlled way. After completing the Gabapentin detox, you need medical clearance before transitioning into an inpatient treatment program. There are several gabapentin addiction treatment options available, including:
Medically-assisted Gabapentin Detox
After heavy or extended use of this drug, your system becomes dependent on Gabapentin and needs it in its system to function and avoid a possible dangerous withdrawal symptom. Getting medically-assisted Gabapentin detox helps you slowly wean off gabapentin while under medical care.
If your gabapentin addiction is severe or you have co-occurring mental health or medical issues, an inpatient program can provide intensive care. Inpatient treatment demands that you live at the facility for the entire duration of your treatment. These programs provide a safe environment and a high level of structure that minimizes triggers to use the drug. Before starting treatment, medical professionals will assess your situation and your addiction to create a tailored treatment plan. This may include group and individual therapy, family therapy, relapse prevention lessons, support groups, and aftercare planning.
Before, during, or after treatment, you may attend 12-step meetings like AA/NA or other support groups. When you go to a support group, you will be welcomed by individuals who know what you’ve been through because they’ve gone through it too. Feeling accepted can make a massive difference in your healing because you will create a new support network of sober people and learn from individuals who have been abstinent from drugs for a longer period of time.
While in rehab, you will get ready for your transition out of treatment by developing an aftercare plan. This will look different for every person and may include:
- Transitioning into a sober living facility
- Locating a counselor or therapist outside of treatment
- Regularly attending 12-step meetings or other support groups
After you leave treatment, you must stay involved with aftercare recovery treatment to prevent relapse.
Find the Right Treatment Plan at We Level Up NJ
The inpatient treatment approach works best to change the person’s behaviors. Also, it will help clients establish social support systems and better methods of coping with stress. However, a person will likely experience many different side effects from the abuse and misuse of Gabapentin. These side effects may be physical, emotional, or mental. For instance, someone in withdrawal will likely experience many uncomfortable feelings and negative thoughts about life during detox. Unfortunately for those with dependency, medically assisted Gabapentin detox is an unavoidable first step towards recovery.
Please, do not try to detox on your own. The detox process can be painful and difficult without medical assistance. However, getting through the detox process is crucial for continued treatment. We Level Up NJ provide proper care with round-the-clock medical staff to assist your recovery. So, reclaim your life, call us to speak with one of our treatment specialists. Our counselors know what you are going through and will answer any of your questions.
 NIH – https://medlineplus.gov/druginfo/meds/a694007.html
 NCBI – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3404313/
 NCBI – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7762328/
 FDA – https://www.fda.gov/drugs/drug-safety-and-availability/fda-warns-about-serious-breathing-problems-seizure-and-nerve-pain-medicines-gabapentin-neurontin