Many of the prescription drugs commonly misused or abused are well-known brands. Opioids, such as morphine, codeine, oxycodone, and hydrocodone (OxyContin, Vicodin, Lortab), are among the most frequently abused drugs, according to data from the New York State Department of Health. Depressants like Valium and Xanax used to treat anxiety and sleep disorders are also commonly misused, as are stimulants like Ritalin, Dexedrine, and Adderall used to treat ADHD.
Dr. Holly Geyer, an addiction medicine specialist and lead physician of the Mayo Clinic opioid stewardship program in Arizona, explains that in the fight against opioid abuse, many doctors are turning to a non-controlled substance class of drugs called gabapentinoids. This push has led to gabapentin becoming the sixth-most prescribed medication in the United States. However, this trend has inadvertently resulted in an increase in gabapentin abuse nationwide, both on its own and in combination with other drugs like opioids.
Gabapentin was initially approved for epilepsy treatment by the FDA in 1993. It functions by binding to a specific type of calcium channel in nerve cells, altering nerve function. This mechanism allows it to control nerve pain and manage seizure disorders.
Common side effects of gabapentin include drowsiness, dizziness, headache, dry mouth, weight gain, swelling in the hands, feet, or ankles, and flu-like symptoms. Rare but severe side effects include rash, yellowing of the skin, swelling of the face and throat, and changes in memory and concentration.
Gabapentin has various FDA-approved uses, including seizure control and treatment of post-herpetic neuralgia, a nerve pain condition following shingles. It is typically taken orally two to three times a day and is available as both a brand name product (Neurontin, Gralise) and a generic version.
In addition to its FDA-approved uses, Tedeschi mentions that gabapentin is sometimes prescribed off-label by healthcare providers for a variety of other medical conditions. Off-label use refers to situations where there is evidence indicating that a drug can be beneficial in treating conditions different from those for which it has obtained FDA approval. Common off-label uses of gabapentin prescribed by doctors include treating hot flashes, restless leg syndrome, mood disorders, anxiety, as well as alleviating nerve pain associated with diabetes or neck and back pain linked to conditions like sciatica. One of the main reasons for its widespread popularity is its affordability as a generic medication, as highlighted by Lombardi. Geyer notes that gabapentin provides excellent pain relief for numerous medical conditions stemming from nerve damage.
Despite its FDA approval and proven therapeutic benefits, gabapentin is frequently misused. While not considered addictive, Geyer points out that in some individuals, the drug can induce a sense of euphoria, enhancing its potential for abuse. It is also known to augment the psychological effects of opioids, potentially contributing to their misuse and even leading to fatal drug overdose cases, as cited by Harvard Medical School. Due to these concerns, several states have designated gabapentin as a schedule V controlled substance, according to Lombardi.
Misuse of gabapentin can occur when the prescribed dosage is not followed as directed, and similar to illicit substances, it can also be illicitly procured without a prescription from the dark web, as highlighted by Geyer. While gabapentin is generally considered safe for most individuals, she emphasizes that its potential for abuse is becoming increasingly recognized. Predicting who may be prone to abusing the drug is challenging, although a history of addiction to other substances could be a risk factor. Geyer recommends that patients should be informed about the potential for abuse when initiating gabapentin therapy and should feel encouraged to communicate any concerns they may have.
Originally published on USA TODAY, this article delves into the various uses of gabapentin, shedding light on its side effects and the concerns surrounding its misuse.
