Is Gabapentin Addictive?

Gabapentin is among the top 10 most commonly prescribed medications in the United States.[1] Initially, it was praised for its effectiveness in treating nerve pain and seizures without the risk of addiction. However, recent studies have shown that it may contribute to polysubstance use disorder in approximately 22% of individuals seeking treatment at drug rehab facilities.[2] While gabapentin is not inherently addictive, misuse can elevate the risk of developing a dependency. Gabapentin is an FDA-approved medication sold under the brand names Neurontin, Gralise, and Horizant.[3] It belongs to a class of drugs called anticonvulsants, commonly prescribed to treat restless leg syndrome, seizures related to epilepsy, and neuropathic pain (nerve pain) caused by the following conditions:

• Diabetic neuropathy
• Shingles
• Postherpetic neuralgia
• Fibromyalgia

Gabapentin works differently for different conditions. It is thought to modify gamma-aminobutyric acid (GABA) receptor expression in the brain, reducing electrical signal excitability in people with seizures.[4] It interferes with the way pain signals are sent through the brain and body in people with nerve pain. However, scientists are unsure how it works in individuals with restless leg syndrome. Some clinical trials support gabapentin’s use for the treatment of other conditions, though they aren’t FDA-approved. This is called off-label use.

Side Effects of Gabapentin 

It is common to experience some side effects while taking gabapentin.[5] Many of these are mild, though some may be bothersome. They include, but aren’t limited to:

• Aggression
• Nausea and vomiting
• Dizziness
• Fatigue
• Headache
• Difficulty speaking
• Vision changes
• Flu-like body aches
• Sore throat
• Fever
• Chills
• Sleepiness
• Swollen hands, legs, or feet
• Difficulty balancing
• Poor coordination
• Uncontrollable eye movements

Warning: Individuals who have recently used an opioid or alcohol should avoid gabapentin.[6] This combination can make it difficult or impossible to breathe.

Is Gabapentin Addictive?

People who use gabapentin more than they should can develop a tolerance to the medication. A tolerance occurs when your body becomes used to the medication and requires more to feel the effects.[7] People who have a tolerance to gabapentin may continually increase their doses to achieve pain relief despite the dangers of doing so. This can lead to dependence. Once the body is dependent on gabapentin, the user may experience rebound pain and other withdrawal symptoms when they attempt to stop using it.[8] People who have abused drugs or other substances in the past are at higher risk for developing gabapentin dependence and addiction.

What are the Signs and Symptoms of Gabapentin Addiction?

People who have a gabapentin addiction may try hard to hide the physical signs. They may blame their symptoms on being under the weather or tired and may become agitated when questioned about their gabapentin use. Other signs of gabapentin addiction include:[9]

• Doctor shopping to secure more gabapentin
• Needing to borrow or buy someone else’s gabapentin
• Exaggerating their symptoms to get a higher dose
• Hiding pills from loved ones
• Refusing to quit despite no longer needing them
• Experiencing withdrawal when trying to quit
• Experiencing intense cravings to use gabapentin

How Dangerous is Gabapentin Addiction?

Gabapentin addiction can be dangerous, especially in combination with opioid abuse. According to Drugs.com, combining gabapentin with sedatives or opioids increases the risk of an opioid-related death.[10] The risk of opioid-related overdose death increases significantly, up to four times when gabapentin is used alongside prescription opioids. People who abuse gabapentin are at a higher risk of suffering an overdose. The symptoms of gabapentin overdose include rapid heartbeat, low blood pressure, and impaired coordination. According to U.S. Poison Control, lethargy and death may also occur in severe cases.[11]

Can You Treat Gabapentin Addiction by Stopping the Medication?

Individuals addicted to gabapentin can experience rebound pain and withdrawal symptoms if they stop using it suddenly.[8] These symptoms may persist for days or even weeks after discontinuation. Unfortunately, the discomfort caused by withdrawal may lead some individuals to resume using gabapentin at a higher dose or to seek other medications to alleviate their symptoms. This approach can be dangerous and may increase the risk of overdose. It is always advisable to discontinue use under the supervision of a medical professional to minimize withdrawal symptoms and avoid other negative effects.

Is Gabapentin Withdrawal Dangerous?

Gabapentin withdrawal can be dangerous, especially in those being treated for seizures. Abruptly stopping gabapentin may cause them to have an epilepticus, which is a rare seizure that will not stop.[12] This is why most doctors prefer their patients to gradually lower their doses instead of stopping abruptly.

Gabapentin Withdrawal Symptoms

Anyone who has taken gabapentin for longer than three weeks or at a high dose is at risk of experiencing withdrawal symptoms after cessation. These symptoms include:[8]

• Difficulty sleeping
• Agitation
• Anxiety
• Restlessness
• Disorientation
• Dizziness
• Headaches
• Excessive sweating
• Nausea or vomiting
• Fast heartbeat
• Irregular heartbeat
• Confusion
• Seizures

How Long Does it Take to Experience Gabapentin Withdrawal?

According to the Food and Drug Administration(FDA), gabapentin’s elimination half-life is approximately 5 to 7 hours.[13] People may begin experiencing withdrawal symptoms within four to five half-lives, which is the time it takes for gabapentin to clear the system.[14] This rate may vary depending on factors such as renal function but is not significantly influenced by dosage or frequency. However, elderly people and those with renal insufficiency may experience a quicker elimination half-life.

Can You Overdose on Gabapentin?

Yes, it is possible to overdose on gabapentin. The FDA approves medications like gabapentin to treat specific health issues at doses that have been deemed safe and effective. It’s important to adhere to the prescribed dosage, as exceeding it can significantly increase the risk of a gabapentin overdose. Symptoms of a gabapentin overdose include double vision, slurred speech, diarrhea, and drowsiness.[15] In severe cases, breathing may be severely suppressed or stopped altogether.

What are the Treatment Options for Gabapentin Addiction?

Individuals who are addicted to gabapentin may be diagnosed with a substance use disorder (SUD) or polysubstance use disorder, particularly if they misuse it alongside other addictive substances such as cannabis or alcohol.[16][17] This is a chronic condition characterized by a strong preoccupation with using gabapentin, developing tolerance and dependence, and experiencing withdrawal symptoms when attempting to stop its use. People with an SUD will have difficulty stopping on their own and will require treatment.

Detox: First Line Treatment for SUDs

The primary treatment approach for substance use disorder is detoxification. Detoxification involves abstaining from gabapentin long enough for it to be eliminated from the body. Given that gabapentin has a half-life of 5 to 7 hours, it may take four to five half-lives for the drug to completely clear from the system.[14] However, the psychological effects of addiction can persist beyond this timeframe. This is why most individuals requiring detox also participate in talk therapy.

Therapy: Supportive Sessions for Behavioral Changes 

Therapy can help individuals identify the underlying reasons for their addiction and uncover the triggers that lead them to abuse gabapentin. It also equips them with coping skills necessary to prevent relapse. Participants may attend individual and group sessions to help them achieve their recovery goals. Detoxification and therapy are both essential components of a comprehensive addiction treatment plan. Other treatment options include:

• Experiential Therapy
• EMDR Therapy
• Dialectical Behavior Therapy (DBT)
• Cognitive Behavioral Therapy (CBT)
• Intensive Outpatient Programs (IOP)
• Partial Hospitalization Programs (PHP)

Who is at Risk of Adverse Effects from Taking Gabapentin?

Gabapentin is prescribed to people aged six and older. However, it isn’t suitable for everyone. People in the following categories should avoid the use of gabapentin:[15]

• Had an allergic reaction to gabapentin in the past
• Is pregnant or may become pregnant while taking gabapentin
• Has misused or abused medications like gabapentin in the past
• Are on a diet with controlled sodium and potassium intake
• Have kidney disease or other kidney problems
• Had an allergic reaction to drugs in the same class
• Experienced adverse reactions to gabapentin in the past
• Are on medications that may interact poorly with gabapentin

Overcome Gabapentin Addiction Today

Gabapentin addiction does not have to be a lifelong struggle. With the right combination of programs, individuals can successfully recover from gabapentin addiction and prevent future relapses. Call Southeast Addiction Center, TN, today to find out how we can help.