Why Is Gabapentin Bad? The Hidden Dangers of Drug Abuse

Key Takeaways

• Gabapentin is a legitimate prescription medication used to treat nerve pain, seizures, and restless legs syndrome, and is sometimes prescribed off-label for anxiety.

• Gabapentin is not a narcotic or opioid, but it does affect the nervous system and can cause side effects such as drowsiness, dizziness, and cognitive impairment.

• While generally considered low-risk for addiction, gabapentin misuse is more common among individuals with existing substance use disorders, especially opioid or alcohol addiction.

• Long-term gabapentin use can lead to physical dependence, making sudden discontinuation dangerous due to withdrawal symptoms, including anxiety, insomnia, and seizures.

• Gabapentin should always be taken exactly as prescribed and tapered under medical supervision, as improper or prolonged use increases health risks and misuse potential.

Question:

Why is gabapentin bad when abused?

Answer:

Like all drugs, gabapentin can be helpful when used as prescribed. But it can also be abused. In this article, we’ll go over why gabapentin is bad when used improperly.

What Is Gabapentin? 

Gabapentin is an anticonvulsant medication developed to treat nerve pain and seizures. It can also be prescribed off-label to treat anxiety. It’s sold under the brand name Neurontin. Gabapentin works by increasing the production of a chemical called GABA, which helps control abnormal electrical activity and pain signals in the brain.

Experts aren’t exactly sure how gabapentin works. They know it binds strongly to a specific site in the brain (called the alpha2-delta site), and it’s thought that this is how it treats nerve pain and seizures. This would make gabapentin different from Xanax, a benzodiazepine that directly affects GABA receptors to produce fast-acting sedation and anxiety relief. Gabapentin is considered an effective treatment for nerve pain and seizure disorders by modulating pain signals.

Nerve pain and seizures are issues that coincide with a wide range of conditions. For nerve pain, these include diabetic neuropathy, post-herpetic neuralgia (pain following shingles), and central neuropathic pain. Gabapentin is prescribed to control seizures (partial seizures) in adults and children, and is also prescribed for restless legs syndrome (RLS), with the extended release tablet being the only approved formulation for RLS. For seizures, gabapentin has been prescribed as an adjunct (added to other medications) for epilepsy and alcohol withdrawal syndrome.

When prescribed gabapentin, it is important to follow your gabapentin prescription and use it only under medical supervision, as with other prescription drugs. Gabapentin is not classified as a controlled substance at the federal level, but some states have enacted restrictions due to increased reports of misuse.

Is Gabapentin a Narcotic?

No, gabapentin is not a narcotic. Narcotic is another term for opioid, which gabapentin is not.

However, although gabapentin is not a narcotic, it does affect the nervous system and can cause drowsiness or dizziness. In recent years, some states like Kentucky, Michigan, West Virginia, and others have classified gabapentin as a controlled substance due to concerns about its potential for misuse, particularly when combined with other substances like opioids. However, it does not have the same risk of physical dependence or addiction associated with narcotics.

If gabapentin is prescribed, it’s important to follow the dosage carefully, as misuse can lead to unwanted side effects.

What Does Gabapentin Treat?

Gabapentin is a prescription medication widely used to manage a variety of medical conditions, most notably those involving nerve pain and abnormal electrical activity in the brain. One of its primary uses is to control partial seizures in adults and children with epilepsy, helping to stabilize the nervous system and prevent sudden surges of electrical activity. Gabapentin is also highly effective in treating neuropathic pain, a type of chronic pain caused by nerve damage, which can occur after conditions like shingles. In fact, gabapentin is FDA approved for the treatment of postherpetic neuralgia, a persistent nerve pain that lingers long after the shingles rash has healed.

Beyond its role in epilepsy and nerve pain, gabapentin is commonly prescribed to relieve the uncomfortable sensations of restless legs syndrome, a condition that causes an irresistible urge to move the legs, especially at night. In some cases, healthcare professionals may prescribe gabapentin off-label to help manage symptoms of generalized anxiety disorder or other mental health conditions, although its effectiveness for these uses is still being studied.

Because gabapentin can treat such a wide range of medical conditions—from controlling seizures to easing neuropathic pain and restless legs—it has become a valuable tool in modern medicine. However, it is important to use gabapentin only as directed by a healthcare provider, as misuse can lead to serious side effects and increase the risk of gabapentin abuse.

Is Gabapentin Dangerous?

This is tricky. In and of itself, gabapentin does not appear to be generally addictive. A 2023 study of 140 patients found only 18% were abusing the drug, for example.

But it seems if a person is already in the grips of addiction, the likelihood of gabapentin addiction increases. The same study found alcohol and smoking addiction were factors in gabapentin abuse. Another study on 250 ex-convicts discovered that opioid addiction significantly contributes to gabapentin misuse. When asked, 26% of people with an opioid addiction indicated recreational gabapentin use. For individuals who were not addicted to opioids, that number fell to 4%.

So, it appears that other addictions can make a gabapentin addiction more likely. In addition, it’s worth noting that gabapentin does induce physical dependence, which is why gabapentin is bad to take long term.

Why Is Gabapentin Bad When Used Long-Term?   

Although gabapentin is not considered highly addictive in the traditional sense, long-term use can cause physical dependence. If someone stops taking it abruptly after long-term use, they may experience withdrawal symptoms such as anxiety, insomnia, nausea, sweating, or even seizures.

Long-term gabapentin use is associated with cognitive side effects such as memory problems, confusion, and difficulty concentrating. These effects may worsen over time, particularly in older adults or those with pre-existing cognitive issues.

However, it’s not always an easy drug to quit. Sudden discontinuation can lead to withdrawal symptoms like restlessness, agitation, confusion, headache, and, in some cases, seizures, particularly in those using it for epilepsy. For this reason, it’s best to gradually taper off gabapentin if you are trying to quit.