Gabapentin: The Surprising Drug Fueling America’s Opioid Crisis



Hey there, Kevin here from, and today I want to talk about a topic that’s been keeping me up at night. As a seasoned pharmacist with over a decade of experience in our family-run pharmacy, I’ve seen my fair share of prescription drugs come and go. But there’s one medication that’s been raising red flags lately, and it’s not what you might expect.

I’m talking about gabapentin, a drug that was once hailed as a safe alternative to opioids but has now become a major player in America’s ongoing opioid epidemic. This article will dive deep into the shocking rise of gabapentin misuse, the risks it poses, and what we can do to tackle this growing threat.

Trust me, as someone who’s dedicated their career to promoting safe medication use, I was floored when I discovered just how much gabapentin is being abused and the devastating consequences it can have. It’s time we shine a light on this issue and take action before it’s too late.

What is Gabapentin?

Alright, let’s start with the basics. Gabapentin, which you might know by brand names like Neurontin or Gralise, is a prescription drug that was first approved by the FDA way back in 1993. Its original purpose? Treating seizures. But as time went on, it also got the green light for managing postherpetic neuralgia, a type of nerve pain that can crop up after a nasty case of shingles.

Now, here’s where things get interesting. Gabapentin is being prescribed left and right for all sorts of off-label uses, from anxiety and insomnia to hot flashes and beyond. It works by calming down overexcited brain activity and changing the way our bodies perceive pain, thanks to its ability to latch onto calcium channels in the nervous system.

Many doctors have started to see gabapentin as a safer choice compared to opioids for managing chronic pain. After all, it’s not an opioid, and at first, it seemed like it had a low risk of abuse and addiction. But as we’ll see, that perception has led to some serious consequences.

The Rise of Off-Label Prescribing and Abuse

Buckle up, because the numbers I’m about to drop are pretty staggering. Get this: a whopping 95% of gabapentin prescriptions are written for off-label uses, meaning conditions that haven’t been approved by the FDA. And between 2012 and 2016, the number of gabapentin prescriptions in the U.S. shot up by a jaw-dropping 64%. That’s a whole lot of pills floating around out there.

But here’s where it gets really scary. Gabapentin abuse is running rampant, especially among folks who have a history of opioid use disorder. Studies have found that 15-22% of opioid users admit to abusing gabapentin, often mixing it with other drugs to chase a more intense high or to self-medicate for pain or withdrawal symptoms.

Recreational users of gabapentin report feeling euphoric, almost like they’re on marijuana, or experiencing a “zombie-like” sedation. It’s no wonder that this drug has become a prime target for abuse and diversion.

Risks and Dangers

Now, let’s talk about the risks. When gabapentin is combined with other central nervous system depressants, like opioids, benzodiazepines, or alcohol, it can be a recipe for disaster. Gabapentin can make the respiratory depression caused by these substances even worse, sending the risk of overdose and death through the roof.

In fact, research shows that when gabapentin is present in opioid-related overdoses, the risk of death can skyrocket by up to 60%. That’s a terrifying statistic, and it underscores just how cautious we need to be when prescribing gabapentin to patients who have a history of opioid use or addiction.

But the dangers don’t stop there. Abusing gabapentin can also lead to some nasty withdrawal symptoms when you try to quit cold turkey. We’re talking anxiety, insomnia, nausea, pain, sweating—the works. In some cases, gabapentin withdrawal can even trigger seizures, which is why it’s so important to have medical supervision when attempting to kick the habit.

And if you do overdose on gabapentin? Brace yourself for a world of hurt. Symptoms can include labored breathing, extreme drowsiness, confusion, diarrhea, and even coma. The real kicker? Gabapentin doesn’t show up on standard drug screens, so many cases of gabapentin overdose might be flying under the radar or getting mistaken for other substance-related emergencies.

Gabapentin’s Role in the Opioid Epidemic

As the opioid crisis has spiraled out of control, healthcare providers have been desperate for safer alternatives to manage pain. Enter gabapentin, the supposed knight in shining armor. But here’s the thing: the evidence backing up gabapentin’s effectiveness for many off-label uses is pretty flimsy, and its potential for misuse and addiction has become a huge red flag.

Gabapentin’s ability to produce a high and slip past routine drug tests has made it a go-to choice for people looking to abuse substances or self-medicate for opioid withdrawal. As a result, we’re seeing a massive diversion of gabapentin prescriptions, with the drug being sold or traded on the streets like candy.

And the consequences have been nothing short of tragic. Gabapentin is now showing up in a significant chunk of opioid-related overdose deaths, often in a toxic cocktail with other substances. This alarming trend has pushed some states, like Kentucky, Tennessee, and Michigan, to take action by classifying gabapentin as a controlled substance, putting it under tighter prescribing and monitoring rules.

What Can Be Done?

So, what can we do to tackle the growing threat of gabapentin misuse and abuse? It’s going to take a team effort from healthcare professionals, policymakers, and the public. Here are some key strategies:

  1. We need to get the word out to prescribers about the risks of gabapentin and the fact that there’s not a ton of evidence to support its off-label uses. Educating healthcare providers about the potential for misuse and the need to be extra careful when prescribing gabapentin, especially to patients with a history of substance abuse, is absolutely crucial.
  2. We’ve got to beef up the monitoring and tracking of gabapentin prescriptions through prescription drug monitoring programs (PDMPs). By making sure gabapentin is part of these programs, healthcare providers and pharmacists can spot patterns of misuse early on and step in to prevent harm.
  3. Patients need to be warned about the potential dangers of gabapentin, especially when it’s mixed with opioids, benzodiazepines, or other CNS depressants. Providing clear, no-nonsense information about the risks of misuse and the importance of taking gabapentin only as prescribed can go a long way in reducing the likelihood of abuse.
  4. We need more research on how effective gabapentin really is for various off-label uses and its potential for addiction. The more we understand about gabapentin’s risks and benefits, the better we can inform prescribing practices and develop safer, more effective treatment options.
  5. It’s time to consider making gabapentin a controlled substance at the federal level. By putting gabapentin under the watchful eye of the Controlled Substances Act, policymakers can ramp up oversight, crack down on overprescribing, and put a dent in diversion and abuse.


The rise of gabapentin as a major player in America’s opioid crisis has shattered the illusion that it’s a harmless, risk-free medication. As the misuse and abuse of gabapentin continue to climb, claiming lives and fueling addiction, it’s clear that we can’t afford to sit on the sidelines any longer.

It’s going to take a united front from healthcare professionals, policymakers, and the public to raise awareness about the dangers of gabapentin misuse, put effective monitoring and prevention strategies in place, and prioritize research to develop safer, more effective treatments for chronic pain and other conditions.

By tackling the challenges posed by gabapentin head-on and taking proactive steps to reduce misuse and prevent harm, we can make real progress in the fight against the opioid epidemic and protect the health and well-being of people and communities across the United States. It’s time to wake up and smell the coffee—gabapentin is a potentially dangerous drug that demands our attention and action, and we can’t afford to wait any longer.

As a pharmacist and the founder of, I’m committed to spreading the word about this critical issue and working towards solutions that can make a real difference. Together, we can turn the tide on gabapentin misuse and build a healthier, safer future for all. Stay informed, stay vigilant, and stay safe out there, everyone.