Misuse of gabapentin apparently on the rise

[aihfl]

I was looking for information about gabapentin's effectiveness as an analgesic and stumbled across this article. Now that it's on the radar of American law enforcement and justice system, (no matter how ridiculous it would be) anyone else thinking it might end up getting scheduled? In the interests of full disclosure, I've been on it for over 3 years and just don't get what all the fuss is about it, although my dose is relatively low at 900mg. The article dates from last year, but was news to me.

On April 5, Ciera Smith sat in a car parked on the gravel driveway of the Rural Women's Recovery Program here with a choice to make: go to jail or enter treatment for her addiction. Smith, 22, started abusing drugs when she was 18, enticed by the "good time" she and her friends found in smoking marijuana. She later turned to addictive painkillers, then anti-anxiety medications such as Xanax and eventually Suboxone, a narcotic often used to replace opioids when treating addiction. Before stepping out of the car, she decided she needed one more high before treatment. She reached into her purse and then swallowed a handful of gabapentin pills.

Last December, Ohio's Board of Pharmacy began reporting sales of gabapentin prescriptions in its regular monitoring of controlled substances. The drug, which is not an opioid nor designated a controlled substance by federal authorities, is used to treat nerve pain. But the board found that it was the most prescribed medication on its list that month, surpassing oxycodone by more than 9 million doses. In February, the Ohio Substance Abuse Monitoring Network issued an alert regarding increasing misuse across the state. And it's not just in Ohio. Gabapentin's ability to tackle multiple ailments has helped make it one of the most popular medications in the U.S. In May, it was the fifth-most prescribed drug in the nation, according to GoodRx.

Gabapentin is approved by the Food and Drug Administration to treat epilepsy and pain related to nerve damage, called neuropathy. Also known by its brand name, Neurontin, the drug acts as a sedative. It is widely considered non-addictive and touted by the federal Centers for Disease Control and Prevention as an alternative intervention to opiates for chronic pain. Generally, doctors prescribe no more than 1,800 to 2,400 milligrams of gabapentin per day, according to information on the Mayo Clinic's website. Gabapentin does not carry the same risk of lethal overdoses as opioids, but drug experts say the effects of using gabapentin for long periods of time or in very high quantities, particularly among sensitive populations like pregnant women, are not well-known.

Athens, home to Ohio University, lies in the southeastern corner of the state, which has been ravaged by the opioid epidemic. Despite experience in combating illicit drug use, law enforcement officials and drug counselors say the addition of gabapentin adds a new obstacle. As providers dole out the drug in mass quantities for conditions such as restless legs syndrome and alcoholism, it is being subverted to a drug of abuse. Gabapentin can enhance the euphoria caused by an opioid and stave off drug withdrawals. In addition, it can bypass the blocking effects of medications used for addiction treatment, enabling patients to get high while in recovery. "I don't know if we have a clear picture of the risk," said Joe Gay, executive director of Health Recovery Services, a network of substance abuse recovery centers headquartered in Athens.

A 2016 literature review in the journal Addiction found about a fifth of those who abuse opiates misuse gabapentin. A separate 2015 study of adults in Appalachian Kentucky who abused opiates found 15 percent of participants also misused gabapentin in the past six months to get high. In the same year, the drug was involved in 109 overdose deaths in West Virginia, the Charleston Gazette-Mail reported. Rachel Quivey, an Athens pharmacist, said she noticed signs of gabapentin misuse half a decade ago when patients began picking up the drug several days before their prescription ran out.
"Gabapentin is so readily available," she said. "That, in my opinion, is where a lot of that danger is. It's available to be abused."

In May, Quivey's pharmacy filled roughly 33 prescriptions of gabapentin per week, dispensing 90 to 120 pills for each client. For customers who arrive with scripts demanding a high dosage of the drug, Quivey sometimes calls the doctor to discuss her concerns. But many of them aren't aware of gabapentin misuse, she said. Even as gabapentin gets restocked regularly on Quivey's shelves, the drug's presence is increasing on the streets of Athens. A 300-milligram pill sells for as little as 75 cents. Yet, according to Chuck Haegele, field supervisor for the Major Crimes Unit at the Athens City Police Department, law enforcement can do little to stop its spread. That's because gabapentin is not categorized as a controlled substance. That designation places restrictions on who can possess and dispense the drug. "There's really not much we can do at this point," he said. "If it's not controlled it's not illegal for somebody that's not prescribed it to possess it." Haegele said he heard about the drug less than three months ago when an officer accidentally received a text message from someone offering to sell it. The police force, he said, is still trying to assess the threat of gabapentin.

Nearly anyone arrested and found to struggle with addiction in Athens is given the option to go through a drug court program to get treatment. But officials said that some exploit the absence of routine exams for gabapentin to get high while testing clean. Brice Johnson, a probation officer at Athens County Municipal Court, said participants in the municipal court's Substance Abuse Mentally Ill Program undergo gabapentin testing only when abuse is suspected. Screenings are not regularly done on every client because abuse has not been a concern and the testing adds expense, he said. The rehab program run through the county prosecutor's office, called Fresh Start, does test for gabapentin. Its latest round of screenings detected the drug in five of its roughly 238 active participants, prosecutor Keller Blackburn said. Linda Holley, a clinical supervisor at an Athens outpatient program run by the Health Recovery Services, said she suspects at least half of her clients on Suboxone treatment abuse gabapentin. But the center can?t afford to regularly test every participant. Holley said she sees clients who are prescribed gabapentin but, due to health privacy laws, she can't share their status as a person in recovery to an outside provider without written consent. The restrictions give clients in recovery an opportunity to get high using drugs they legally obtained and still pass a drug test.

"With the gabapentin, I wish there were more we could do, but our hands are tied," she said. "We can't do anything but educate the client and discourage them from using such medications." Smith visited two separate doctors to secure a prescription. As she rotated through drug court, Narcotics Anonymous meetings, jail for relapsing on cocaine and house arrest enforced with an ankle bracelet, she said her gabapentin abuse wasn't detected until she arrived at the residential recovery center. Today, Smith sticks to the recovery process. Expecting a baby in early July, her successful completion of the program not only means sobriety but the opportunity to restore custody of her eldest daughter and raise her children. She intends to relocate her family away from friends and routines that helped lead her to addiction and said she will help guide her daughter away from making similar mistakes. "All I can do is be there and give her the knowledge that I can about addiction," Smith said, "and hope that she chooses to go on the right path."

Source: https://www.statnews.com/2017/07/06/gabapentin-becomes-target-of-opioid-abuse/

 

[S.J.B.]

These breathless stories - "we thought this drug wasn't recreational and/or addictive, but no!" - are so predictable. If a drug has CNS effects that can be broadly characterized as sedation, stimulation, or significant alteration of perception, people will inevitably use it to get high.

 

[aspiringchemist]

In the hospital I work for the psychiatrists are know fixated on gabapentin and quetiapine as medications with recreational effects and street value. I've seen a few recovery programs refuse to admit people who are using these medicines for psychiatric or medical treatment; anecdotes of course.

It never ceases to amaze me how far behind the larger administration seems to be than communities like BL. People have been posting about gabapentin and pregabalin for years and somehow it's just now hitting the mainstream medical community.

IME gabapentin is not very recreational alone, but works well to potentiate opioids and benzodiazepines, as well as has great value in opioid withdrawl. I'm speaking from personal experience using these medicines prescribed for pain management.

 

[tremours]

i know gabapentin can be abused but is it actually dangerous?

 

[aihfl]

i know gabapentin can be abused but is it actually dangerous?

The short answer is no, not when compared to benzos and opiates and if used by itself. The half life is short, around 5-7 hours. The side effect profile reads very similarly to the side effect profile of antidepressants. I have never experienced withdrawals from it but by all accounts it can be unpleasant. Frankly I find it to be a shit high and I can't imagine myself abusing it unless I had no other way to deal with my anxiety. If I take it during the day I get unpleasantly dizzy so I take my entire dose right before bed.

 

[cj]

i know gabapentin can be abused but is it actually dangerous?

No it's extremely benign in my experience. I took upwards of 6 grams over a 4 hour period multiple times with zero adverse affect. That's pretty damn far above the therapuedic line. Tolerance builds real fast

 

[tremours]

ive taken it a few time and noticed the thing about tolerance, i think the most ive taken is 2400, i was just confused why they were getting so worked up about a pretty harmless drug. I guess some people are pretty strict about sobriety and it has to be all or nothing, they in turn like to force this viewpoint on other people.

 

[zuzubear]

I take 40mgs Oxycontin slow release 2X a day and 300mgs Gabapentin 3 times a day. I really feel nothing from either except "some" relief from my chronic back pain due to Arachnoiditis in my back. I don't want more opiates; I'm 65, but I was wondering if I took more Gabapentin would it mess me up with the oxy? Might it ease my pain a little more? I'm a new member so I thought y'all might have thoughts. Thanks for letting me in your group.

 

[tremours]

i could be wrong but i think gapapentin is is primarily used for nerve pain, so i don't know if that would help with your back

 

[oxyloveUK]

Only for nerve pain, useless for others and won't help your back, get some tramadol or Vicodin �� Many shitty doctors like to prescribe it instead of opiates because right now it's less regulated.

Ps 10 gabapentin 300mg with no tolerance feels like 20mg Valium for me, very nice

 

[ColoredHares]

I for one, am glad that this drug is finally being looked at. I have thoracic outlet syndrome, and was first prescribed gaba in 2011. Had surgery in 2013, and all along my dosage was steadily increased. I also had ulnar nerve decompression and carpal tunnel decompression in both wrists. I kept telling my docs that I was having all of these weird mood swings: fine one moment, and then for no reason hysterical crying or total anger rage. And the whole time, I would feel like I was floating above the situation, watching, and thinking, “oh, this is not going to end well....,” but I couldn’t stop.... ALL said I needed to go to a psychiatrist. Which I did. Each doc knew exactly what I was on because I always take a chart with me to each appt. with my current meds, dosage, etc. ALL said I was not on anything that should be causing this behavior. I even asked that since each area had the nerves released, could I stop the gaba (withdrawals are HORRIBLE). Was told by all no, it is a very safe drug. Just stay on it..... Well, after my 2nd involuntary hospitalization (this time, I was put in hand and ankle cuffs, and then struggled and lost count of being tased at 12..... 4 shots of Haldol knocked me out), a friend of mine picked me up (hubby had moved out) and said, ‘we need to talk about your gaba...’. I looked up the side effects, and I had 10 out of 12. Spent the next 5 days withdrawing from the 3600 mg that I had been taking daily for at least 3 years..... ALL of the mood swings stopped, and haven’t returned, thankfully. And, ironically, the nerve pain I do have is about the same as it was while on the gaba. When I told my primary care doc, his response was, ‘yes, I have heard about it causing psychotic breaks....’. I have a pain management doc I see quarterly, but ironically, whenever I see any of my docs, and they have a med student with them, the FIRST the med student asks me is, “have you tried Gabapentin?” So, it is painfully clear that it is still being a go to drug...... FYI, I’m not taking any opiates, and haven’t since I had the extra ribs cut off of m

 

[Jabberwocky]

A prescription medicine discovered to be "mis-usable" is also being irresponsibly prescribed by doctors...


























what a surprise.

 

[LucidSDreamr]

i could be wrong but i think gapapentin is is primarily used for nerve pain, so i don't know if that would help with your back

Guess what senses the pain in the back? Nerves.

Gabas cousin preegabalin is highly effective for my back pain due to a herniated disk that was repaired surgically

 

[LucidSDreamr]

The war on pain patients continued. Soon heroin will be the first line of treatment.

 

[oxyloveUK]

Before my GP cut me off my oxycontin and morphine causing me horrific agony nearly causing a heroin habit he tried to increase my gabapentin saying its not addictive and ill be fine if I stop. What bullshit, the withdrawal is far more dangerous with a seizure risk and it is very addictive. Gabapentin is being marketed as non-addictive now just like oxycontin in the 90s, only gaba is useless for most pain and a nastier addiction.

https://www.youtube.com/watch?v=VpEQaa6jzUU the lady mentions how gabapentin caused her to black out at the wheel and drive off the road

Please fight back against this shit guys

 

[Jabberwocky]

Surprisingly nice youtube vid. Sometimes I forget how good Al Jazeera is. I need to watch the doc Control Room again...

Anyways, thanks for sharing. Reminds me a little bit about my DUI experience. It pretty much as silly as a DUI can be without actually causing anyone serious harm, but it was still a [hangs head in shame...]

Back on topic...

Gapabentin dependency is pretty brutal, but it isn't as problematic as opioids or benzos on a systems level. I don't even know where to begin, but it must be noted that gabapentin is basically an essential front line detox comfort med to treat symptoms of acute opioid withdrawal. It has some very serious utility in other ways as well.

But like anything else, when improperly taken it can lead to problems. And I don't want to even think about how uncomfortable something like gabapentinoid withdrawal would be for some who is seriously dependent and stops abruptly.

 

[oxyloveUK]

Yeah things are great done correctly and reasonably for everything. It is great for opiate withdrawal and anxiety, wasnt criticizing it for that but for acute physical pain it is useless for anything other than neuropathic (personal exp too) and the withdrawal symptoms like seizure risk and extreme paranoia seem nastier and more dangerous than oxycodone withdrawal. I'm just saying that for physical pain (non-neuropathic) like a broken bone or dislocation an opioid seems much more appropriate benefit to risk wise, they attack pain quickly from every angle and not everyone builds a short-term tolerance

A doctor getting someone hooked on gabapentin because they dont want opioid scrutiny or care about someone's pain and quality of life is what the NHS are doing right now and its fucked up

Gabapentin was worse to withdraw for me after my GP recently cut me off everything (2nd worst personal withdrawal ever to methadone) than oxycontin, I had light sensitivity to the point I laid with a blindfold for hours listening to soothing music which I never thought I'd do before and really wanted to kill myself and was agitated with everything 10/10, seemed similar to what benzo withdrawal sounds like and the only thing that got me through was the idea of revenge at my GP for doing this to me this way and plenty of other people

 

[treezy z]

I've been taking this shit for years as a harmless alternative to a benzo script (which would probably ruin my life.) If my doctor cuts me off I'll probably go ballistic (literally, it calms my anxiety.)

 

[mp44god]

I take pregabalin (basically a more potent version of gabapentin) when I'm out or running low on my k-pins. You can definitely get a pleasurable, dissociated euphoria on this drug in large enough doses, but it pales in comparison to benzos, or even alcohol imo. Even though Lyrica is actually scheduled, I've never heard of it being sold on the streets.

 

[someguyoz]

I'm on 300mg x3 day for chronic pain I've had for 17 yrs....grudgingly went up from 300mg/day after a flare up 1 1/2 years ago which won't settle down. Grudgingly as I had an iv heroin habit during the 90s and am uber resistant to taking anything which has a "discontinuation syndrome" as my doctors are only just now admitting is the case - would never have agreed to take the shit if I'd known at the start. Interestingly we don't have as much of a problem with gaba abuse in Australia as its only available at a concession rate from public hospital pharmacies for pain, a GP script requires you to have epilepsy or be on a Veteran's Affairs pension otherwise it's full price.