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SWISS MEDICAL EXPERTISE: ZURICH, MALLORCA, LONDON, MARBELLA

11 Minutes

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Commonly prescribed to manage seizures and neuropathic pain, gabapentin has recently become a topic of great concern, specifically because of its high potential for addiction. While it is generally safe when used as directed, its potential to cause strong euphoria and anxiety relief attract millions of individuals toward using it recreationally, increasing the risk of dependence.

This misuse has recently skyrocketed in the past few years, raising alarm in the medical community regarding the potential complications associated with Gabapentin dependence. Understanding Gabapentin, and learning how to identify and overcome its addiction has; therefore, become an important topic for de-escalation and management, especially in those actively relying on this medication in everyday life.

Gabapentin, also known as Neurontin, is a prescription medication primarily used to treat neurological and psychiatric conditions. Initially developed as an anticonvulsant, it has since been approved and commonly prescribed for many medical purposes, such as:

  • Nerve pain management: Gabapentin is widely given for conditions such as postherpetic neuralgia, a type of nerve pain that occurs after shingles. Studies show it is also effective for managing neuropathic pain caused by diabetes or spinal cord injuries. [1]
  • Seizure disorders: Approved as an adjunctive therapy for partial seizures, Gabapentin is usually used with other drugs for controlling seizures.
  • Restless legs syndrome: Gabapentin has been shown to relieve the discomfort linked to RLS, improving sleep and quality of life in affected individuals.
  • Fibromyalgia: The drug is commonly given off-label to control pain and improve functionality in individuals with fibromyalgia, a condition characterized by widespread musculoskeletal pain.
  • Anxiety disorders: Gabapentin is sometimes used off-label to manage anxiety, particularly in individuals who do not respond well to traditional medications like benzodiazepines.
  • Alcohol withdrawal: Doctors may prescribe Gabapentin to ease symptoms of alcohol withdrawal and prevent relapse, especially in individuals with co-occurring anxiety or nerve pain.

Gabapentin addiction usually starts with misuse, either through taking higher doses than prescribed or using it for non-medical purposes. The following is an explanation of how the drug works and paves the way for the development of addiction:

How Gabapentin affects the brain

According to research, Gabapentin primarily targets the nervous system, particularly binding to calcium channels in the brain. This action decreases the release of certain neurotransmitters, such as glutamate, which are linked to excitatory signals. By controlling these signals, Gabapentin helps to calm overactive nerve activity, providing relief from conditions like seizures or nerve pain. However, this calming effect can go beyond therapeutic use. 

When taken in higher doses, Gabapentin can cause relaxation, sedation, and mild euphoria. These effects occur as the drug modulates the brain’s reward system, indirectly impacting the release of dopamine. While not as intense as with other substances like opioids or stimulants, the euphoria can drive individuals to take Gabapentin more frequently or in higher doses, leading to addiction. [2]

Recreational use and misuse

Gabapentin misuse usually begins accidentally, with individuals increasing their dosage to manage pain or anxiety when their prescribed dose no longer feels effective. In some cases, individuals seeking its euphoric effects may take it recreationally, usually in combination with other substances like alcohol, for a more intense high. This behavior significantly contributes to the risk of Gabapentin dependence. As tolerance develops, the brain becomes used to the drug’s presence, requiring higher doses to get the same effects. Over time, individuals reportedly feel unable to function without Gabapentin, resulting in physical and psychological dependency. [3]

Tolerance and dependency

The development of tolerance is a key factor in Gabapentin addiction. With repeated use, the brain’s natural balance disrupts, decreasing its ability to regulate nerve activity without the drug. Dependency occurs when the body adjusts to the constant presence of Gabapentin, and discontinuing its use results in withdrawal symptoms. These symptoms, which can include anxiety, insomnia, and nausea, typically make individuals continue using the drug regardless of adverse outcomes.

Psychological support

In addition to physical dependency, studies have highlighted the role of Gabapentin-induced psychological reinforcement as a cause of addiction. Individuals may come to rely on the drug as a way to cope with stress, anxiety, or other emotional issues. This reliance, combined with withdrawal symptoms, leads to addiction that can be challenging to control without professional intervention. [4]

Gabapentin addiction can cause different symptoms. While overall symptom profile may vary depending on factors like severity of addiction, individual health, and combination with other drugs, the general signs include the following:

Physical symptoms

Gabapentin addiction can have noticeable effects on the body, often manifesting as the following changes in health:

  • Unexplained drowsiness or constant lethargy, even after resting.
  • Dizziness or difficulty maintaining balance, unrelated to other conditions.
  • Increased sensitivity to pain even when using Gabapentin for pain management.
  • Blurred or double vision, impacting daily activities like driving.
  • Swelling, particularly the hands and feet, usually because of fluid retention.

Mental symptoms

Gabapentin’s effects on the brain can result in significant psychological changes such as:

  • Elevated anxiety levels or even paranoia, specifically when the drug is unavailable.
  • Periods of confusion or forgetfulness, typically interfering with routine tasks.
  • An increasing dependency on Gabapentin to control emotions or stress.
  • Depressive episodes that come with hopelessness or despair.
  • Inability to focus or stay mentally present, even in everyday situations.

Behavioral Symptoms

Addiction to Gabapentin also causes shifts in behavior, which show the individual’s dependence on the drug. Some common behavioral signs of Gabapentin dependence are:

  • Repeatedly requesting early refills or seeking prescriptions from different healthcare providers. [5]
  • Social withdrawal, including avoidance of friends or family to hide drug use.
  • Ignoring professional or academic responsibilities because of the drug’s effects.
  • Putting oneself at risk by certain behaviors, such as driving while under the influence of Gabapentin.
  • Spending a lot of time or money to obtain the drug illegally.

Rare symptoms

While uncommon, some symptoms of Gabapentin addiction are severe and need immediate attention, such as:

  • Hallucinations, either auditory or visual, specifically at high doses.
  • Seizures in individuals who were not previously diagnosed with seizure disorders as a result of abrupt discontinuation.
  • Unexplained muscle weakness or inability to move, resembling the signs of a  neurological disorder.
  • Constant gastrointestinal issues, such as nausea or severe constipation, unrelated to diet or other medicines.
  • Mood swings, causing an individual to rapidly switch from euphoria to uncontrollable anger or irritability.

Recognizing and addressing Gabapentin addiction early is necessary for reducing its long-term effects and increasing the chances of successful recovery. Addiction to Gabapentin adversely affects physical and psychological health, and delaying treatment usually worsens these challenges. Seeking professional help as soon as signs of addiction appear is the most effective way to address dependency and regain control over one’s life. 

The first step in seeking help involves consulting a healthcare provider who can assess the severity of the addiction, general health, and any co-occurring mental or physical health conditions. Based on this evaluation, the following options are advisable for Neurontin addiction:

Supervised detoxification

Detoxification is usually the first step in treating Gabapentin dependency, especially for individuals with a severe addiction. Medically supervised detox ensures that the individual can safely discontinue use while decreasing withdrawal symptoms. Healthcare providers carefully oversee the process, changing the tapering schedule and providing treatments as needed to manage symptoms. Detoxification in a medical setting also helps in immediate intervention if any health issues arise during the withdrawal phase.

Inpatient rehabilitation

Inpatient rehabilitation programs for Gabapentin addiction provide a safe space for individuals with severe addiction or co-occurring mental health conditions. These programs offer 24/7 medical assistance, helping individuals focus on recovery without the triggers of daily life. Inpatient care typically utilizes a combination of individual therapy, group counseling, and educational sessions to address the underlying causes of addiction while teaching individuals the strategies for long-term recovery.

Outpatient treatment

Outpatient treatment is a flexible option for those with mild to moderate Gabapentin addiction who do not need 24/7 supervision. As a part of this treatment,  Individuals attend scheduled therapy sessions, counseling, and workshops while continuing to live at home. Outpatient care helps individuals to maintain their responsibilities while receiving treatment. This option is usually recommended to those switching from an inpatient program or those with a strong support system and a safe environment at home.

Dual diagnosis treatment

For individuals struggling with Gabapentin addiction and co-existing mental health conditions such as anxiety or PTSD, dual diagnosis treatment is crucial. This approach combines addiction treatment with mental health care, treating both issues for a comprehensive recovery. Therapy sessions may focus on identifying the links between substance use and mental health challenges, teaching individuals the skills to manage both effectively.

Aftercare and relapse prevention

After completing primary treatment, ongoing support through aftercare programs is necessary for maintaining sobriety from Gabapentin. Aftercare usually includes regular check-ups with healthcare providers, participation in support groups, and continued therapy to prevent relapse. These programs are tailored to the individual’s specific challenges so that they are prepared to manage any difficulties without relying on Gabapentin.

Failing to seek treatment for Gabapentin addiction can lead to severe consequences that affect all aspects of life. These issues can worsen over time, making recovery more difficult. Some of the common consequences of untreated Neurontin addiction are as follows:

Physical health issues

  • Organ damage: Gabapentin abuse can negatively impact the liver and kidneys, two key organs responsible for metabolizing and excreting the drug. Over time, this effect can lead to organ dysfunction or even total failure.
  • Respiratory issues: Consuming high doses or mixing Gabapentin with other substances can suppress respiratory function, adding to the chances of breathing difficulties or respiratory arrest.
  • Neurological problems: Constant use of Neurontin can cause persistent issues with balance and reflexes, which may become irreversible without timely treatment.

Mental health complications

  • Cognitive decline: Chronic abuse of Gabapentin may result in memory issues and decreased mental functioning, affecting the ability to focus or solve problems.
  • Worsening of existing issues: Pre-existing conditions like anxiety and depression can worsen, as Neurontin may no longer provide relief but instead contribute to emotional instability.
  • Increased chances of self-harm: Persistent Gabapentin addiction and the isolation it comes with can contribute to the risk of self-harming behaviors or suicidal ideation, specifically during withdrawal from the drug.

Social and lifestyle problems

  • Strained relationships: Gabapentin addiction can result in the neglect of personal responsibilities and emotional withdrawal, causing issues in relationships with family and friends.
  • Loss of employment and financial stability: Constant Neurontin misuse and its impact on physical and mental health can impact job performance, often leading to unemployment and financial issues.
  • Legal issues: Obtaining Gabapentin through illegal ways, such as multiple prescriptions from different healthcare providers or purchasing from unauthorized sources, can result in legal consequences, including fines and jail time.

Risk of overdose

Without proper intervention, individuals with Gabapentin addiction are at an elevated risk of overdose. Overdose can occur from taking high doses of the drug or combining it with other substances, causing symptoms like extreme sedation and respiratory failure. Without immediate medical intervention, Gabapentin overdose can be life-threatening and result in irreversible issues or death.

Preventing Gabapentin dependency requires different steps to ensure its safe and responsible use. Some examples of these steps include the following:

Step One – Follow prescription guidelines

The most effective way to prevent Gabapentin addiction is to follow the prescribing healthcare provider’s instructions strictly. Individuals should always take the medication at the prescribed dose and frequency and never change the dosage without consulting a doctor. Avoid using Gabapentin off-label, even if it offers temporary relief.

Step Two – Regularly seeing a doctor

Staying in contact and regularly visiting a doctor is crucial to keep Gabapentin use safe and effective. Attend follow-up appointments to discuss any changes in symptoms or concerns about side effects. If the medication seems less effective over time, discuss other options with the doctor instead of increasing the dose without any discussion.

Step Three – Avoid ploysubstance use

It is possible to enhance Gabapentin’s effects by combining it with other substances, such as alcohol, opioids, or sedatives. Known as polysubstance use, taking multiple substances with Gabapentin can significantly increase the chances of misuse and addiction. Hence, it is essential to inform healthcare providers of any other medications or substances they are currently taking to prevent dangerous interactions.

Step Four – Awareness of common addiction signs

Identifying early signs of Gabapentin misuse is key to preventing addiction. For individuals using Gabapentin off-label or without prescription, it is essential to get guidance from a medical professional immediately. Recognizing and addressing these behaviors can prevent further misuse.

Step Five – Exploring alternative options

For individuals with the possibility of an underlying Gabapentin addiction, checking non-pharmacological treatments can be an important preventive measure. Options such as cognitive-behavioral therapy, physical therapy, or healthy lifestyle changes can help address the underlying addiction without the need for long-term medication.

Gabapentin addiction is a severe condition that can adversely impact physical and mental health. Despite the associated challenges, recovery is possible with timely intervention. Recognizing the symptoms of dependency early and getting professional help, such as detoxification and therapy, can prevent severe complications. Following prescribed use of gabapentin and exploring alternative treatment options when addiction starts to develop are important steps in lowering the chances of addiction. While recovery from Neurontin misuse may be difficult, extensive treatment and support systems provide the tools required for lasting change and a healthier life.

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