Gabapentin Addiction: Misuse, Risks and Treatment Options

Gabapentin is not a federally controlled substance, but it can be misused, and people who take it for a long time can become physically dependent on it. Misuse is most common among people with a history of other drug use, and the biggest danger comes from mixing gabapentin with opioids, alcohol or other sedatives. Help is available, and stopping safely starts with a gradual taper guided by a doctor.

What Gabapentin Is

Gabapentin (brand names Neurontin, Gralise and Horizant) is an anticonvulsant. MedlinePlus lists its main uses as helping control certain seizures, easing nerve pain after shingles, and, in one extended-release form, treating restless legs syndrome. Doctors also prescribe it off-label for other nerve pain. Because it is widely prescribed and often seen as low-risk, many people do not realize it can be misused.

The FDA label for Neurontin states that gabapentin is not a controlled substance under federal law. Still, the same label describes reports of misuse and abuse, and it tells prescribers to screen for a history of drug use and watch for warning signs.

How Gabapentin Misuse Happens

According to the Neurontin label, most reported misuse involves people with a history of using several substances, some of whom took doses higher than recommended. Common patterns include:

• Taking more than prescribed to feel calm, relaxed or "buzzed"
• Combining it with opioids to strengthen or stretch out their effects
• Mixing it with alcohol or other sedatives, which deepens drowsiness
• Using pills without a prescription, often from friends or family
• Raising the dose on their own as the effect fades

Whether gabapentin is truly "addictive" is a common question. We cover that in detail in Is Gabapentin Addictive?

The Biggest Danger: Mixing Gabapentin With Opioids or Other Sedatives

The FDA has warned that gabapentin and pregabalin can cause serious breathing problems. The risk is highest when they are taken with opioids or other drugs that slow the central nervous system, such as anti-anxiety drugs, sleep medicines and some antihistamines. Older adults and people with lung problems are also at higher risk.

The Neurontin label adds that breathing trouble in these situations can be life-threatening or fatal. Alcohol adds to gabapentin's drowsiness as well.

Warning signs of dangerous breathing problems include:

• Confusion or unusual dizziness
• Extreme sleepiness or being hard to wake
• Slow, shallow or difficult breathing
• Bluish lips, fingers or toes

If someone shows these signs, call 911 right away.

Warning Signs of Gabapentin Misuse

Gabapentin misuse can be hard to spot because the drug is so common. Watch for:

• Taking extra doses or running out of a prescription early
• Asking for higher doses, or seeing more than one prescriber
• Seeming drowsy, slurred, unsteady or "out of it"
• Using gabapentin together with opioids, alcohol or sleeping pills
• Feeling anxious, sweaty or sick when a dose is missed
• Mood changes, including new depression or agitation

Gabapentin, like other anticonvulsants, carries a warning about suicidal thoughts. If you or someone you love is thinking about self-harm, call or text 988.

How to Stop Gabapentin Safely

Do not stop gabapentin suddenly, especially after long-term or high-dose use, without talking to your doctor. The Neurontin label reports withdrawal effects that can begin within about two days of stopping, after both short and long courses. People with epilepsy face an added risk: stopping too fast can bring on more seizures.

The FDA label says that when gabapentin is stopped or the dose is lowered, it should be done gradually over at least one week, and that longer tapers are up to the prescriber. In practice, people who have taken high doses for a long time often need a slower plan.

Your prescriber sets the schedule. Never change your dose on your own. For an overview of how doctors usually approach this, see our gabapentin taper chart guide.

Treatment Options for Gabapentin Misuse

There is no specific medication approved to treat gabapentin misuse. NIDA's guidance for sedative-type drugs applies well: people who are dependent should not quit on their own, a medically supervised taper is safer, and counseling should follow. NIDA also stresses that when more than one substance is involved, such as gabapentin plus alcohol, treatment should address all of them at once.

Medical detox

A supervised detox lets a medical team taper the dose, monitor for seizures and severe symptoms, and treat anxiety or sleep problems. This is especially important for people who also use alcohol or other sedatives. Programs that run sedative and sleeping pill detox commonly handle this kind of taper.

Rehab and therapy

• Cognitive behavioral therapy helps people understand their triggers and build healthier ways to manage pain, stress and sleep.
• Pain and mental health care matters because many people started gabapentin for nerve pain, anxiety or sleep. A good program finds other ways to treat those problems.
• Family support helps loved ones learn how to help without enabling.

Levels of care

Care can range from outpatient counseling, to intensive outpatient or partial hospitalization several days a week, to residential rehab where you live on-site. Heavy use, mixing with other drugs, or past relapses usually point toward more support.

Finding Treatment Near You

Gabapentin is usually treated by programs that also care for people dependent on sleeping pills and other prescription drugs. Start with our national sleeping pill and sedative rehab directory. If gabapentin misuse is tied to stimulant use, the Adderall rehab directory lists programs that treat both.

You can also browse by location: try Tennessee, Kentucky, or city pages such as Louisville and Knoxville. The full list of states is on our states page, and our insurance guides explain how to check your coverage. SAMHSA also runs a free, confidential national helpline, open 24/7, for treatment referrals.

Sources

• Neurontin (gabapentin) Prescribing Information (U.S. Food and Drug Administration)
• Serious Breathing Difficulty Risk with Gabapentinoids (FDA Drug Safety Communication summary) (Indian Health Service)
• Gabapentin (MedlinePlus, National Library of Medicine)
• How Can Prescription Drug Addiction Be Treated? (National Institute on Drug Abuse)
• SAMHSA's National Helpline (SAMHSA)

Related guides

• Adderall Addiction: Signs, Risks and Treatment Options
• Ambien Addiction: Signs, Risks and Treatment Options
• Lunesta and Sonata Addiction: Risks and Treatment
• Lyrica (Pregabalin) Addiction: Risks and Treatment Options
• Soma and Muscle Relaxer Addiction: Risks and Treatment
• Sleeping Pill Withdrawal: Symptoms, Risks and Timeline

Find treatment

Ambien & Sleeping Pill Rehab by stateAdderall Rehab by state