Gabapentin is a Central Nervous System Depressant used to treat nerve pain and epilepsy. You may know this drug by the brand names Neurontin, Horizant, or Gralise. Many doctors have been prescribing it in place of opiates for bad backs and other nerve pain afflictions to quell the opiate crisis. In fact, Gabapentin has a low addiction liability level. However, this drug is now being diverted at an alarming rate.

As of right now, Gabapentin is not scheduled under the Controlled Substances Act (CSA), but that may change quickly. A number of overdoses have been reported where Gabapentin has been abused with opiates like Oxycodone. Because of this, there is a call to place Gabapentin in the CSA. When that will happen is anyone’s guess.

How are People Diverting Gabapentin?

Diversion occurs when someone diverts a medication from its intended purpose to an unlawful one. Theft is a great example of diversion. This may occur in a pharmacy robbery where a suspect does a stick up of a pharmacy to steal drugs. Or it may happen in a convalescent hospital when an employee or other trusted person steals medication from a patient. Theft of Gabapentin is one way people are diverting the drug. Another is by doctor shopping. Here, a drug user may go to several doctors with the same symptoms or affliction in an effort to be prescribed Gabapentin. It is fairly easy to do this. Just Google how to get Gabapentin prescribed to you and you will see scripts to tell your doctor so they prescribe the drug to you. Although most states have a prescription monitoring program to detect doctor shopping, the system is only as good as the information going into it. Gabapentin diversion also occurs when people share medication between each other or trade it on the street.

Who is Using Gabapentin?

The biggest abusers of Gabapentin are opiate addicts. Many will take Gabapentin with their opiate drug of choice to enhance their high. This type of poly drug use has been going on for decades. Prior years showed people combining other CNS Depressants like Klonopin or Valium. There is a definite high with Gabapentin at high doses. People can be prescribed this drug in high doses to control severe neuralgia. They often describe that they feel like they are in a fog and feel as if they are drunk. If someone were to use this with an opiate, it would enhance that feeling.

The drug comes in pill form, but many users aren’t just swallowing it. They are injecting it and snorting it. Some users are mixing the drug with heroin and then injecting the two simultaneously. Selling the drug can be quite lucrative, too. In Michigan, some users are reporting that Gabapentin is going for $10 a pill. To me, that seems highly over valued for the high that the drug delivers. It would make sense that it would be more along the lines of $2 a pill.

How bad is the Problem and Who is Abusing This?

Kentucky has seen a staggering 2,950% increase in gabapentin misuse among prescription opioid abusers. Another study showed that up to 65% of opioid addicts have a Gabapentin prescription. By interviewing an addict, you can see why they would want the drug beyond enhancing their high. Gabapentin can be used off label to treat addiction. Many addicts use the drugs to treat their own addiction outside of medical care. A 43-year-old Hispanic opiate addict said, “First learned of gabapentin at a treatment center. They gave me gabapentin. It kinda worked for the detox so from then on, I knew when I wanted to detox, I would go to my primary. I have a bad neck so he never had an issue giving me the gabapentin.” This same addict added, “It’s a seasoned junky’s detox.”

Some other excerpts from drug abusers about Gabapentin sheds light on why it has become so popular:

“I would wake up in the morning with withdrawals from my drugs of choice [cocaine] and I didn’t have withdrawals after I woke up if I had taken gabapentin.”
-22-year-old addict

• “I had been using Percocets with this guy and he had a bunch of [gabapentin] – he was prescribed them – and so I ended up taking a handful to try to not be sick from withdrawal.”
-32-year-old addict

“That’s a cocktail. That’s a good one. It’s like Suboxone is a fire and gabapentin’s oil and you’re throwing oil on that fire. It feels like it enhances the buprenorphine so much.”
“Gabapentin is cheap and easy. Suboxone’s kinda expensive if you don’t have an income. So, most of the times it was just gabapentin, but the preferred way was with Suboxone.”
“I shot it up a couple of times. It was kinda difficult.”
“I remember the first time I shot it up, it was like I had just taken heroin again. That first time came back to me.”
-52-year-old addict

Under the Influence of Gabapentin: The Signs

Whether you are a cop or work in the private sector, we all need drug influence training. Before we talk about what signs and symptoms, you will see for people under the influence, private sector people can get training in our CSi program (more information is available if you click the link). For law enforcement, you should get training in our Drug Abuse Recognition Program (click the link for more info).

Most, but not all, of the people under the influence of Gabapentin will be using another drug like an opiate. This may cause some confusion, but the person will still be high. To put it simply, they will look like they are drunk, but you won’t detect any odor of alcohol or they may test low or .00 on a blood alcohol screening test. Take a look at our diagram below to see the major signs and symptoms.

Most people with visible signs and symptoms of intoxication cannot drive a motor vehicle or continue working in the workplace. Being under the influence of this drug will cause slow reactions and poor motor function.

If you want more training in current drug trends, you can take one of our courses around the country or you can take the course online. If you want training in how to detect drug influence and how to document drug influence, private sector partners can get more information here and law enforcement can get more information here.