Many of the prescription medications that are commonly misused or abused are brands that most people have heard of. Painkillers, also called opioids, are the most commonly abused, according to data from the New York State Department of Health. These include morphine, codeine, oxycodone and hydrocodone, with brand names OxyContin, Vicodin and Lortab. Depressants used to treat anxiety and sleep disorders include brands like Valium and Xanax and are also commonly abused. Ditto for stimulants that treat ADHD, such as Ritalin, Dexedrine and Adderall.
Dr. Holly Geyer, an addiction medicine specialist and physician-in-chief of the Mayo Clinic’s opioid management program in Arizona, explains that in an effort to help combat opioid-related drug abuse, many physicians have turned to a class of drugs that isn’t. t classified as a controlled substance: gabapentinoids. This has helped make a drug called gabapentin the sixth most prescribed drug in the United States.
As a result, and somewhat ironically, “we are now seeing emerging patterns of abuse with gabapentin across the country,” says Geyer, adding that such abuse can occur with gabapentin alone, “or in combination with other drugs of abuse, such as opioids .”
Here’s who gabapentin was originally approved for, what it’s used for today, and why it’s becoming a drug of increasing abuse and misuse.
What is gabapentin?
Gabapentin is a prescription drug that was approved by the U.S. Food and Drug Administration in 1993 as a treatment for epilepsy. It works by binding to a type of calcium channel in nerve cells, “which is thought to change the way the nerve functions,” explains Dr. Tom Lombardi, medical director of neuroscience at Intermountain Health in Salt Lake City, said.
In this capacity, the drug can help control specific types of nerve pain and treat seizures, “because it acts on the nervous system to help reduce nerve transmission,” says Geyer.
It is usually administered as an oral medication, usually taken by mouth two to three times a day, and is available in pill or liquid form, says Andrea Tedeschi, a neuroscientist at the Ohio State University College of Medicine and co-author of gabapentin -related research. . It is available “as a branded product and as a cheaper generic product,” he says. Brand names include Neurontin, Horizant and Gralise.
What are the side effects of gabapentin?
Although gabapentin may be useful in a number of conditions, some of the common side effects associated with taking the drug as directed include drowsiness, dizziness, headache, dry mouth, weight gain, swelling of the hands, feet or ankles, back – or joint pain. and flu-like symptoms such as nausea, fever and body aches, according to Harvard Medical School.
Rare but serious side effects include rash, itching, yellowing of the skin, swelling of the face and throat, difficulty speaking, difficulty swallowing and changes in memory, personality or ability to concentrate.
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What is gabapentin used for?
Gabapentin, when used as directed, is known to have numerous uses and benefits. It is FDA-approved to control and treat seizures and to reduce a specific type of nerve pain, restless leg syndrome, that often follows a diagnosis of shingles.
In addition to these FDA-approved uses, Tedeschi says gabapentin is also sometimes prescribed off-label by providers for a variety of other medical conditions. (Off-label use means there is evidence that a drug is useful in treating conditions other than those for which it is approved by the FDA.)
Common off-label uses in which doctors prescribe gabapentin include as a treatment for hot flashes, mood disorders, anxiety and to reduce nerve pain related to diabetes or neck and back pain associated with conditions such as sciatica.
One reason it’s so popular is that “it’s a generic drug, so it’s relatively cheap,” Lombardi says. It also provides “excellent pain control for many medical conditions caused by damaged nerves,” says Geyer.
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What is the controversy with gabapentin?
Despite its FDA approval and proven benefits, gabapentin is often abused. Although not considered addictive, “the drug can cause a ‘high’ in some patients, increasing its abuse potential,” Geyer notes.
It is also known to enhance the psychological effect of opioids, Tedeschi says, and therefore may contribute to their continued misuse — even to the point of being linked to overdose deaths, notes Harvard Medical School. Because of such factors, “several states have moved to list gabapentin as a schedule V controlled substance,” Lombardi says.
Its abuse can occur by using a prescription version of the drug differently than prescribed, and, like other illicit substances, “can also be purchased on the dark web without a prescription,” Geyer says.
She says gabapentin is a safe drug to take for most people, “but its potential for abuse is increasingly recognized.” She says it’s impossible to predict who might be prone to abusing the drug, but a history of addiction to other drugs could be a risk factor. “Patients should be informed about this potential side effect when starting the medication,” she warns, “and encouraged to speak up if they have any concerns.”
This article originally appeared on USA TODAY: What is gabapentin used for? Plus the side effects
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