Gabapentin, a drug that’s primarily wont to control seizures in patients with epilepsy and to ease nerve pain, is becoming one among the foremost misused and abused drugs within the country.
Also referred to as Neurontin, it acts as a sedative, creating feelings of relaxation and, in some cases, euphoria, specifically when paired with opioids. The drug is FDA approved and isn’t considered a drug , but, still, Gabapentin abuse is rampant and lots of states are calling upon the federal for a change in drug classification. If you or a beloved take gabapentin, here’s what you ought to know.
What is Gabapentin?
Gabapentin has been utilized in the us for quite 25 years. it had been initially approved by the FDA for seizure control in adults and youngsters with epilepsy and was then later approved to assist manage postherpetic neuralgia (or nerve pain in folks who have had shingles). It also has off-label uses (meaning it’s applied in ways in which aren’t FDA-approved) like alcohol use disorder, chronic cough, restless legs syndrome syndrome, and nerve pain. One study found that gabapentin significantly reduced pain and other nerve symptoms in women undergoing chemo for ovarian cancer.
Side Effects of Gabapentin:
Thirty-five percent of individuals on gabapentin had to prevent taking it thanks to side effects, particularly dizziness and gastrointestinal problems. While gabapentin are often helpful during a number of conditions, it also causes side effects which will be debilitating for several people, and even deadly for a few.
In December 2019, the FDA issued a warning that folks with respiratory risk factors, like chronic obstructive pulmonary disease (COPD), who are taking gabapentin or pregabalin, a gabapentin-like drug, could experience serious breathing difficulties which will cause death. The warning also applies to the utilization of either of those drugs together with central systema nervosum depressants, like opioids, anti-anxiety drugs, antidepressants, or antihistamines. The FDA is requiring gabapentin and pregabalin manufacturers to feature warnings about the danger of respiratory depression to their labels, citing reports of a dozen deaths in people with one or more risk factors.
What’s more, both pregabalin and gabapentin were shown to extend the danger of suicidal behavior, unintentional overdoses, injuries, traffic incidents, and violent crimes, particularly in users between the ages of 15 to 24 years old. (Pregabalin was stronger overall than gabapentin.) Other side effects include dizziness, drowsiness, diarrhea, anxiety, unwanted eye movements, strange or unusual thoughts, weight gain, and more.
Misuse and Abuse
A review of 11 studies and 23 case reports published within the journal Addiction reported that up to 65% of individuals who had prescriptions for gabapentin misused the drug. Users take more to amplify the drug’s side effects of relaxation, calmness, and euphoria, but it also can be wont to debar withdrawal symptoms and block the consequences of medicines won’t to treat addiction, prolonging a user’s high. In some cases, the user’s goal was self-harm or suicide. Most of the abuse was from people that also took other substances, particularly opioids. When paired with opioids, gabapentin can bolster the drug’s effects, but combining the 2 can cause significant organ and brain damage, and even death.
Of the people on gabapentin or pregabalin, only 1.6% of non-opioid users abused the drugs compared to 68% of opioid users who engaged in misuse. Gabapentin is that the 9th-most prescribed drug within the us . IQVIA reported that 67 million prescriptions for gabapentin were written within the us in 2019, a 71% increase from 2012.
“My radar wasn’t on in terms of gabapentin being abused,” said Michele Matthews, PharmD, professor of pharmacy practice at the Massachusetts College of Pharmacy and Health Sciences in Boston.“With the shift from prescription opioids, there was a rise in non-opioid alternatives, and gabapentin was at the highest of the list,” she said. “For the foremost part, it wasn’t something we had to stress about. We’re seeing something different now.”
Matthews works with high-risk patients within the pain management clinic at Brigham and Women’s Hospital. She said that a typical dose of gabapentin for pain is between 1,800 and 3,600 mg each day. “We’re seeing requests for early refills,” Matthews said. “It’s almost like patients who could also be misusing opioids. It reminds prescribers that medications got to be monitored closely.”
But consistent with a 2019 survey of medical care physicians by Quest Diagnostics, 83% of prescribers feel that due to the opioid crisis it’s now much harder to treat patients with chronic pain. And although quite 80% of survey respondents believe they’re ready to recognize and screen for prescription misuse, 75% wish that they had more training on what to try to to if a patient shows signs of addiction.
Gabapentin isn’t scheduled as a drug by the federal because when given alone it’s not been considered addictive. However, when the drug is crazy other medications, like opioids, benzodiazepines, and amphetamines, gabapentin’s potential for abuse and addiction increases.
Experts are calling for a change in gabapentin’s classification thanks to the drug’s potential for abuse. The CDC creates a national list of medicine that are considered likely to cause addiction, abuse, or harm. Presently gabapentin isn’t on any of the five levels of Drug Classifications, implying that the CDC considers gabapentin to be as safe from causing addiction, abuse, or harm as drugs like insulin or aspirin. States can apply a more stringent Schedule level for his or her healthcare community. Quite a dozen states now require prescribers to report back to a state-level prescription monitor program whenever they dispense gabapentin. In 2017 Kentucky became the primary state to vary gabapentin’s classification to Schedule V, rock bottom drug level, increasing regulations and adding restrictions to prescribing and dispensing the drug. variety of states have taken an equivalent step, including West Virginia , Tennessee, Michigan, Virginia, Alabama, and North Dakota . Several others have taken steps to imitate .
As with all medicines, gabapentin in its many forms are often helpful for a few conditions. But it comes with side effects and risks that ought to be understood and thought of before committing to using it.
