Many widely known prescription medications are unfortunately abused. According to the New York State Department of Health, opioids like morphine, codeine, oxycodone, and hydrocodone—branded as OxyContin, Vicodin, and Lortab—top the list of frequently misused drugs. Additionally, medications used for anxiety and sleep disorders, such as Valium and Xanax, are commonly abused, as are stimulants for ADHD, including Ritalin, Dexedrine, and Adderall.

Dr. Holly Geyer, an addiction medicine expert and the head of the Mayo Clinic opioid stewardship program in Arizona, points out that as a way to address the issue of opioid misuse, many doctors are opting for a category of medications that aren’t regulated as controlled substances: the gabapentinoids. This shift has propelled gabapentin to become the sixth-most prescribed drug in the U.S.

Ironically, this has led to new patterns of gabapentin misuse spreading throughout the country, according to Geyer. She noted that people may abuse gabapentin by itself or mix it with other drugs, including opioids.

Below are insights into the original approval of gabapentin, its current uses, and the growing concerns surrounding its potential for abuse and misuse.

What is gabapentin?

Gabapentin is a prescription medication that the U.S. Food and Drug Administration (FDA) approved in 1993 for treating epilepsy. It functions by targeting specific calcium channels in nerve cells, which is believed to change how those nerves operate, as explained by Dr. Tom Lombardi, medical director of neurosciences at Intermountain Health in Salt Lake City.

This medication can aid in managing certain types of nerve pain and assist in controlling seizure disorders by acting on the nervous system to decrease nerve signal transmission, according to Geyer.

Gabapentin is usually taken orally two to three times a day and comes in both pill and liquid forms. It is available as both a branded and generic product, including brand names like Neurontin, Horizant, and Gralise, states Andrea Tedeschi, a neuroscientist at The Ohio State University College of Medicine, and a researcher in gabapentin studies.

What are gabapentin side effects?

Gabapentin is effective for many users, but it can also lead to various side effects when taken as prescribed. Commonly reported side effects include drowsiness, dizziness, headaches, dry mouth, weight gain, swelling of hands, feet, or ankles, back or joint pain, and flu-like symptoms such as nausea, fever, and body aches, according to Harvard Medical School.

There are also rare but serious side effects, including rashes, itching, jaundice, facial and throat swelling, speech difficulties, trouble swallowing, and cognitive changes like memory issues or altered personality.

What is gabapentin used for?

When correctly prescribed, gabapentin boasts numerous applications and advantages. The drug is FDA-approved for managing seizures and reducing a specific type of nerve pain known as post-herpetic neuralgia, which can occur after a shingles infection.

Additionally, Tedeschi notes that gabapentin is frequently prescribed off-label by healthcare providers for various conditions. Off-label use refers to cases where evidence suggests that a drug can effectively treat conditions beyond its FDA-approved uses.

Common off-label prescriptions of gabapentin include for hot flashes, restless leg syndrome, mood disorders, anxiety, and nerve pain tied to diabetes, as well as neck and back pain associated with conditions such as sciatica.

One of the reasons for gabapentin’s popularity is its affordability as a generic medication, as pointed out by Lombardi. It is also praised for providing “excellent pain control for many conditions influenced by nerve damage,” according to Geyer.

What is the controversy with gabapentin?

Despite being FDA-approved and widely recognized for its effectiveness, gabapentin often faces misuse. While it is not classified as addictive, “some individuals may experience a ‘high’ from the drug, which raises its abuse risk,” Geyer observes.

Gabapentin is also noted for its ability to enhance the effects of opioids, as stated by Tedeschi, which can perpetuate opioid misuse and even link it to overdose fatalities, according to Harvard Medical School. Consequently, several states have officially classified gabapentin as a Schedule V controlled substance, according to Lombardi.

Misuse can happen when someone takes prescribed gabapentin in ways other than directed or acquires it illegally online, just like other illicit drugs, Geyer explains.

She emphasizes that for the majority of people, gabapentin is generally considered safe, “but its potential for misuse is increasingly coming to light.” According to Geyer, it is challenging to predict who may be vulnerable to abusing this medication, although a prior history of addiction may serve as a risk factor. “Patients should be made aware of this potential risk when starting the medication,” she advises, “and should be encouraged to communicate any concerns.”

If there are any issues, they should share their worries.