- Gabapentin is an anticonvulsant medication marketed as Neurontin
- FDA-approved for epilepsy and postherpetic neuralgia (shingles pain)
- Widely prescribed off-label for anxiety, insomnia, and chronic pain conditions
- Not an opioid but increasingly involved in polysubstance misuse patterns
- Produces mild euphoria and sedation at high doses, driving recreational use
- Classified as a Schedule V controlled substance in several U.S. states
- Withdrawal can cause seizures and should be medically managed
- Gabapentin misuse often co-occurs with opioid and benzodiazepine use disorders
Published: February 2026 | Last Updated: February 2026 | Reading Time: 6 min
What Is Gabapentin?
Gabapentin is a prescription medication originally developed as an anticonvulsant (anti-seizure drug). Marketed under the brand name Neurontin and available in generic form, gabapentin was approved by the FDA in 1993 for the adjunctive treatment of partial seizures in adults and children, and later for the management of postherpetic neuralgia — chronic nerve pain following shingles.
Chemical Properties
Despite its name suggesting a relationship to the neurotransmitter GABA (gamma-aminobutyric acid), gabapentin does not directly bind to GABA receptors or affect GABA synthesis or metabolism. Instead, it binds to the alpha-2-delta subunit of voltage-gated calcium channels in the central nervous system, modulating the release of excitatory neurotransmitters.
Prescribing Trends
Gabapentin has become one of the most prescribed medications in the United States, with over 70 million prescriptions filled annually. Much of this prescribing is for off-label uses — conditions not formally approved by the FDA — including generalized anxiety disorder, fibromyalgia, diabetic neuropathy, restless legs syndrome, alcohol withdrawal management, and insomnia.
How Gabapentin Works
Gabapentin's primary mechanism involves binding to calcium channel subunits in the nervous system, reducing the influx of calcium into nerve terminals. This decreases the release of excitatory neurotransmitters like glutamate, norepinephrine, and substance P, resulting in reduced nerve signal transmission.
Effects on the Body
At therapeutic doses, gabapentin produces anticonvulsant, analgesic (pain-relieving), and anxiolytic (anxiety-reducing) effects. Side effects commonly include drowsiness, dizziness, fatigue, peripheral edema, and coordination problems. At doses significantly above therapeutic range, gabapentin can produce euphoria, enhanced sociability, and a sense of calm that some describe as similar to a mild benzodiazepine or alcohol-like effect.
Gabapentin Misuse and Addiction Potential
Why Gabapentin Is Misused
Gabapentin was historically considered to have minimal abuse potential. However, growing evidence reveals a significant misuse problem, particularly among individuals with existing substance use disorders. Studies suggest that 15-22% of individuals in substance abuse treatment report misusing gabapentin.
The drug is misused for several reasons: to enhance the euphoric effects of opioids, to alleviate opioid withdrawal symptoms, to produce standalone intoxication at high doses (often 3,000-5,000 mg, well above the typical prescribed range of 900-1,800 mg), and to self-medicate anxiety or insomnia.
Polysubstance Risk
Gabapentin is rarely a primary drug of abuse. More commonly, it is misused alongside opioids, benzodiazepines, or alcohol. This combination is particularly dangerous because gabapentin potentiates the respiratory depressant effects of these substances, increasing overdose risk. Multiple states have reported gabapentin involvement in drug overdose deaths.
Regulatory Response
In response to growing misuse concerns, several states including Kentucky, West Virginia, Tennessee, Michigan, and Virginia have classified gabapentin as a Schedule V controlled substance, requiring prescriptions to be tracked through prescription drug monitoring programs (PDMPs). It remains unscheduled at the federal level.
Gabapentin Withdrawal
Physical dependence on gabapentin can develop with regular use, even at prescribed doses. Abrupt discontinuation can trigger withdrawal symptoms including anxiety, insomnia, nausea, sweating, body pain, and — most concerning — seizures. Withdrawal should be medically supervised with a gradual dose taper over days to weeks.
Treatment for Gabapentin Misuse
Treatment for gabapentin misuse typically involves medically supervised tapering, followed by comprehensive assessment for co-occurring substance use disorders and mental health conditions. Since gabapentin misuse frequently co-occurs with opioid use disorder, integrated treatment addressing all substances simultaneously produces the best outcomes.
Frequently Asked Questions
Is gabapentin an opioid?
No. Gabapentin is an anticonvulsant medication and is not chemically related to opioids. However, it is increasingly misused alongside opioids and has been found in combination with opioids in overdose deaths, leading to confusion about its classification.
Can gabapentin cause addiction?
While gabapentin's addiction potential is lower than opioids or benzodiazepines, dependence and misuse are well-documented. Individuals with a history of substance use disorders are at elevated risk for gabapentin misuse.
How long does gabapentin stay in your system?
Gabapentin has a half-life of 5-7 hours in most adults. It is typically eliminated from the body within 24-48 hours. Gabapentin is not detected by standard drug screening panels but can be identified through specialized testing.
What happens if you stop gabapentin suddenly?
Abrupt discontinuation of gabapentin after regular use can cause withdrawal symptoms including seizures, anxiety, insomnia, nausea, and pain. The drug should always be tapered gradually under medical supervision.
References
- Evoy, K.E., et al. (2017). Abuse and Misuse of Pregabalin and Gabapentin. Drugs.
- Goodman, C.W. & Brett, A.S. (2017). Gabapentin and Pregabalin for Pain — Is Increased Prescribing a Cause for Concern? NEJM.
- Smith, R.V., et al. (2016). Gabapentin misuse, abuse and diversion: A systematic review. Addiction.
- National Institute on Drug Abuse. (2023). Emerging Trends and Alerts.
- U.S. Food and Drug Administration. (2019). FDA warns about serious breathing problems with gabapentinoids.
This article was reviewed by the Valley Spring Recovery Center Editorial Team. For more information about prescription drug misuse treatment, call (201) 781-8812 or visit our admissions page.
Valley Spring Recovery Center — Evidence-based addiction treatment in Norwood, New Jersey.