Gabapentin is one of the most prescribed medications in the country. It isn’t an opioid and it has no federal controlled substance classification.
People in recovery may take gabapentin for nerve pain, anxiety or insomnia. Clinicians also sometimes use it to ease alcohol withdrawal.
The new study suggests that when people with opioid use disorder or other addictions misuse gabapentin, the misuse needs its own attention.
Gabapentin Misuse Is Linked to Stronger Cravings
The study explored gabapentin use for nonmedical purposes in people being treated for opioid addiction.
Researchers compared craving scores for patients who took gabapentin as prescribed with those who used it without a prescription or who took more than prescribed.
The nonmedical use group had an average gabapentin craving score of 3.8 and the prescribed use group scored 2.2. Researchers found the difference statistically significant.
Opioid craving scores didn’t differ between the groups. That means that people who misused gabapentin reported wanting gabapentin more strongly. Their desire for opioids looked much the same as everyone else’s.
These results suggest that gabapentin’s own reinforcing effects may help drive misuse in this group. The drug may not simply be acting as an add on to opioid use.
Gabapentin Gets More Attention in Opioid Care
Clinicians have debated gabapentin’s role in addiction treatment for years. Emergency department mentions of the drug have increased nationally, and earlier research has linked gabapentin use with worse overdose outcomes when it’s combined with opioids.
Some treatment programs now monitor gabapentin more closely. They may track it along with other medications that cause sedation .
The new study raises another concern. Screening patients for potential opioid relapse may pose a risk to those who misuse gabapentin because they crave the medication itself.
This is why clinicians are increasingly treating gabapentin misuse as a separate problem with specific screening and treatment protocols.
Clinicians may need to ask about gabapentin directly. Patients also need to feel comfortable answering honestly.
Screen for Gabapentin Misuse During Treatment
Clinical assessment for gabapentin misuse be especially important when someone has a prescription for pain or sleep problems.
Patients and families can help by telling the care team about every substance being used. That includes medications taken outside their prescribed instructions.
Ask About Medication Safety
You can use this study as a starting point when comparing addiction treatment programs. Ask these two questions before enrolling.
The answers can tell you more about how a program handles medication safety and co occurring substance use.
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