Gabapentin (sold as Neurontin, Gralise, and Horizant) is one of the most-prescribed medications in the United States, used for seizures, nerve pain, and a long list of off-label conditions. Once considered low-risk for addiction, gabapentin is now linked to dependence, misuse, and a sharp rise in overdose deaths, particularly when combined with opioids or other depressants.
This guide covers what gabapentin is, the signs of abuse and addiction, what to expect during withdrawal, and the treatment options that can support recovery.
Key Points
- Gabapentin (sold as Neurontin, Gralise, and Horizant) treats seizures, nerve pain, and restless leg syndrome, with many off-label uses.
- Once considered non-addictive, gabapentin can cause physical dependence, withdrawal, and addiction, especially at high doses or when combined with opioids, alcohol, or benzodiazepines.
- CDC data show overdose deaths involving gabapentin nearly doubled from 2019 to 2022.
- Withdrawal from gabapentin can begin within 12 hours of the last dose and, in severe cases, may include seizures.
- Treatment for gabapentin addiction starts with medical detox and may include inpatient, outpatient, or aftercare programs.
In This Article
- What is gabapentin?
- Gabapentin abuse
- Gabapentin side effects
- Signs of gabapentin addiction
- Combining gabapentin with other drugs
- Can you overdose on gabapentin?
- Gabapentin withdrawal
- Recognizing gabapentin addiction in a loved one
- Where to find help for gabapentin abuse treatment
- Treatment options for gabapentin addiction
What Is Gabapentin?
Gabapentin received FDA approval in 1993 and is sold under the brand names Neurontin, Gralise, and Horizant. It is most commonly prescribed for seizure disorders, postherpetic neuralgia, restless leg syndrome, and diabetic neuropathy.
More recently, gabapentin has been prescribed as an alternative to opioids for chronic pain and as an off-label option to ease withdrawal symptoms from alcohol and stimulant use disorders. It is also prescribed off-label for fibromyalgia, bipolar disorder, anxiety, mood disorders, migraine prophylaxis, post-traumatic stress disorder (PTSD), refractory chronic cough, and postmenopausal hot flashes.
Early on, physicians widely prescribed gabapentin as a safer alternative to prescription opioid medications because of the misconception that it carried little risk of addiction. Today, studies show that gabapentin misuse is increasingly common, especially among people who also use opioids or other substances. In addition to dependence and addiction risk, gabapentin has been linked to suicidal ideation, mood swings, and sudden changes in behavior.
2x Growth
U.S. gabapentin prescriptions roughly doubled between 2011 and 2017 as the medication was widely adopted as an opioid alternative for chronic pain.
69 Million
Estimated U.S. gabapentin prescriptions written in 2019, making it one of the country’s most-prescribed medications.
Prescriptions of gabapentin doubled between 2011 and 2017, and by 2019 an estimated 69 million prescriptions were written in the United States. It remains one of the most-prescribed medications in the country today, and by 2018 nearly one in five adults with chronic pain were prescribed gabapentin.
On the street, Gabapentin may be misused it for its ability to produce relaxation or calm and, at higher doses (above 800 mg), euphoria. It is also sometimes used recreationally because it does not appear on most standard drug screens.
How Does Gabapentin Work?
Despite its name, gabapentin does not directly increase levels of gamma-aminobutyric acid (GABA) in the brain. Instead, it binds to the alpha-2-delta subunit of voltage-gated calcium channels in the central nervous system, reducing the release of certain excitatory neurotransmitters. This calming effect on nerve activity is what makes gabapentin useful for managing seizures and several types of neuropathic pain.4
Because gabapentin works on a different mechanism than opioids or benzodiazepines, it has historically been viewed as a safer option for pain and anxiety. However, its effect on the brain’s reward and inhibition pathways is also what gives it the potential for misuse at high doses.
Gabapentin Abuse
The rate of gabapentin addiction in the general population is roughly 1.1%, but it climbs to about 22% among people in drug treatment programs.5 People who misuse gabapentin often do so to enhance the effects of opioids, alcohol, or other substances rather than to get high from gabapentin alone.
1.1%
The estimated rate of gabapentin addiction in the general U.S. population, based on a peer-reviewed analysis of misuse patterns.
22%
The estimated rate of gabapentin misuse among individuals already in drug treatment, where gabapentin is often used to potentiate other substances.
Gabapentin misuse most often occurs alongside other substances. People who misuse opioids, in particular, may take gabapentin to amplify the opioid high or to manage opioid withdrawal symptoms, a pattern that significantly raises the risk of respiratory depression and overdose.
Although gabapentin is not federally scheduled as a controlled substance, several states (including Virginia, Kentucky, Tennessee, Michigan, and West Virginia) have added it to their state controlled-substance schedules in response to rising misuse and overdose involvement. Other states have added gabapentin to their prescription drug monitoring programs (PDMPs).
On the street, gabapentin is sometimes sold under the names “Gabbies” or “Johnnies.” Pills can cost less than a dollar each, which has helped fuel non-prescribed use, particularly in Appalachian and rural communities.6 The medication is also part of the broader landscape of prescription drug misuse in the United States.
Gabapentin Side Effects
Gabapentin is generally well tolerated at prescribed doses, but it can cause side effects including drowsiness, coordination problems, mood changes, and (in some people) suicidal thoughts. Side effects are more pronounced at higher doses or when gabapentin is combined with other substances.
When taken as prescribed, the most common gabapentin side effects are mild and tend to improve over time as the body adjusts. Side effects can become more pronounced if a person takes higher doses than prescribed or combines gabapentin with alcohol, opioids, or benzodiazepines.
Common Side Effects
Drowsiness, dizziness, fatigue, loss of coordination, tremors, blurred or double vision, peripheral edema, and nausea.
Serious Side Effects
Mood changes, suicidal thoughts, respiratory depression (especially with opioids or other depressants), and severe allergic reactions.7
Anyone taking gabapentin who notices new or worsening mood changes, thoughts of self-harm, or trouble breathing should contact their prescriber promptly. If breathing becomes labored or the person becomes unresponsive, call 911.
Signs of Gabapentin Addiction
Gabapentin can cause both physical dependence (which produces withdrawal when use stops) and full addiction, which is marked by compulsive use, escalating doses, and continued use despite consequences. Recognizing the signs early can make treatment more effective.
Many people who take gabapentin as prescribed will develop some degree of physical dependence, meaning their body adjusts to the medication and they experience withdrawal symptoms if they stop suddenly. Dependence alone does not mean a person has an addiction.
Addiction is a more serious pattern in which gabapentin use becomes compulsive. Signs may include:
- Taking larger or more frequent doses than prescribed
- Asking for early refills, exaggerating symptoms to providers, or seeking prescriptions from multiple doctors
- Strong cravings for gabapentin between doses
- Continuing to use gabapentin despite negative effects on work, finances, relationships, or legal status
- Difficulty cutting back or stopping, even when the person wants to
- Combining gabapentin with other substances to intensify its effects
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Combining Gabapentin with Other Drugs
Combining gabapentin with opioids, benzodiazepines, alcohol, or other central nervous system depressants significantly raises the risk of respiratory depression and fatal overdose. The FDA issued a public warning about this risk in December 2019.7
Using gabapentin with central nervous system depressants such as opioids, antidepressants, and benzodiazepines has been linked to slowed or stopped breathing (respiratory depression). In its 2019 warning, the FDA discussed the potential risk of using these medications together due to the risk of overdose death.
Roughly 9 in 10 unintentional fatal overdoses involving gabapentin also involve opioid use, according to clinical analysis cited in peer-reviewed reviews.
An estimated 40% of people prescribed gabapentin take higher doses than recommended, which raises the risk of side effects and dependence.3
Frequently, individuals will misuse this medication in combination with other drugs to intensify the gabapentin side effects and increase the high feeling or euphoria. The combination of these drugs can cause breathing difficulties, especially for people with respiratory disorders such as asthma or COPD, as well as older adults.
Can You Overdose on Gabapentin?
Yes, gabapentin overdose is possible. The CDC reported that gabapentin-involved overdose deaths nearly doubled between 2019 and 2022.9 Unlike opioid overdoses, there is no specific antidote for gabapentin, which makes emergency medical care essential.
Nearly 2x Increase
Gabapentin-involved overdose deaths nearly doubled from 2019 to 2022, according to a CDC report on changing overdose patterns.
No Antidote
Unlike opioid overdoses, gabapentin overdose cannot be reversed by naloxone (Narcan) or any other specific antidote, which makes emergency medical care the only option.
Gabapentin overdoses can occur accidentally or as a result of misuse. Used alone and in accordance with a doctor’s prescription, gabapentin is relatively benign. Yet when combined with other drugs, the risk of overdose increases. Unlike opioid drugs such as fentanyl and heroin, there is no antidote that reverses a gabapentin overdose.
What to Do If You Suspect a Gabapentin Overdose
If you suspect a gabapentin overdose, call 911 immediately. Signs of overdose include extreme drowsiness, slurred speech, double vision or unusual eye movements, decreased muscle coordination, labored breathing, and unresponsiveness. These symptoms can become more severe quickly, especially if gabapentin was taken with opioids, alcohol, or other depressants.
Naloxone (Narcan) will reverse an opioid overdose but does not reverse gabapentin’s effects. That said, if opioids are also suspected, administering naloxone can still be lifesaving and is recommended while waiting for paramedics.
Emergency medical teams may use hemodialysis, breathing support, intravenous fluids, and close monitoring to stabilize the person until the drug clears the body.
Gabapentin Withdrawal
Gabapentin withdrawal can begin as soon as 12 hours after the last dose and can last for several weeks. Symptoms range from anxiety, insomnia, and nausea to (in severe cases) changes in blood pressure, heart palpitations, and seizures. Withdrawal is safest under medical supervision.
Anyone who has taken gabapentin regularly, especially at higher doses, can experience withdrawal when they stop or reduce their dose. Stopping gabapentin abruptly is not recommended; in some cases, sudden discontinuation can trigger seizures, even in people who have never had a seizure disorder.
Common gabapentin withdrawal symptoms include anxiety, restlessness, insomnia, sweating, nausea, fatigue, and pain or sensitivity returning to areas previously controlled by the medication. More severe symptoms can include changes in blood pressure, heart palpitations, and seizures.
| Symptom category | Common symptoms | Severe / emergency symptoms |
|---|---|---|
| Psychological | Anxiety, irritability, restlessness, depression, disorientation | Confusion, hallucinations, suicidal ideation |
| Sleep & energy | Insomnia, vivid dreams, fatigue | Severe sleep disruption with cognitive impairment |
| Body & nervous system | Sweating, nausea, headaches, tremors, return of pain or nerve sensitivity | Changes in blood pressure, heart palpitations, seizures |
Withdrawal typically begins within 12 hours of the last dose, peaks in the first several days, and may continue for one to several weeks. In some cases, particularly after long-term, high-dose use, symptoms may persist longer.10
The safest way to stop gabapentin is a medically supervised taper, in which a clinician gradually reduces the dose over weeks or months. A taper allows the body to readjust and lowers the risk of seizure or other complications. Medical detox programs can manage symptoms and monitor for medical emergencies if a taper is not feasible.
Recognizing Gabapentin Addiction in a Loved One
If you suspect a friend or family member is misusing gabapentin, watch for behavioral changes (secrecy around medication, doctor shopping, or borrowing or stealing pills) alongside physical signs like excessive drowsiness, slurred speech, or coordination problems. A direct, non-judgmental conversation can be the first step toward help.
The signs that someone you care about may be misusing gabapentin often show up as a combination of behavioral, physical, and social changes. Behavioral changes may include sudden secrecy about medication, visiting multiple doctors or pharmacies, borrowing or taking pills that were not prescribed to them, and drastic shifts in mood or sleep patterns. In more serious cases, a person may forge prescriptions or take medication from friends and family.
Physical signs can include excessive drowsiness or sleeping at unusual times, slurred speech, coordination problems, and sudden weight changes. People misusing gabapentin alongside opioids or alcohol may show signs of intoxication that look more severe than what a normal prescription would produce.
If you suspect a loved one is struggling, approaching the conversation with empathy and without judgment is more effective than confrontation. Treatment for gabapentin addiction is available and can begin with a conversation about options rather than a demand for immediate change.
Where to Find Help for Gabapentin Abuse Treatment
Recovery from gabapentin addiction usually begins by acknowledging the problem and reaching out for help. SAMHSA, your primary care provider, and Rehab.com’s treatment finder are all good starting points for locating a program that fits your needs.
Recovery begins with acknowledging there is a problem and being willing to change. The next step is locating the treatment program that is right for you. Gabapentin withdrawal can be dangerous, and it usually requires close medical supervision and support. Medical detox is often required to safely navigate this process.
The U.S. government has resources to help you locate treatment centers and programs to meet your needs. Many people begin by reaching out to the Substance Abuse and Mental Health Services Administration (SAMHSA). The SAMHSA website is a great starting point.11
Your medical provider is another resource that can help find the right appropriate treatment programs. They can assist you with assessments and also give referrals if needed. At times, prior authorization is needed before insurance providers will cover treatment costs. Your provider can assist you with navigating this process.
Local support groups such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) can help you locate treatment centers in your area and may also include members who have experience in recovery from gabapentin addiction. Online resources such as our treatment finder tool at Rehab.com can also help you locate facilities that specialize in gabapentin addiction.
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Treatment Options for Gabapentin Addiction
Treatment for gabapentin addiction typically begins with medically supervised detox or a slow taper, followed by inpatient or outpatient rehab, behavioral therapy, and aftercare support. The right combination depends on the severity of use, co-occurring conditions, and personal circumstances.
Treatment for gabapentin addiction typically begins with medically supervised detox or a structured taper. Medical detox helps the body clear gabapentin under close clinical supervision, monitoring for withdrawal symptoms such as anxiety, pain, nausea, tremors, and (in severe cases) changes in blood pressure, heart palpitations, or seizures. Symptoms may start within 12 hours of the last dose and continue for several weeks.
Once a person completes detox, the treatment team can recommend the right next level of care.
Inpatient treatment is the most intensive option. People live at the treatment facility, usually for 28 to 30 days, and take part in individual and group therapy, medication management, and other recovery-focused programming. Inpatient care is recommended for moderate to severe addiction or when the person needs 24/7 supervision.
Outpatient programs offer comprehensive care with more flexibility. Intensive options include partial hospitalization programs (PHP) and intensive outpatient programs (IOP), both of which involve multiple sessions per week while a person continues to live at home. Outpatient is well suited to people with stable housing, supportive home environments, or family and work responsibilities that make inpatient care difficult.
Aftercare continues the recovery process after intensive treatment ends. It may include continued individual therapy, peer support groups, relapse prevention programs, and transitional housing options like sober living.
Tapering Off Gabapentin Safely
A medically supervised taper is often the safest way to discontinue gabapentin, especially for people who have taken it for a long time or at high doses. A typical taper involves reducing the daily dose by a small amount every few days or weeks under medical supervision, allowing the body to adjust gradually and reducing the risk of seizures or other complications.
The right taper schedule depends on the original dose, how long the person has been taking gabapentin, kidney function, and any co-occurring conditions. Tapering should not be attempted without medical guidance; even in people without a history of seizures, abrupt discontinuation can trigger them.
Sources
- Smith RV, Havens JR, Walsh SL. Gabapentin Misuse, Abuse, and Diversion: A Systematic Review. Addiction. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC5573873/. Accessed June 1, 2026.
- Bridge S. Gabapentin Use Doubled, Reflecting Opioid Crisis. Psychiatric News, American Psychiatric Association. November 6, 2023. Available at: https://psychiatryonline.org/doi/full/10.1176/appi.pn.2023.11.11.29. Accessed June 1, 2026.
- American Addiction Centers. Neurontin (Gabapentin) Addiction: Effects, Symptoms & Treatment. Updated June 23, 2023. Available at: https://americanaddictioncenters.org/neurontin-abuse. Accessed June 1, 2026.
- American Addiction Centers. Neurontin (Gabapentin) Addiction: Mechanism of Action. Updated June 23, 2023. Available at: https://americanaddictioncenters.org/neurontin-abuse. Accessed June 1, 2026.
- Smith RV, Havens JR, Walsh SL. Gabapentin Misuse, Abuse, and Diversion: A Systematic Review. PMC. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC5573873/. Accessed June 1, 2026.
- Quinones S. Abuse of Opioid Alternative Gabapentin Is on the Rise. Pew Stateline. May 10, 2018. Available at: https://stateline.org/2018/05/10/abuse-of-opioid-alternative-gabapentin-is-on-the-rise/. Accessed June 1, 2026.
- U.S. Food & Drug Administration. FDA Warns About Serious Breathing Problems With Seizure and Nerve Pain Medicines Gabapentin (Neurontin, Gralise, Horizant) and Pregabalin (Lyrica, Lyrica CR). December 19, 2019. Available at: https://www.fda.gov/drugs/drug-safety-and-availability/fda-warns-about-serious-breathing-problems-seizure-and-nerve-pain-medicines-gabapentin-neurontin. Accessed June 1, 2026.
- Centers for Disease Control and Prevention. Notes from the Field: Gabapentin-Involved Overdose Deaths, 27 States. Morbidity and Mortality Weekly Report (MMWR). 2024. [Editor: verify primary MMWR URL before publish.]
- Mersfelder TL, Nichols WH. Gabapentin: Abuse, Dependence, and Withdrawal. Annals of Pharmacotherapy. 2016;50(3):229-233.
- Substance Abuse and Mental Health Services Administration (SAMHSA). National Helpline and Find Help Tool. Available at: https://www.samhsa.gov. Accessed June 1, 2026.
