Gabapentin Use on the Rise: Benefits, Risks, and Growing Concerns

Gabapentin is a medication that’s become increasingly familiar in doctors’ offices and pharmacies in Alabama and across the United States. In 2024, 73.1 million prescriptions were dispensed for gabapentin–a number up from 69 million dispensed in 2020.[1]

For many people, gabapentin plays an important role in managing seizures, nerve pain, and other medical conditions when it is used as prescribed. At the same time, health care providers, public health officials, and prevention organizations are paying closer attention to how this medication is being used outside of medical guidance and whether or not it is addictive.

Unfortunately, while rates of prescribing have increased, so have reports of misuse, especially when gabapentin is taken in higher doses or combined with other substances.

What is Gabapentin?

Gabapentin is a prescription medication that affects how the nerves send signals in the body. It was originally approved to treat seizure disorders, and it is also commonly prescribed for certain types of nerve pain, such as pain that can happen after shingles. Gabapentin may be sold under the brand name Neurontin.[1,2]

Gabapentin is not an opioid, and it does not work the same way as traditional pain medications. Instead, it helps calm overactive nerve activity, which can reduce pain or prevent seizures in some patients. When the medication is taken as prescribed, it can be safe and effective. And, because it has been viewed as having a lower risk profile than some other medications, gabapentin has become a common option in pain management and neurological care.

Is Gabapentin a Controlled Substance? Regulations in Alabama and Nationwide

As of January 2026, gabapentin is not considered a federally controlled substance under the U.S. Controlled Substances Act. However, several states, including Alabama, have taken steps to regulate it more closely because of concerns about misuse.

In Alabama, gabapentin was classified as a Schedule V controlled substance in 2019 in an effort to combat growing misuse of the drug across the state.[3] This means that the drug has potential for misuse and that prescribers must follow stricter rules for prescribing, dispensing, and monitoring gabapentin prescriptions.

Why Non-Medical Use of Gabapentin is On The Rise

Although gabapentin is not an opioid, it can still be misused when taken in higher doses than prescribed or combined with other substances, like alcohol or opioids, to enhance its psychoactive effects. Some people report feeling relaxed, drowsy, or calm when overusing the drug.

As more people receive gabapentin for legitimate medical reasons, it becomes more available in households and communities, increasing the chances that it may be used in ways not intended by a prescriber.

Aside from increased access to the drug, there are a number of reasons that drive the non-medical use of gabapentin, including:

Low perception of risk – Since it isn’t an opioid, some may view gabapentin as safer or less addictive.
Lack of early regulation – Gabapentin isn’t federally regulated, so it’s easier for people to obtain multiple prescriptions or use it without much oversight.
Mental health issues – Some people may use gabapentin as a way to “escape” feelings of anxiety or depression.
Self-medication – Some may overuse gabapentin in an attempt to self-medicate for a physical condition, such as chronic pain, or emotional difficulties.

Across the general population, about 1% of people use gabapentin in a way that is considered misuse or non-medical use. Among opioid users, 15-22% are thought to engage in non-medical use of gabapentin. Non-medical use of gabapentin is on the rise across all populations; however, with some studies suggesting 40-65% of all gabapentin use is considered misuse.[4,5]

Understanding the Risks of Gabapentin Misuse

Overusing gabapentin can be harmful to your mental and physical health. Potential risks include:

Mental, Emotional, and Cognitive Effects

Misusing gabapentin can affect how the brain processes information and regulates mood. Some people report feeling unusually relaxed, detached, or emotionally numb, while others experience confusion or difficulty concentrating. Memory problems and slowed thinking have also been reported, particularly at higher doses.

Side Effects and Physical Safety Risks

Taking gabapentin in ways other than prescribed can increase the likelihood and severity of side effects.

Common side effects and safety concerns include:

Dizziness
Extreme drowsiness
Poor coordination
Blurry vision
Increased risk of falls, accidents, and injuries
Slowed breathing
Reduced alertness

These risks become even greater when gabapentin is combined with alcohol, opioids, or other sedating medications. Together, these substances can slow breathing, reduce alertness, and increase the chance of serious medical emergencies. Because of these risks, using gabapentin alongside other substances should always be discussed with a health care provider.

Dependence and Withdrawal

Some people who use gabapentin heavily over time may develop physical dependence on gabapentin, meaning their body adapts to the presence of the drug. If gabapentin is reduced or stopped suddenly, withdrawal symptoms such as anxiety, nausea, or sleep disturbances can occur.

Dependence is not the same as substance use disorder, but it does often require medical supervision when stopping or reducing the medication.

Gabapentin Overdose

While a gabapentin overdose is less common than an overdose involving opioids or other central nervous system depressants, it can and does occur, particularly when gabapentin is taken in very high doses or combined with other substances. The risk increases significantly when gabapentin is used alongside opioids, alcohol, benzodiazepines, or other medications that slow the nervous system.

From 2019-2020, the CDC found that 9.7% of drug overdose deaths involved gabapentin, and gabapentin was thought to be a contributing factor toward the cause of death in over 52% of those cases.[6]

Symptoms of an overdose may include:

Extreme drowsiness
Sedation
Severe dizziness
Loss of balance
Slurred speed
Blurry vision
Confusion
Disorientation
Nausea
Vomiting
Uncontrollable eye movements
Slowed breathing
Unresponsiveness
Loss of consciousness

A suspected gabapentin overdose is a medical emergency. If someone shows signs of overdose, you should call 911 immediately.

Recognizing Signs of Gabapentin Misuse

Gabapentin misuse does not always look obvious at first. Because it is a prescription medication, changes in use can be subtle and easy to overlook. However, there are warning signs that may indicate a problem, including:

Taking higher doses than prescribed or running out of medication early
Using gabapentin without a prescription or borrowing it from others
Combining gabapentin with alcohol, opioids, or other substances without medical guidance
Doctor shopping or visiting multiple pharmacies to obtain prescriptions
Noticeable changes in mood, behavior, or daily functioning
Increasing isolation, secrecy, or defensiveness around medication use

What to Do if You’re Concerned About Your or a Loved One’s Gabapentin Use

If you or someone you care about is misusing gabapentin, early intervention can make a major difference, potentially preventing the development of a substance use disorder. Consider having a conversation with a health care provider or seek professional guidance.

Treatment for gabapentin misuse depends on individual needs, overall health, and whether other substances are involved. In some cases, medical supervision may be needed to manage withdrawal symptoms safely.

With the right care, people can safely reduce or stop using gabapentin and improve their overall health and quality of life. To find resources and support in Alabama, visit https://apcbham.org/findhelp/ now.

References: