Gabapentin is one of the most widely prescribed medications in the country, and for most people it does exactly what it should. It’s not a narcotic, not federally scheduled, and often prescribed precisely because it’s considered a safer alternative to opioids. All true — and all of it is why gabapentin misuse goes unrecognized for so long.
The risk shows up most clearly in overdose data. A CDC analysis of overdose deaths across 23 states and the District of Columbia found gabapentin present in 9.7% of deaths with toxicology results during 2019 and 2020, and judged it to have contributed to roughly half of those. Between 85% and 90% of the deaths where gabapentin was detected also involved an opioid.
That’s the shape of the problem. Gabapentin is rarely the whole story, but it makes other things considerably more dangerous. This page covers how misuse develops, why stopping abruptly is risky and what treatment involves.
If you or someone you know is in immediate danger, call 911 or go to the nearest emergency room. If you are in crisis or having thoughts of suicide, call or text the 988 Suicide & Crisis Lifeline at 988. The National Rehab Hotline at 866-210-1303 is for non-emergency information, support and referrals.
What Is Gabapentin?
Gabapentin is an anticonvulsant sold as Neurontin, Gralise and Horizant. The FDA approved it for partial seizures and postherpetic neuralgia — the lingering nerve pain that can follow shingles.
Most prescriptions today aren’t for either. It’s used extensively off-label for general nerve pain, fibromyalgia, restless legs, migraines, anxiety and alcohol withdrawal. Off-label prescribing is legal and often appropriate, but it means many people take gabapentin for conditions its approval never covered, with little warning about dependence.
Despite the name, gabapentin doesn’t act directly on GABA receptors the way benzodiazepines do. It binds to a subunit of voltage-gated calcium channels and dampens excitatory neurotransmitter release. At prescribed doses, that means calm and pain relief. At high doses — particularly in people with a history of opioid use — it can produce sedation and euphoria.
Gabapentin isn’t scheduled under the federal Controlled Substances Act. A small number of states classify it as Schedule V under state law, and that list has changed more than once in recent years. If you’re unsure how it’s treated where you live, your pharmacist can tell you. For how gabapentin fits alongside other medications in this category, see our prescription drug addiction page.
Signs of Gabapentin Abuse
Because gabapentin carries so little stigma, misuse often develops without anyone reading it as a warning sign — including the person doing it.
Behavioral Signs
- Taking more than prescribed, or taking it in large single doses rather than spread through the day
- Combining it deliberately with opioids, benzodiazepines or alcohol to intensify the effect
- Running out early, requesting refills ahead of schedule or getting it from other people
Physical Signs
- Pronounced drowsiness, slurred speech or poor coordination
- Dizziness, tremor and unsteadiness on the feet
- Slowed or shallow breathing, especially alongside other sedating substances
Psychological Signs
- Confusion, memory lapses or difficulty concentrating
- Anxiety that surfaces sharply as a dose wears off
The respiratory risk deserves emphasis. In 2019 the FDA required new gabapentinoid labeling warnings after reports of serious breathing difficulties — particularly in people also taking opioids or other CNS depressants, those with reduced lung function and older adults. That’s the mechanism behind most gabapentin-related deaths: not gabapentin alone, but gabapentin stacked on something else. Our opioid addiction and benzodiazepine addiction pages cover the substances most often involved.
How Gabapentin Dependence Develops
Physical dependence can develop with regular use at prescribed doses, especially at higher doses or over time. Dependence isn’t addiction — it means the body has adapted and will react when the drug is removed. Addiction adds compulsive use and continued use despite harm.
Two patterns account for most misuse. In the first, someone prescribed gabapentin for pain or anxiety finds the dose stops working, raises it on their own and gradually loses the ability to stop. In the second, someone with an existing opioid or alcohol problem uses it deliberately — to extend a high, blunt withdrawal, or substitute when their primary substance is unavailable. The second carries the higher overdose risk.
Withdrawal is the part most people aren’t warned about. Stopping abruptly after sustained use can produce anxiety, insomnia, sweating, nausea, agitation and, importantly, seizures — including in people with no seizure history. Symptoms can begin within a day or two. This is why gabapentin should be tapered under medical supervision, and why it’s worth being honest with a prescriber about how much you’re taking. More on recognizing a developing problem is on our signs of drug abuse page.
If you or someone you love is struggling, the National Rehab Hotline is available 24/7 to provide information, guidance and referrals to local treatment resources. Call 866-210-1303 — it’s free and confidential.
Treatment Options for Gabapentin Addiction
No medication is approved specifically for gabapentin use disorder, so treatment centers on a controlled taper plus the behavioral approaches used for other substances.
- Supervised taper. A structured dose reduction over weeks, paced to how long and how heavily the drug has been used. Medical oversight matters chiefly because of seizure risk.
- Co-occurring substance use. When gabapentin is used alongside opioids or alcohol, treating it in isolation rarely holds. The combination needs one coordinated plan.
- Behavioral therapy. Cognitive behavioral therapy and contingency management address the patterns driving use. Where gabapentin was prescribed for chronic pain, an alternative pain plan is essential — otherwise the original problem returns untreated.
- Care for anxiety and mood conditions. Many people take gabapentin partly for anxiety. Removing it without treating that leaves the reason for use intact — our mental health page is a starting point.
Gabapentin Hotline
The National Rehab Hotline is free, confidential and available 24/7. It’s not an emergency service — for an overdose or medical crisis, call 911. For anything short of that, calling 866-210-1303 connects you with information, guidance and referrals to treatment resources near you.
You don’t need to have decided anything first. People reach the substance abuse hotline to ask what a taper involves, whether outpatient treatment is realistic around work, or what programs exist in their state. Others call about someone else — a family member whose prescription got away from them, or a partner combining gabapentin with something worse. Both are reasons to call.
When you’re ready to take the next step, call the National Rehab Hotline at 866-210-1303 — available 24 hours a day, 7 days a week, 365 days a year. You don’t have to face this alone.
Frequently Asked Questions
- Is gabapentin a controlled substance?
Not federally. The DEA doesn’t schedule gabapentin under the Controlled Substances Act. A small number of states classify it as Schedule V under their own law, and several more track it through prescription monitoring programs. That list has changed in recent years, so check with your pharmacist. - Is gabapentin addictive?
It can be. Gabapentin has lower abuse potential than opioids or benzodiazepines, and most people who take it as prescribed never develop a problem. Risk rises sharply at high doses and among people with a history of opioid or alcohol use disorder. - What makes gabapentin dangerous with opioids?
Both depress the central nervous system, and gabapentin can intensify an opioid high while adding its own sedation. The combination raises the risk of slowed or stopped breathing. CDC data show the large majority of overdose deaths where gabapentin was detected also involved an opioid. - Can you have withdrawal from gabapentin?
Yes. Stopping abruptly after regular use can cause anxiety, insomnia, sweating, nausea, agitation and seizures — including in people who’ve never had one. Symptoms may start within a day or two. A gradual, supervised taper is the safe approach. - How is gabapentin addiction treated?
Usually a supervised taper plus behavioral therapy, along with treatment for any other substance use or mental health condition involved. The plan is built around managing withdrawal safely and addressing why the use started. - Is calling a hotline confidential, and does it cost anything?
Calls are free and confidential. You aren’t required to give your full name, and calling doesn’t commit you to treatment. Many people call simply to understand what options exist before deciding anything.
If gabapentin has become something you manage rather than take, call 866-210-1303 — free, confidential and available 24/7.