Gabapentin was introduced as a safer alternative to older seizure medications and widely embraced as a solution to the opioid crisis — a non-opioid option for chronic pain that was presumed to carry little risk of abuse. That assumption has not held up. Today, gabapentin is one of the most prescribed medications in the United States, with more than 73 million prescriptions written in 2024 according to the Drug Enforcement Administration (DEA) and a growing body of evidence confirms that misuse, dependence and diversion are far more common than originally understood. According to a systematic review published in the journal Addiction, gabapentin misuse affects between 15% and 22% of individuals who also misuse opioids — a population already at elevated risk for overdose and serious harm.
What makes gabapentin especially concerning is the gap between its reputation and its reality. Because it’s not a federally controlled substance and often perceived as a mild or medically benign drug, people who misuse it — and sometimes even clinicians who prescribe it — may not recognize the warning signs of a developing problem. Withdrawal from gabapentin can be severe. Overdose risk, particularly when combined with opioids or benzodiazepines, is significant. And dependence can develop even among those taking the drug exactly as prescribed.
If you or someone you love has been struggling with gabapentin misuse, you’re not alone — and help is available. The National Rehab Hotline is here 24 hours a day, 7 days a week. Call (866) 210-1303 for free, confidential guidance and treatment referrals. If you or someone you know is in immediate danger, call 911 or go to the nearest emergency room. The National Rehab Hotline is for nonemergency information, support and referrals.
What Is Gabapentin?
Gabapentin is an anticonvulsant and analgesic medication first approved by the U.S. Food and Drug Administration (FDA) in 1993 for the treatment of certain types of seizures. In 2004, the FDA expanded its approved indications to include postherpetic neuralgia — the nerve pain that follows a shingles infection. Brand names for gabapentin include Neurontin, Horizant and Gralise.
Despite its relatively narrow list of FDA-approved uses, gabapentin has been widely prescribed off-label for a broad range of conditions, including neuropathic pain, fibromyalgia, anxiety, insomnia, bipolar disorder, restless leg syndrome and alcohol withdrawal and as an adjunct to opioid-based pain management. This off-label expansion, driven in part by efforts to reduce opioid prescribing, contributed to a rapid rise in gabapentin’s prescription volume: from approximately 39 million prescriptions in 2012 to over 73 million by 2024.
Gabapentin is structurally similar to the neurotransmitter gamma-aminobutyric acid (GABA), though it doesn’t bind directly to GABA receptors. Its precise mechanism of action isn’t fully understood, but it’s believed to reduce the activity of excitatory neurotransmitters in the brain. At higher doses or in combination with other CNS depressants, this activity produces sedation, euphoria and a sense of calm that some people seek out deliberately.
Signs of Gabapentin Abuse
Because gabapentin is a legal prescription medication, misuse can be difficult to recognize — especially when it involves taking a legitimately prescribed drug in higher doses or more frequently than directed. The following signs may indicate that gabapentin use has crossed into problematic territory.
Behavioral Signs
- Taking gabapentin in larger amounts or more frequently than prescribed
- Obtaining gabapentin from sources other than a personal prescription (friends, family or illicit markets)
- Using gabapentin recreationally to produce a euphoric or sedating effect
- Combining gabapentin with opioids, benzodiazepines or alcohol to intensify effects
- Doctor shopping or visiting multiple providers to obtain multiple prescriptions
- Hiding or minimizing gabapentin use from family members or health care providers
- Continuing to use despite negative consequences at work, in relationships or with health
- Spending significant time obtaining, using or recovering from gabapentin
Physical Signs
- Unusual drowsiness or sedation
- Slurred speech or lack of coordination
- Dizziness, unsteadiness or frequent stumbling
- Memory gaps or confusion
- Blurred or double vision
- Swelling in the hands or feet
- Tremors or unusual movements
- Nausea or gastrointestinal distress
Psychological Signs
- Mood swings or increased emotional volatility
- Anxiety or agitation, particularly when gabapentin is unavailable
- Depression or emotional blunting
- Preoccupation with when the next dose will be available
- Using gabapentin to cope with stress, anxiety or emotional pain
Addiction and Dependence
When gabapentin was introduced, it was widely characterized as having minimal abuse potential — a characterization that’s been significantly revised as real-world data has accumulated. The research published in the journal Addiction found that gabapentin misuse rates range from 40% to 65% among people who’ve been prescribed the medication and between 15% and 22% among individuals who also misuse opioids. A 2022 Centers for Disease Control and Prevention (CDC) report documented that overdose deaths involving gabapentin approximately doubled from 2019 to 2020, underscoring how rapidly the risk landscape has shifted.
Physical dependence on gabapentin can develop with regular use, even at prescribed doses. The brain adapts to the drug’s presence over time, and when gabapentin is reduced or stopped abruptly, withdrawal symptoms can emerge. Unlike many medications where dependence is straightforward to recognize, gabapentin dependence often goes unidentified because neither patients nor providers expect it.
Gabapentin misuse is especially common among people with co-occurring opioid use disorder. Research indicates that some individuals use gabapentin to amplify the euphoric effects of opioids, to manage opioid withdrawal symptoms or to substitute for opioids when they’re unavailable. This combination significantly increases the risk of respiratory depression and fatal overdose. The FDA issued a formal warning in 2019 about the risk of serious breathing problems when gabapentin is used with other CNS depressants, including opioids and benzodiazepines.
Gabapentin Withdrawal
One of the most underappreciated risks of gabapentin use is the withdrawal syndrome that can occur when the drug is stopped abruptly or reduced too quickly. Gabapentin withdrawal isn’t universally experienced, but it’s clinically significant and can be dangerous — particularly for individuals who’ve been using high doses or taking the drug for an extended period.
Common gabapentin withdrawal symptoms include:
- Anxiety and agitation
- Insomnia and sleep disturbances
- Sweating and tremors
- Nausea, vomiting and diarrhea
- Heart palpitations
- Sensitivity to light and sound
- Confusion or disorientation
- Seizures (in severe cases)
Withdrawal symptoms typically begin within 12 to 48 hours of the last dose and may persist for several days to 2 weeks. Because seizures are a known risk — particularly in individuals with underlying seizure disorders or those who stop abruptly after high-dose use — gabapentin withdrawal shouldn’t be managed alone. A medically supervised taper is strongly recommended.
Treatment Options for Gabapentin Addiction
There’s no single approved medication for treating gabapentin addiction, but a range of evidence-based treatment approaches is effective when properly matched to the individual’s needs and the severity of their use.
Medical Detox and Supervised Tapering
Because abrupt cessation can trigger seizures and severe withdrawal, the recommended approach is a gradual, medically supervised taper, slowly reducing the gabapentin dose over a period of weeks to allow the brain to adjust. The pace of the taper is individualized based on how long a person has been using gabapentin, the doses involved and whether other substances are in the picture. Attempting to stop gabapentin on your own without medical guidance isn’t recommended.
Inpatient and Residential Treatment
For individuals with significant gabapentin dependence, co-occurring substance use disorders or a history of unsuccessful outpatient attempts, inpatient residential treatment provides around-the-clock medical supervision, structured programming and a controlled environment away from triggers and access to substances.
Outpatient and Intensive Outpatient Programs (IOP)
Outpatient treatment is appropriate for individuals with less severe dependence and a stable home environment. Intensive outpatient programs (IOPs) offer multiple sessions per week — typically combining individual therapy, group counseling and psychoeducation — while allowing the person to remain at home. IOPs are commonly used as a step-down from inpatient care.
Behavioral Therapies
Cognitive behavioral therapy (CBT) is among the most well-supported approaches for treating prescription drug addiction, helping individuals identify the thoughts and situations that drive drug-seeking behavior and develop healthier coping strategies. Motivational interviewing (MI) is often used alongside CBT to strengthen internal motivation for change. For those with co-occurring mental health conditions — anxiety, depression, post-traumatic stress disorder (PTSD) — an integrated dual-diagnosis treatment model that addresses both the addiction and the underlying condition simultaneously produces the best outcomes.
Addressing Polysubstance Use
Because gabapentin misuse is strongly correlated with opioid use disorder, treatment often needs to address both substances. Medication-assisted treatment (MAT) with buprenorphine or methadone may be appropriate for individuals with opioid use disorder, and treating the opioid dependence often reduces gabapentin misuse as well. A comprehensive clinical assessment at the outset of treatment helps ensure the full picture is addressed.
Gabapentin Abuse Hotline
If you’re concerned about your own use of gabapentin — or worried about someone you care about — the National Rehab Hotline can help. Many people who call aren’t sure whether what they’re experiencing rises to the level of addiction. That uncertainty is exactly the kind of thing our specialists are here to help you work through. You don’t need to have a diagnosis or a treatment plan before you call.
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 us at (866) 210-1303 — it’s free and confidential.
Frequently Asked Questions: Gabapentin Abuse and Addiction
- Is Gabapentin Addictive?
Yes, gabapentin can cause physical dependence and, in some cases, addiction. While it was originally marketed as having minimal abuse potential, research has since shown that misuse is common — particularly among individuals who also use opioids. Physical dependence, characterized by withdrawal symptoms when the drug is reduced or stopped, can develop even in people taking gabapentin exactly as prescribed. - What Does Gabapentin Abuse Feel Like?
People who misuse gabapentin report a range of effects, including euphoria, sedation, feelings of calm or relaxation, reduced inhibition and intoxication similar to alcohol. At higher doses or when combined with opioids or benzodiazepines, the sedative effects are intensified — and the risk of respiratory depression and overdose rises significantly. - Can You Overdose on Gabapentin?
Yes. While a gabapentin overdose from the drug alone is less common, the risk increases substantially when gabapentin is combined with opioids, benzodiazepines or alcohol. The CDC documented a near-doubling of overdose deaths involving gabapentin between 2019 and 2020. Symptoms of gabapentin overdose include extreme drowsiness, slurred speech, double vision and respiratory depression. If you suspect an overdose, call 911 immediately. - Is Gabapentin a Controlled Substance?
Gabapentin isn’t currently classified as a controlled substance at the federal level in the United States. However, several states — including Kentucky, Tennessee, Michigan, Virginia and West Virginia — have reclassified it as a Schedule V controlled substance due to documented misuse and diversion. Federal scheduling status doesn’t mean the drug is without risk; it means regulatory oversight hasn’t yet caught up with the clinical evidence. - What Happens If You Stop Taking Gabapentin Suddenly?
Stopping gabapentin abruptly — especially after prolonged or high-dose use — can trigger a withdrawal syndrome that includes anxiety, insomnia, sweating, tremors, nausea and in some cases seizures. A gradual, medically supervised taper is strongly recommended for anyone who wants to discontinue gabapentin after regular use. Don’t attempt to stop on your own without speaking to a health care provider first.
How Do I Get Help for Gabapentin Addiction?
The first step is reaching out. The National Rehab Hotline is available 24 hours a day at (866) 210-1303 — free, confidential and staffed by specialists who can answer your questions, explain your treatment options and connect you with programs in your area. Whether you’re ready to enter treatment or just trying to understand what you’re facing, we’re here to help.
When you’re ready to take the next step, help is just a phone call away. 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.