Doctors who are cutting back on prescribing opioids increasingly are opting for gabapentin, believed to be a safer, non-narcotic drug. The anticonvulsant is available in generic form and sold under the brand names Neurotonin and Gralise, among others. However, recreational use and abuse of the prescription drug is on the rise, and the increase has raised concern among officials in several states.
The Food and Drug Administration has approved gabapentinoids for the treatment of postherpetic neuralgia (gabapentin and pregabalin), fibromyalgia (pregabalin), and neuropathic pain associated with diabetes or spinal cord injuries (pregabalin).
Past marketing practices also help explain the growing use of gabapentinoids for various types of pain. The manufacturer (Parke-Davis, a subsidiary of Warner-Lambert, which was later acquired by Pfizer) engaged in an extensive marketing campaign to increase off-label prescribing of Neurontin for pain.
On the street gabapentin pills, known as “johnnys” or “gabbies,” which often sell for less than a dollar each, enhance the euphoric effects of heroin and when taken alone in high doses can produce a marijuana-like high.
Gabapentin is currently not a controlled substance in the United States, so federal authorities do not consider it a drug with a high potential for abuse. But recent data indicate that the drug promoted as an alternative to opioids is one to watch as gabapentin-related complications and overdose deaths are increasing.
Gabapentin is now one of the most popular prescription drugs in the United States, according to the New England Journal of Medicine. It was the 10th-most-prescribed medication in 2016. Its more expensive cousin, pregabalin, sold as Lyrica and also made by Pfizer, was the eighth best-selling.
Some states have taken note of the increase in use and are pursuing stricter measures for access to the drug.
Gabapentin was the No. 1 drug dispensed in Ohio in December 2016, according to the Ohio Board of Pharmacy. In that same year, the medication was dispensed at a greater rate than any other controlled substance. This information promoted the Ohio Substance Abuse Monitoring Network to issue an alert about the illicit use of gabapentin across the state.
Kentucky designated gabapentin as a Schedule 5 controlled substance in July 2017. The regulation requires authorized practitioners to be properly licensed and registered with the DEA before they can dispense the medication.
West Virginia is also tracking gabapentin abuse and may introduce legislation in January 2018 that would aim to classify it as a controlled substance in the state. Gabapentin has market value on the streets and it is being abused according to the definition of a scheduled drug, Dr. Brad Henry, president of the West Virginia State Medical Association, told the newspaper.
According to the Charleston Gazette-Mail, “In a recent month, West Virginia pharmacies filled prescriptions for 5.8 million gabapentin tablets – more than the combined number of doses of two popular painkillers, hydrocodone, and oxycodone.”
Ohio also has been monitoring gabapentin prescriptions for more than a year.
People who have abused gabapentin and now find themselves addicted to the drug are advised to avoid going cold turkey. Instead, a professional addiction recovery treatment program is well advised..