Is Gabapentin a Narcotic? Everything You Need to Know

Gabapentin is an anticonvulsant drug approved by the Food and Drug Administration (FDA) to treat seizure disorders and neuropathic pain. It isn’t a narcotic or federally controlled substance, but it may be regulated and recognized as a controlled substance in some states for its misuse potential.

What Is Gabapentin?

Gabapentin is an FDA-approved medication used to treat certain types of nerve pain, postherpetic neuralgia, and certain seizure disorders. It’s commonly prescribed to treat other conditions off-label, including anxiety, postoperative pain, alcohol withdrawal, diabetic nerve pain, restless legs syndrome, and cannabis use disorder.

The way gabapentin works isn’t well understood. However, researchers know that it has a similar structure to gamma-aminobutyric acid (GABA), a chemical in the brain that can produce feelings of drowsiness and relaxation.

Gabapentin Side Effects

Gabapentin is well tolerated and safe for most people when used as prescribed. However, there is still a risk of side effects and misuse. Some of the potential side effects include:[1]

• Blurred vision
• Diarrhea
• Drowsiness
• Constipation
• Headache
• Dry mouth
• Nausea
• Swelling in the arms and legs
• Vomiting

Some rare but serious side effects can occur, including:[2]

• Fever
• Hallucinations
• Insomnia
• Stomach pain or prolonged vomiting
• New or worsening depression, anxiety, or irritability
• Respiratory depression
• Panic attacks
• Severe tiredness
• Suicidal thoughts or actions
• Unusual bruising or bleeding

Seek emergency medical attention if you experience any of these serious side effects.

Gabapentin Risks

Gabapentin can cause drowsiness. It’s best to avoid driving or using machinery until you know how this drug affects you. You should never drink alcohol with gabapentin.

Serious breathing problems can occur in people with existing respiratory conditions like chronic obstructive pulmonary disease (COPD) or asthma.

Is Gabapentin a Narcotic?

“Narcotics” may refer to any psychoactive compound that can numb or paralyze, but its traditional use in the US is associated with opiates and opioids. This may include prescription opiates and opioids like hydrocodone and morphine, as well as illicit opioids like heroin. Opiates are derived from the opium poppy plant, while opioids may be natural or synthetic.

Gabapentin is not an opiate or opioid, nor does it work the same as these drugs. While it relieves pain, it’s not usually used for the same type of pain and works differently. Gabapentin also has a much lower abuse and misuse potential compared to the highly addictive opiates and opioids.

Gabapentin isn’t a controlled substance on the federal level as of 2022. However, several states consider gabapentin a Schedule V controlled substance.[3] In states where gabapentin is controlled, there are stricter laws for prescribing and dispensing it from pharmacies.

There are five groups of controlled substances. Schedule V substances are the least likely of the controlled substances to cause addiction or dependence, but they still carry abuse risks.

Some states include gabapentin in their prescription drug monitoring programs (PDMPs). This is an online database that tracks refills of controlled substance medications to monitor usage, such as patients who refill controlled substances at more than one pharmacy or receive prescriptions for the same medication from several prescribers.[4]

Which States Consider Gabapentin a Controlled Substance?

As of 2022, Alabama, Kentucky, North Dakota, Michigan, Tennessee, Virginia, and West Virginia consider gabapentin a controlled substance.[5] Some states have mandated gabapentin reporting that adds prescriptions to the PDMP system, including Connecticut, Massachusetts, Kansas, Indiana, New Jersey, Minnesota, Nebraska, Utah, Ohio, Oregon, Wyoming, and Washington D.C.[6]

These states have controlled or monitored the drug because of the risks of gabapentin misuse. The drug can cause euphoria and extreme relaxation that may lead to gabapentin abuse, especially at higher doses. Gabapentin is classified as a Schedule V medication in states where it’s a controlled substance, which means it has a lower risk of addiction compared to other controlled substances.

Is Gabapentin Addictive?

Some research into gabapentin has shown that it can lead to dependence, addiction, and withdrawal in some people. When it initially hit the market in 1993, the abuse risk was thought to be minimal. However, gabapentin has been associated with drug abuse in high numbers in recent years, particularly with polydrug use involving opioids or alcohol.[7] In addition, the close monitoring of gabapentin has led to a street market for illicit gabapentin.

In the general population, about 1% of people are estimated to misuse gabapentin. However, in people who abuse opioids, one study indicated that 15% to 20% of people abuse gabapentin as well.[8] People who abuse opioids and gabapentin together do so to boost the euphoria they get from the opioids.

Combining gabapentin with other drugs can be extremely dangerous, especially with opioids or sedatives. The risk of respiratory depression (slowed or stopped breathing) and death increases significantly.

Signs of Gabapentin Addiction

Gabapentin addiction has similar signs and symptoms to other substance use disorders. The signs may include:[9]

• Taking larger doses or using gabapentin more frequently than prescribed
• Having strong cravings for gabapentin
• Visiting multiple doctors to obtain gabapentin prescription medication
• Trying to stop the use of gabapentin without success
• Spending a lot of time trying to get, use, or recover from gabapentin
• Gabapentin use that’s interfering with your ability to fulfill responsibilities
• Experiencing withdrawal symptoms if you stop using gabapentin

Gabapentin Withdrawal

Gabapentin withdrawal can occur if you become dependent on the drug, but that doesn’t necessarily mean you’re addicted. The withdrawal symptoms may include anxiety, agitation, restlessness, headaches, disorientation, dizziness, confusion, trouble sleeping, nausea, abnormal heart rate, and seizures.[10]

It’s best to taper your gabapentin dose gradually to reduce the severity of withdrawal symptoms. This should be done under the guidance of a doctor. Don’t try to stop taking gabapentin on your own. Stopping gabapentin suddenly can cause serious seizures.

Medical detox may help with gabapentin withdrawal, particularly if you’re abusing other substances that may cause complicated and intense withdrawal. After detox is complete, it may be best to transition into an addiction treatment program on an inpatient or outpatient basis to address the underlying causes of addiction.

Safety Precautions for Gabapentin

Gabapentin can have risks. Here are some ways you can ensure you’re as safe as possible with gabapentin:

• Take the lowest dose possible to relieve your symptoms
• Follow the prescribing instructions from your healthcare provider
• Avoid combining gabapentin with other central nervous system (CNS) depressants like alcohol or benzodiazepines
• Avoid taking gabapentin if you have a history of substance use disorder

You should never combine gabapentin with opioids, which can be extremely dangerous. An opioid overdose is more likely if you use opioids with gabapentin. Based on research from the Centers for Disease Control and Prevention (CDC), gabapentin was detected in almost 10% of opioid-related overdose cases from 2019 to 2020.[11]

Combining gabapentin and opioids can increase the risk of breathing problems. Opioids also raise gabapentin concentration to dangerous levels.

Be Careful with Gabapentin

Gabapentin is a generally safe and well-tolerated drug for treating seizures and certain types of nerve pain. It’s not a narcotic painkiller or a controlled substance on the federal level, but it is controlled or monitored in several states because of its abuse potential. If you’re misusing or abusing gabapentin – especially with other drugs like opioids – it’s important to get help as soon as possible.