Is Gabapentin an Opioid? Drug Facts, Uses, and Side Effects
If you or someone you know has been prescribed gabapentin, you may ask, “Is gabapentin an opioid?” This question arises during the opioid epidemic as people seek safe pain relief. Gabapentin is becoming a popular alternative for pain management, leading to questions about its classification.
Gabapentin knowledge avoids unsafe use and the lack of awareness of risks. It’s widely used for nerve pain and seizures, but there’s misinformation. It’s used by some instead of or in addition to opioids. Being aware of gabapentin’s drug class, effects, and risks makes good health choices possible.
By the end of this article, you will understand if gabapentin is an opioid, its mechanism, approved and off-label uses, and potential gabapentin side effects. We will clarify its abuse potential, differences from opioids, and dependency. This information empowers you to use medications wisely and seek help for gabapentin misuse if needed.
Is Gabapentin an Opioid?
Gabapentin is an anticonvulsant drug, not an opioid. Opioids act on opioid receptors for pain relief and euphoria (e.g., morphine). Gabapentin, chemically unrelated, does not affect those receptors. The National Institutes of Health states, “Gabapentin is in a class of medications called anticonvulsants. It was initially developed to treat epilepsy and later approved for nerve pain.
Unlike opioids, gabapentin calms nerve activity and controls seizures or nerve pain but does not provide immediate relief or a high. Legally, most opioids are controlled substances due to abuse potential, while gabapentin isn’t federally regulated.
The DEA has not classified gabapentin as a controlled substance. In contrast, pregabalin (Lyrica) is Schedule V. With rising abuse, some states, like Michigan, now control gabapentin.
How Does Gabapentin Work in the Body?
Gabapentin works differently from opioids by calming certain nervous system activities. It reduces abnormal excitement in the brain and alters nerve pain signal transmission.
Despite its name, gabapentin does not directly act on GABA receptors or increase GABA levels at regular doses. Its calming effect comes from modulating calcium channels, effectively stabilizing electrical activity in the brain. This results in fewer seizures for people with epilepsy and reduced pain signal intensity for those with nerve pain.
In contrast, opioids block pain signals by attaching to opioid receptors, producing euphoria, which gabapentin does not do. It doesn’t rapidly numb sharp pain like opioids, but it can dull chronic nerve pain over time.
Medical Uses of Gabapentin
Gabapentin, which was introduced in the 1990s, has become well-loved for its versatile FDA-approved uses, such as managing epilepsy, easing neuropathic pain, and helping with anxiety treatment.. Its approval has made it a key option for managing these conditions, offering relief to many patients.
Some FDA-approved uses:
Seizure Control: Approved as an anti-epileptic, gabapentin is used adjunctively for certain seizures in adults and children from age 3, reducing seizure frequency by calming neuronal activity.
Postherpetic Neuralgia (PHN): Gabapentin is FDA-approved for nerve pain following shingles. It alleviates burning and stabbing pain by dulling nerve signals.
Restless Legs Syndrome (RLS): The extended-release form, gabapentin enacarbil (Horizant), treats moderate-to-severe RLS by reducing nighttime leg discomfort.
Nerve Pain from Other Conditions: Gabapentinoids, including gabapentin, are recognized for treating neuropathic pains, such as those from diabetes or spinal cord injuries, even without formal FDA labels for the immediate-release form.
Gabapentin vs. Opioids
Understanding gabapentin and opioids is crucial for pain management. Gabapentin addresses nerve pain and seizures, while opioids alleviate moderate to severe pain. Recognizing their differences clarifies confusion about their effects and risks, aiding in safer treatment plans.
Drug Class and Purpose: Gabapentin is an anticonvulsant and nerve pain modulator; opioids are narcotic pain relievers. Opioids (e.g., morphine, oxycodone, fentanyl) treat moderate to severe pain and are used in anesthesia by binding to opioid receptors in the brain and spinal cord to block pain signals. Gabapentin controls seizures and nerve pain but isn’t effective for acute pain (like post-surgery). It’s used for chronic neuropathic pain or as an adjunct.
Chemical Action: Opioids activate opioid receptors for pain relief, drowsiness, and sometimes euphoria. Gabapentin modulates calcium channels without acting on opioid receptors or interacting with endorphins. Opioids can increase dopamine levels, making addiction more likely; gabapentin has a milder or negligible impact on dopamine, resulting in less euphoria.
Addiction and Dependence
Opioids pose a high risk of dependence and misuse, even with short-term use, which can lead to tolerance and withdrawal. The NIH states that opioid misuse can cause overdose or death. Gabapentin has much lower abuse potential; most users do not develop cravings, unlike many long-term opioid users. Although gabapentin isn’t entirely free of abuse potential, it’s significantly less than opioids.
Euphoria and “High”: Opioids can cause intense euphoria, particularly when misused. Gabapentin may lead to mild sedation or a subtle high, but it doesn’t trigger compulsive use like opioids do.
Side Effect Profile: Both drugs can cause sedation and dizziness, but opioids have additional severe side effects, including pinpoint pupils, constipation, nausea, and respiratory depression, which can be fatal. Gabapentin primarily causes dizziness and drowsiness without lethal risks unless combined with other depressants.
Overdose Antidote: The antidote for opioid overdose is naloxone, which can reverse the effects quickly. No specific antidote exists for gabapentin overdose, where supportive treatment is needed. Gabapentin overdose fatalities are rare when isolated, unlike opioids.
Legal Status: Most opioids are Schedule II or III controlled substances due to the potential for abuse, with strict prescribing regulations. Gabapentin is not federally controlled, making it easier to prescribe, though some states may regulate it.
Gabapentin Withdrawal Symptoms and Overdose Risks
If someone takes gabapentin regularly, especially in high doses, and suddenly stops, they may experience withdrawal symptoms. This can occur with many medications as the body adapts; it doesn’t mean someone was “addicted,” but rather that their body depended on the substance.
Reported gabapentin withdrawal symptoms include:
Anxiety and restlessness: The person may feel anxious, irritable, or restless. Gabapentin has a calming effect on the nervous system, so removing it can cause a rebound of nervousness or agitation.
Insomnia or sleep difficulties: Trouble falling asleep or staying asleep is common, according to MedlinePlus.gov. People often report rebound insomnia when they come off gabapentin, meaning if gabapentin made them sleepy, its absence makes it hard to sleep.
Nausea: Some individuals feel sick or may even vomit when withdrawing.
Pain: There can be generalized body aches or even a resurgence of the pain that gabapentin was managing (e.g., neuropathic pain coming back worse temporarily).
Sweating: Night sweats or general sweating is noted as a withdrawal effect.
Palpitations or increased heart rate: Some might feel their heart pounding.
Flu-like symptoms: This term often appears, describing a mix of feeling unwell, maybe mild feverish feelings, a runny nose, etc., though this is less pronounced than opioid withdrawal flu-like symptoms.
Seizures: If you take gabapentin for seizures (epilepsy), stopping suddenly can trigger rebound or more frequent seizures. Rarely, someone without a seizure history may experience one from abrupt cessation due to the sudden over-excitation of the nervous system.
Overdose Risks of Gabapentin:
Yes, you can technically overdose on gabapentin, but it is rarely fatal. People have survived high doses with supportive care, though overdose can still lead to severe symptoms and complications.
Symptoms of gabapentin overdose may include:
- Extreme drowsiness or sedation (unable to stay awake).
- Double or blurred vision.
- Slurred speech.
- Ataxia (severe incoordination, a person can’t walk properly).
Treating Gabapentin Misuse and Addiction
Treatment for gabapentin misuse is available, even if addiction is less common than opioid or alcohol use. Key steps include:
Medical Assessment: A professional evaluates gabapentin use, potential opioid use, and underlying issues like chronic pain or anxiety.
Safe Taper/Detox: A medically supervised taper is recommended for dependence, with doctors gradually reducing doses to minimize withdrawal symptoms.
Treatment of Co-occurring Disorders: Addressing underlying issues is vital. This includes:
Therapy and Counseling: Individual and group therapy, often cognitive-behavioral therapy (CBT), helps identify triggers and develop coping strategies.
Mental Health Treatment: Treat mental health conditions to prevent self-medication with gabapentin.
Pain Management: Implement a pain management plan for chronic pain.
Behavioral Therapies and Support:
Treatment resembles other prescription drug addictions, including:
Inpatient Rehabilitation: Residential rehab for structured recovery and therapy.
Intensive Outpatient Programs (IOP): Attend therapy while living at home.
Support Groups: Groups like Narcotics Anonymous (NA) provide valuable peer support, though specific gabapentin groups don’t exist.
No FDA-Approved Medication for Gabapentin Addiction: Unlike opioid dependency, no specific medication treats gabapentin misuse; support is the primary focus. However, if combined with opioids, Medication-Assisted Treatment (MAT) may be needed.
Relapse Prevention: A relapse prevention plan is crucial to identify triggers and manage cravings, supported by ongoing therapy and support groups.
Family Involvement: Family participation can enhance success, address enabling behaviors, and support recovery.
DeNovo Recovery’s Full Continuum of Care for Gabapentin Misuse
DeNovo Recovery offers a comprehensive treatment for substance misuse, including gabapentin abuse. Recognizing each journey’s uniqueness, especially with gabapentin tied to larger issues like co-occurring opioid use or mental health problems, DeNovo Recovery provides a full continuum of care:
Co-Occurring Disorders Treatment: DeNovo Recovery addresses co-occurring disorders, treating substance use and mental health issues together. For clients misusing gabapentin due to anxiety or depression, the team offers psychiatric evaluation and therapy, treating the “whole person” to reduce substance misuse urges.
Day Treatment (PHP): The Day Treatment or Partial Hospitalization Program provides structured daytime treatment without overnight stays, ideal for those needing intensive therapy while living at home. Clients engage in counseling and educational groups, potentially including medication management, ensuring support and independence.
Intensive Outpatient Program (IOP): DeNovo Recovery IOP involves 3-5 therapy sessions weekly, focused on sobriety support and relapse prevention. It follows detox or serves as an entry point for moderate cases, enabling clients to practice recovery skills while living at home or in sober living.
Residential Treatment (Inpatient Rehab): Residential treatment offers clients on-site living for weeks to months, which is essential for severe cases that require constant care and removal from triggers. Clients engage in therapies and wellness activities, establishing a solid recovery foundation.
Sober Living and Aftercare: Post-treatment recovery at DeNovo emphasizes aftercare planning and sober living, providing drug-free environments that support the transition to independent living.
Family Support Program: DeNovo Recovery’s Family Support Program features therapy, workshops, and support groups to help families set healthy boundaries and support recovery, fostering better communication at home.
Experienced, Compassionate Staff: DeNovo Recovery’s team includes medical professionals and counselors who use evidence-based practices, monitor detox, prescribe medications, and compassionately guide clients through recovery.
Individualized Treatment Plans: DeNovo Recovery tailors’ treatment to individual needs, addressing chronic pain or trauma based on personal histories, allowing clients to progress through various care levels.
Hope and Help at DeNovo Recovery
Gabapentin is a potent medication that can be beneficial but carries risks. Follow prescriptions, be aware of side effects, and avoid harmful combinations. Used correctly, it can improve lives affected by seizures or nerve pain. However, misuse, especially with other substances, can lead to severe consequences like addiction or overdose. If you’re struggling with misuse, help is available; seeking support is always a good choice.
DeNovo Recovery in St. Joseph, MO, is here to assist you. We offer personalized treatment options, including medical supervision to taper off gabapentin, therapy for misuse, or a supportive setting to rebuild your life. Our programs feature residential treatment and outpatient services.
If you or a loved one is experiencing difficulties with gabapentin, don’t wait for the problem to escalate. Contact DeNovo Recovery today. Our compassionate team in St. Joseph is ready to listen and assist. We provide confidential assessments and guidance for your next steps. Seeking help is a courageous step towards a brighter future.
FAQs
Q1: Is gabapentin an opioid or a narcotic?
A: No, gabapentin is an anticonvulsant or gabapentinoid used to treat seizures and nerve pain. It does not act on opioid receptors and is not federally a controlled narcotic. In summary, gabapentin is a prescription medication, not an opioid.
Q2: What is gabapentin used to treat?
A: Gabapentin is FDA-approved for epileptic seizures (as an adjunct for partial seizures) and postherpetic neuralgia. An extended-release form is approved for restless legs syndrome. It is often prescribed off-label for nerve pains, fibromyalgia, migraines, hot flashes, and anxiety disorders.
Q3: Can gabapentin be addictive or abused?
A: Gabapentin has a lower abuse potential but can lead to misuse and dependence. It usually does not produce a “high,” but high doses can enhance opioid effects or induce sedation. Misusers may need to take it continually to avoid withdrawal. Most people using it as prescribed don’t develop an addiction, though misuse occurs in those with opioid addiction histories. Use gabapentin only as directed by a physician.
Q4: What are the common side effects of gabapentin?
A: Common side effects include drowsiness, dizziness, and fatigue, as well as coordination issues, blurred vision, and tremors. These effects are mild and improve over time or with dosage adjustments. Physicians usually start treatment with a low dose, increasing gradually. It’s advised not to drive or operate machinery until you know how it affects you.
Q5: How is gabapentin misuse or addiction treated?
A: Treatment resembles other prescription drug addictions, starting with medically supervised tapering or detox. There’s no specific medication for reversing gabapentin addiction; care focuses on supportive measures. Post-detox rehabilitation programs, inpatient or outpatient based on misuse severity, provide therapy to address underlying issues. Concurrent issues, like anxiety or depression, are treated simultaneously. Facilities like DeNovo Recovery offer tailored care, making recovery from gabapentin misuse achievable with support.