ATHENS, Ohio — On April 5, Ciera Smith sat in a car parked on the gravel driveway of the Rural Women’s Recovery Program here with a choice to make: go to jail or enter treatment for her addiction.

Smith, 22, started abusing drugs when she was 18, enticed by the “good time” she and her friends found in smoking marijuana. She later turned to addictive painkillers, then anti-anxiety medications such as Xanax and eventually Suboxone, a narcotic often used to replace opioids when treating addiction.

Before stepping out of the car, she decided she needed one more high before treatment. She reached into her purse and then swallowed a handful of gabapentin pills.

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Last December, Ohio’s Board of Pharmacy began reporting sales of gabapentin prescriptions in its regular monitoring of controlled substances. The drug, which is not an opioid nor designated a controlled substance by federal authorities, is used to treat nerve pain. But the board found that it was the most prescribed medication on its list that month, surpassing oxycodone by more than 9 million doses. In February, the Ohio Substance Abuse Monitoring Network issued an alert regarding increasing misuse across the state.

And it’s not just in Ohio. Gabapentin’s ability to tackle multiple ailments has helped make it one of the most popular medications in the U.S. In May, it was the fifth-most prescribed drug in the nation, according to GoodRx.

Gabapentin is approved by the Food and Drug Administration to treat epilepsy and pain related to nerve damage, called neuropathy. Also known by its brand name, Neurontin, the drug acts as a sedative. It is widely considered non-addictive and touted by the federal Centers for Disease Control and Prevention as an alternative intervention to opiates for chronic pain. Generally, doctors prescribe no more than 1,800 to 2,400 milligrams of gabapentin per day, according to information on the Mayo Clinic’s website.

Gabapentin does not carry the same risk of lethal overdoses as opioids, but drug experts say the effects of using gabapentin for long periods of time or in very high quantities, particularly among sensitive populations like pregnant women, are not well-known.

Athens, home to Ohio University, lies in the southeastern corner of the state, which has been ravaged by the opioid epidemic. Despite experience in combating illicit drug use, law enforcement officials and drug counselors say the addition of gabapentin adds a new obstacle. As providers dole out the drug in mass quantities for conditions such as restless legs syndrome and alcoholism, it is being subverted to a drug of abuse. Gabapentin can enhance the euphoria caused by an opioid and stave off drug withdrawals. In addition, it can bypass the blocking effects of medications used for addiction treatment, enabling patients to get high while in recovery.

“I don’t know if we have a clear picture of the risk,” said Joe Gay, executive director of Health Recovery Services, a network of substance abuse recovery centers headquartered in Athens.

Gabacount
Rachel Quivey works as a pharmacist for a branch of Fruth Pharmacy, located in a strip mall beside a Dollar General in Athens, Ohio. She noticed clients were misusing gabapentin when they began picking up prescriptions early. Carmen Heredia Rodriguez/KHN

‘Available To Be Abused’

A literature review published in 2016 in the journal Addiction found about a fifth of those who abuse opiates misuse gabapentin. A separate 2015 study of adults in Appalachian Kentucky who abused opiates found 15 percent of participants also misused gabapentin in the past six months “to get high.”

In the same year, the drug was involved in 109 overdose deaths in West Virginia, the Charleston Gazette-Mail reported.

Rachel Quivey, an Athens pharmacist, said she noticed signs of gabapentin misuse half a decade ago when patients began picking up the drug several days before their prescription ran out.

“Gabapentin is so readily available,” she said. “That, in my opinion, is where a lot of that danger is. It’s available to be abused.”

In May, Quivey’s pharmacy filled roughly 33 prescriptions of gabapentin per week, dispensing 90 to 120 pills for each client. For customers who arrive with scripts demanding a high dosage of the drug, Quivey sometimes calls the doctor to discuss her concerns. But many of them aren’t aware of gabapentin misuse, she said.

Even as gabapentin gets restocked regularly on Quivey’s shelves, the drug’s presence is increasing on the streets of Athens. A 300-milligram pill sells for as little as 75 cents. Yet, according to Chuck Haegele, field supervisor for the Major Crimes Unit at the Athens City Police Department, law enforcement can do little to stop its spread. That’s because gabapentin is not categorized as a controlled substance. That designation places restrictions on who can possess and dispense the drug.

“There’s really not much we can do at this point,” he said. “If it’s not controlled … it’s not illegal for somebody that’s not prescribed it to possess it.”

Haegele said he heard about the drug less than three months ago when an officer accidentally received a text message from someone offering to sell it. The police force, he said, is still trying to assess the threat of gabapentin.

Gabacount
Quivey’s staff takes a photograph of every gabapentin prescription they dispense to keep a record of the number of pills they distribute to each client. They must report every gabapentin prescription they fill to the state drug-monitoring program. Carmen Heredia Rodriguez/KHN

Little Testing

Nearly anyone arrested and found to struggle with addiction in Athens is given the option to go through a drug court program to get treatment. But officials said that some exploit the absence of routine exams for gabapentin to get high while testing clean.

Brice Johnson, a probation officer at Athens County Municipal Court, said participants in the municipal court’s Substance Abuse Mentally Ill Program undergo gabapentin testing only when abuse is suspected. Screenings are not regularly done on every client because abuse has not been a concern and the testing adds expense, he said.

The rehab program run through the county prosecutor’s office, called Fresh Start, does test for gabapentin. Its latest round of screenings detected the drug in five of its roughly 238 active participants, prosecutor Keller Blackburn said.

Linda Holley, a clinical supervisor at an Athens outpatient program run by the Health Recovery Services, said she suspects at least half of her clients on Suboxone treatment abuse gabapentin. But the center can’t afford to regularly test every participant. Holley said she sees clients who are prescribed gabapentin but, due to health privacy laws, she can’t share their status as a person in recovery to an outside provider without written consent. The restrictions give clients in recovery an opportunity to get high using drugs they legally obtained and still pass a drug test.

“With the gabapentin, I wish there were more we could do, but our hands are tied,” she said. “We can’t do anything but educate the client and discourage” them from using such medications.

Smith visited two separate doctors to secure a prescription. As she rotated through drug court, Narcotics Anonymous meetings, jail for relapsing on cocaine and house arrest enforced with an ankle bracelet, she said her gabapentin abuse wasn’t detected until she arrived at the residential recovery center.

Today, Smith sticks to the recovery process. Expecting a baby in early July, her successful completion of the program not only means sobriety but the opportunity to restore custody of her eldest daughter and raise her children.

She intends to relocate her family away from friends and routines that helped lead her to addiction and said she will help guide her daughter away from making similar mistakes.

“All I can do is be there and give her the knowledge that I can about addiction,” Smith said, “and hope that she chooses to go on the right path.”

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  • I’m suffering from post-surgical neropathy and was just prescribed Gabapentin. I took it last night and was able to sleep 10 hours undisturbed. I’m not going to take it during the day as I want to be able to drive safely and I usually can manage the pain during the daytime. It only drives me crazy when I’m trying to sleep. Nearly every drug I’ve seen that is supposed to get you high only makes me sleepy and relieves the pain . In this case, that’s all I need it to do.

  • I’ve been using gabapentin for years for restless leg syndrome and more recently for neuropathy and general pains. I use six capsules a day, and I can’t for the live of me imagine how to get high or addicted from it. And if I did get high and addicted, fine. Addiction could be no worse that the pain and RLS I suffer from without it. Whatever idiot wrote the story about some people complaining about addiction never did proper research first.

  • Oh my God! It works for pain. It may not be adictive or an Opoid but it works for pain so, for God’s sake, make it a Schedule Drug and impossible to obtain even with a prescription for people who really need pain control. Make sure they live in agony because some idiots will abuse any medication to get high.

    • Get a fucking life, your a butt fucked moron. What an absolute idiot you must be to say these bs comments. go butt fuck yourself with a point stick!!!!

    • I am almost 60 years old and I’ve had to resort to going to a methadone clinic for pain management and tell them that I’m a drug addict because I cannot get A doctor to write me pain medicines for My
      Three failed back surgeries I have neuropathy in my feet so bad now to also and gabapentin is the only thing that works if they make it a controlled substance I won’t be able to take it with the Methadone
      Damn the war on drugs that’s made it were people like me can’t get the proper pain medicine WTF

  • I am prescribed gabapentin..it helps the nerve pain in my feet but I dont like the feeling I get like I’m groggy headed so I asked for a lower dose and I only take it if the pain is unbearable..I cant understand that someone would take this to get high..I’m praying for them

    • Mona
      I agree! I doubt anyone would use it for pleasure. I was once given Gabapentin to try. I hated the way the one & only pill l took made me feel. Plus l have a history of sleep walking & sleep behavior (acting out dreams without getting up from bed – picture a sleeping dog running sideways).The Gabapentin gave me a sleep behavior episode l wish never to repeat.

  • Do gabapentin 300 mg do they have opioids in them like tylenol 3 have in them.also do trazodone hydrochloric 100mg got opioids in it.

    • No gabapentin does not have an opioid like Tylenol three which is codeine
      Trazodone does not have an opioid in it either it is an antidepressant sometimes prescribed for sleep

    • Dale – Well Said! Back in the 1920s, when we had alcohol prohibition, criminals would say “the booze made me do it” but back the, people were sensible enough to realize that this was just a claim being made by a population prone to lying – especially when the lie might get them something they want/avoid something the don’t want.

      Sadly, these days so many people think that anyone who is claiming to speak from “personal experience” is providing the highest quality of accurate information.

  • Gabapentin is not an Opioid, and I don’t know where I’d be without it! I have severe spinal stenosis and pain and it’s all that helps! I can’t take Opiates as they cause nausea. The Dr may switch me to Lyrica, but that is a controlled substance. I don’t know of anyone who has a Gabapentin addiction; I’m on 1800 mg a day, but I can’t raise it because I’m not supposed to do that either!

    • I am prescribed gabapentin..it helps the nerve pain in my feet but I dont like the feeling I get like I’m groggy headed so I asked for a lower dose and I only take it if the pain is unbearable..I cant understand that someone would take this to get high..I’m praying for them

  • I was actually surprised that the government started going after Gabapentin, since there doesn’t seem to be a media panic about Gabapentin similar to the panics about opiates.

    But it does confirm that pain patients don’t matter to the authorities one bit.

    We can all take comfort in the fact that our government does care enough about people who use illegally purchased drugs that the federal government not only permits – but funds – free needles to inject illegally purchased drugs.

    Government drug policies are incompatible with the promises made with the Harrison Act of 1914 that patients/doctors would not be subject to opiate restrictions, incompatible with Constitutional rights to the contents of our own minds, and incompatible with any resemblance of compassion for anyone suffering pain.

  • I’ve been taking Gabapentin for year’s for my severe back pain. Had a double laminectomy and double discectomy in 2013, improved dramatically. I found my back was even better with Gabapentin. Now I have found in the last four weeks since running out of Gabapentin my back pain has increased dramatically. I was working out every day, not anymore. What’s next? I do take blood pressure medication everyday, have for years. I guess I’m going to have too start using marijuana and magic mushrooms. Our country has gone mad. Makes me sad I may not be able to work anymore. I will be on the disability rolls. I don’t drink alcohol either, not yet.

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