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.

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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.

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“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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  • Hello. You mentioned that you have seen patients that are using gabapentin to not only increase the euphoria effect of opiates, but to also allow them to get high while on a blocker such as Suboxone. Are you saying that these patients are abusing gabapentin to produce a high of its own? That would make sense, because it’s not an opiate. Or are you saying that the gabapentin is actually capable of kicking that blocker off of the receptor?

  • Outrageous article I’ve taken Neurontin for 20 years for arms and legs going dead, tingling and numbness without any effect. No fatigue, high, nothing but helping neuropathy. Know a bi-polar who took a bottle in suicide attempt did nothing, Doctor responsible for developing said one of the safest pills. Abusers may get a little buzz the first few days by taking a bunch but after that, it stops working for a buzz. The first few days I started it I had a little extra energy but then body adjusts and nothing occurs but help for neuropathy. Started Metanex an active B complex after car accident jamming writs told would need carpal tunnel surgery within a year 50% nerve impulse loss. Took 8 months to start working but reversed/healed 30% nerve damage, take 2 or 3 nerotins a week compared to 3 or 4 daily. Because it actually heals a lot of insurances won’t cover it but can get a discount from the manufacturer. If taking an entire bottle attempting to commit suicide doesn’t do anything to them how can it be compared to an opioid? Neurontin can’t cause an overdose or kill you! Know this as a fact from a young adult who tried and developer of medication Dr. Ramon Sanchez!

  • its safe so doctors are prescribing it more than other, more dangerous drugs. It helps so many things, specifically though it treats chronic pain and depression in one go. It’s not a new, abused drug. Its a miracle drug.

  • Gabapentin has a mild sedative effect . So does Benadryl . Claiming that it is a dangerous drug is nonsense. Some people will take anything that alters their consciousness in any way and feel that they are “getting high”. Gabapentin is not addictive , the problem is that these people are addicts and certainly need help.

  • I didn’t get what kind of affect it had when misused. What I do know is that people are selling their Gabapentin instead of taking it. Found out not only that my sister who has a 5 week old baby told me she took herself if it while pregnant somehow went through 90- 300mg in 5 days. Most llikely sold or unused it because she sold her Sunday take home methadone ! What the heck am I to do, she and baby are staying with us while she heats her new section 8 voucher. Time for tough love…..

  • This article is incorrectly titled and you know it. Gabapentin is an antiepileptic drug that was discovered by seizure patients to relive neuropathy caused mainly by diabetes. It was then tested by the FDA to prove the alligations and then became a drug that targets the prevention of seizures AND neuropathy of all kinds, this led to reasearch that resulted in Pregabalin. This site does provide some useful information, but the political spin about Gabapentin being a drug of abuse just doesn’t hold it’s water.

    • That was a very accurate response. I use it for the nails and needle pain in my feet and I mean the bottom of my feet. The drug is a miracle for me – it still hurts but I can walk

  • Rita what about the people it helps to take less of their narcotic medication. Doctors should not have to worry about prescribing medication to responsible patients because other people decided to use it to get high. I think it sucks! Maybe you health care professionals should be educate yourselves about the aquatic life for people with dibitating health problems that this medication HELPS.

    • I can tell you that it is addictive!!! I am on the suboxone program and started this when I started the program. I decided that I wanted to stop taking it as I didn’t want to be dependent on any pill daily ( the reason I started the suboxone program to start with) so I stopped, I got dope sick worse than any opioid pill I’d ever taken!!! It’s not in my head I’ve tried several times to stop with no success.. This pill dose not get me high in no shape form or fashion… It helps with my pain but it is not a pill that any One should suddenly stop.. I’d suggest to tell your doctor you want to stop and let him or her decide the best way to do so.. I’ve asked my Dr to help me get off of them and he made a plan and I trust and hope at the end I’ll be off this pill and well.. It is laughable to say that people are getting high off this pill!!! The first few days you’ll have some dizziness maybe feel a little discombobulated but high!!!! No!!! It dose help with pain for sure. I know several people that take it for restless leg, they don’t take it everyday so they’re not dependent on it. I’d love it if it weren’t for being addictive!!!

  • Wow! What a ridiculous article… my doc gave me a script of gaba so i wouldnt have to take my xanax as much and i can reassure you that there is no high associated with it for myself. I take 300mg on ocassion at bed time and it helps me sleep… some high lololol… i took it one time during the day and i didnt notice a diff in mood or hapiness or anything. I was actually rather disappointed as i was hoping i would get a mood boost.. oh well..epic fail.. i take it for anxiety and it seems placebo.

    • Your way off track Shawna. The article is compellingly accurate. Those of us in health care understand the risks of abuse and complications addiction present when treating a patients. Please get educated.

    • I take this medication for neuropathy and it does help a little but not much, I take 2- 800mg in the am and then again at noon and again at night. I have quit taking the am and noon meds, due to them making me so tired. I wish there was a cure for this because it keeps me from doing so much, I love walking and now I don’t walk at all. I have used essential oils and that does not work either, lots of wasted money

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