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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  • Now that I’ve been reading this PLEASE LOOK UP “2018 Real Time Death Statistic’s in America”. Med Errors and Hospital Infections kill 4 fold every year than “All Drug Abuse and Prescription Drug Overdose”. Every Year. 60 Minute Dec 17th, DEA report now that he’s retired. Please do look that up and watch. it turned my stomach further on our government. Than find 4 segments on “America’s , War on Drugs”. Our government even bought in the 60’s in Europe a Pharmaceutical Company of all it LSD for warfare. Anyone remember ORANGE SUNSHINE during the hippie times. Timothy Leary pick it up after, we were made into governments experiment. And it backfired. The people loved it. Warfare lost. Guns and Drugs(like Cocaine) our government has been using in trade for years for profit. THEIRS!!!! For people in pain, your doctors know you should use it. But DEA have them( doctors) peeing their pants. I have 2 pain management and a surgeon in letter form saying I need to keep using my pain killers. And still my doctor keeps telling me how 64,000 people die because of these medications. So I told him how Medical Errors and Hospital Infections kill more 4 fold every year than all these 64,000. But how many have taken their own live because doctors cut back on the medications to please the government and know they will not have enough to last the month or just be in pain. So Doctors how many more have YOU KILLED. The only way to fix this is to Instead of killing the people in pain is kill the Government. They are the Drug Dealers!!!

  • How interesting ! Businesses lay off workers — Government is blamed. Corporations grow large and grow rich … but “the money” is “in the pockets” of the POLITICIANS.

    Criminals import illegal drugs (fentanyl) Government is blamed. Hospitals hold ‘flesh eating bacteria’ cases to FOUR per MILLION admissions — and this somehow adds up to “your government lies.”

    When I think of all the crap I took for criticizing the Government during the 60s — sheeesh!

  • Why was my daughter perscriber gabapentin when she had a history of heroin abuse by her doctor? She passed away last month from an overdose and could this drug have played a role in her death?

    • I highly doubt that Gabapentin caused your daughter’s death. It certainly didn’t get her high.

    • sorry to hear this! In the autopsy did they find Fentanyl. Or any other drug that could be her choice at the time. Many of the family members in New Hampshire found out after their reports that it was that drug Fentanyl that was used. Our government has known for years that the Chinese Chemists have been making and delivering this to underground and has really been the root of killing . Please look up a “2018 Real Time Death Statistics in America” Add together Medical Errors and Hospital Infections.
      add together “All Drug Abuse and Prescription Drug Overdoses”
      And its only April, the difference is overwhelming that at least 4 fold die by your Medical Administration. And its every year. You go into the hospital to have a baby at 19 and get a flesh eating bacteria. Or other bacteria that kills you. Now we the People are hearing the where and the what about these Chinese Chemists while years this has been going on. Smoke and Mirrors by the government whom lies to us all the time. Again I’m sorry for your loss. But our country has been failed with horrible education and NO JOBS because of pocket monies in Politicians pockets!

  • This is just getting to be to much! I have been on Gabapentin for chronic pain and neuropathy. How do you abuse Gabapentin???? These stupid people out there will try to get high off of anything which is making it hard for all of us that are in pain. I’m being told that I can no longer take klonopin with the Percocet that is being prescribed by my pain doctor. I am so fed up with these people that are making it hard for us. So what do we do if we can no longer get Gabapentin??? This article just really gets me worked up.

    • Some law-abiding citizens who have managed their medication for years with no problems, will probably become so desperate for relief that they’ll turn to street narcotics like heroin and turn into addicts. Prison or death will be inevitable for some of them. Some will be in so much agony that they may, quite unfortunately, commit suicide. The politicians who cause these tragic outcomes won’t give it a second thought… but ain’t that America?

    • “Drug Warriors” are as cruel as they are self-serving …

      I haven’t a clue what Statnews is up to. All I know is that they didn’t honor my UNsubscribe request

      And that sort of fits in with typical Drug Warrior characteristics: bad science, bad math, bad policy, and BAD FAITH.

      Perhaps it’s worth remembering that in the first flush of Teddy Roosevelt’s anti-opium crusade … there were fringe prohibitionists seeking federal laws and regulations against Chloral Hydrate and, of all things — Saccharine. Maybe this is a 21st century iteration of that.

      Or … not that anyone would know this for certain … it could be that opium addicts have found that Gabbapentin “takes the edge off” the physical symptoms of withdrawal, giving the drug a bit of street value — and therefore attracting the attention of Prohibitionists.

      Were that the case … it would mean the ‘Warriors’ are, once again, making things worse by discouraging the study and use of a useful tool in treating actual drug addiction.

  • I was given Gabapentin for pain due to a cervical spine injury and Brown Sequard Syndrome involving nerve pain in hands and forearms and numbness and hypersensitivity to my left hip and leg because that’s the only thing worker’s compensation would pay for!

  • Gee, Nate… perhaps you could elaborate. Was it something I said about junkies screwing things up for legitimate chronic pain sufferers who are following all the rules under a doctor’s care? Did I guess right? It was probably your inability to properly articulate your thoughts that tipped me off.

  • I was astounded to read this. I take gabapentin for rls and plmd. It does not make me high or feel good. It just makes me really tired!!!! The lady who took it to keep up with her 2 year old!!!!!

  • I have Fibromyalgia, Myofascial Pain Syndrome, Migraines, severe arthritis and an NSAIDS allergy. My doctor is afraid to give me anything but Tylenol. Because my liver is less important than “Omg, what happens to me if she gets addicted?” I’m currently hoarding my muscle relaxers in preperation for them taking those away too.

    • Yes, but our pain is a small price to pay to keep our junkies from abusing the drugs we need, so that they can get high. I mean, they’re such valued members of our society… what if one of them did something really stupid and died?

    • Gabapentin has been essential to control my restless legs and keep the pain away for my neuropathy. I take 2400 mg a day and the only side effect is a little clumbsiness. If I don’t take it my sciatica gets debilitating.

    • You must have Kaiser health care. It is frustrating that they believe EVERYONE has one foot in the gutter of addiction. Finally found a pain clinic who treats me like the responsible grownup I am and is more concerned about treating my pain. Good luck. Find a pain clinic that will help you. You are worth it!

    • Rose where is it you live the drs treat me like I’m ten I’m 47 n been on oxycodone n gabapentin for four yrs now they don’t wanna give it to me unless I get injections my lawsuit is still pending n I don’t have money for injections is why I’ve been taking medication for my 5 slipped discs until my case is settled is the cheapest n best way of controlling my pain they should treat us like the adults we are!!

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