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THENS, 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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  • Kaye: So you have the nerve to come here and admit that your whole family is full of people who make their living by getting meds they don’t need, and selling them on the street for profit? Your family is fueling the so-called “opioid epidemic,” and they’re the biggest reason that those of us who really DO need them and have the self-control necessary to use them responsibly are starting to be cut off to live with constant pain. Don’t expect your comments to be well-received here. If I knew who these “family” members were, I’d report them myself. I’m guessing it would be asking too much of you to do that for us…

  • Have you really looked into this? I take gabapentin for fibromyalgia i have been taking it for years i dont believe that this is worse then opiods. Not everone out takes it to get high.

  • Is there no real drug abuse news to report?

    I’ve been taking the maximum daily dose of both Gabapentin and Pregabalin for years.

    It’s true that they’ll get you mildly stoned. So what? So will nutmeg.

    People will abuse whatever they can, but the very idea that Gabapentin is overwhelming the rehab clinics is absurd.

    It is hard enough getting prescribed meds for pain and this barely credible reporting will only contribute to making our treatment even harder to access.

  • Honestly, it sucks that the government is taking over EVERY part of our lives! A lot of STUPID law makers want to take away guns , but a person who wants to kill will get a gun weather its legal or not! And then the good people who obey the law will have no gun to protect themselves or their family. Now,it’s the same with pain pills . Honestly, the government should stay out of it. There’s people who need their pain pills for pain,and who cares if some people want to get high? Why not let people enjoy themselves on pills? I mean, should we stop driving cars because they too are deadly?! Of course NOT. People race cars and die doing it but it’s legal and yet, the STUPID government wants to take pain killers away from people because they can cause death. A person who is responsible can enjoy getting high without dying. This world sucks.

  • I agree I have also been on it for 15 years and was on pain meds and my doctor died overnight and I haven’t had a pain pill in 4 years. THAT’S 4 YEARS OF MISERY. They had no one to take over so BAM there goes my Perc that I had been on since 04. Can’t hardly even take care of my house. I’m now traveling to UVA I might get nerves burnt but my hips are gone also. Trust me I understand wanting to fill good but they never did that for me. Yes they say it’s a disease but you people that took that first pill and then u start abusing them has taken the life right out of the ones who need it.

    • Ranae, I’m so sorry to hear what you’re going through, and for four years? That’s what these Opioid Warriors don’t seem to understand. With a proven track record of 15 years using opioids responsibly, there shouldn’t even be a question that you’re using them safely. What gives people the right to decide that longevity of life in constant pain is more important than quality of life, anyway… however long it was meant to be. We’re ALL going to die some day!

      You can’t go up to a junky and say “See what your actions have done to MY life”? because he doesn’t care. A junky will steal money from his own grandmother to get that next high. They’re the most selfish and uncaring people on the planet! You can throw new laws out there every day, and you’ll never change the fact that a certain segment of society is just always going to be that way. Why is it that the Government is unwilling to make any effort to recognize the difference between chronic pain sufferers and people who have absolutely no self control over their actions?

      At the very least, they should be looking at MRIs, the patient’s age, and their demonstrated past ability to successfully manage these medications without abusing them. The junkies will always manage get their next high, and it most likely won’t be from the proceeds of a paycheck, either.

      I don’t know if you live in an area where there are a lot of doctors, but my advice to you would be to never give up. There ARE doctors still willing to help us, there just aren’t a lot of them left. Don’t accept a life of constant pain without a fight!

  • This entire article is total BS. I have been taking gabapentin for over 20 years for spinal cord damage. It does not get you ‘high’, but it does relieve the excruciating pain.
    You can abuse anything if you take a handful of pills for God’s sake. Overdose on Aspirin anyone?
    How about an overdose of TIC-TACS?!
    There is a demon under every stone if you look hard enough.

  • Anthony, I’m a diabetic. Does that make ME an addict because I want my insulin? If you take drugs because they make you high, you’re an addict. If you take drugs because you have a condition that requires them to help you just have a somewhat normal functioning life, and you don’t abuse them just because they CAN make you high, you’re not an addict. Addicts are making it hard for people who use drugs responsibly and out of necessity, to even get them. THOSE are the people who don’t get much sympathy from the rest of us who just want a functional life and the ability to make a living.

    • That’s right Jim!! I have had CRPS plus other medical conditions that warrant pain medications. Opioid medication gave me my life back. My doctor that I had seen for years retired and I had to find a new one. Well, this is a nightmare in itself! He flat out told me on my first visit that he couldn’t keep me on my medications that I have been on for years! Even though they gave me a functional life! He added that the CDC and FDA was watching on what medicines were being described…and what does that have to do with my chronic pain?! The so called opioid “epidemic” is from recreational drug users and illicit fentanyl and heroin, not chronic pain patients taking their medically necessary prescribed pain meds!! Of all the people that are over dosing and dying, how many are legitimate chronic pain patients?? Yeah, this is why we are the ones suffering and being dropped from doctor’s. The government need to get out of the patient/doctor relationship…they don’t know any of us or our pain needs! We can NOT be put in a “one size fits all” category when it comes to chronic pain and that is exactly what the CDC and FDA are doing! Totally absurd for a bunch of politicians to be sitting around a table telling what and how much pain meds we can take!??! This barbaric and inhuman! We have got to stand together and get our pain heard! I am attaching a link for a petition to congress, please SHARE, share this!! We have got to fight for our rights!! https://www.petition2congress.com/ctas/chronic-pain-patients-petition-reinstatement-rights
      Thanks Jim!!

  • Reporting like this is outrageous. You have people freaking out about medication that is absolutely necessary for some people. We don’t take opioids because of addicts now you want to take this from us as well. These people Will use anything!!!

    • I’m an addict in recovery and nobody took anything from anyone. If you want to get high you’ll get high. And if you aren’t an addict, your sounding like you are because you want your gabapentin… SMH

    • Unfortunately, here is a reality. Yes there are prescribed that are legitimate. However, there ARE those who are only getting prescriptions filled they take them and sell them. My guess is that the pain isn’t as bad for SOME and they have multiple Tues of meds that they know work for them and the rest they sell to abusers. This can be quite lucrative. I know because I have family members that have been doing this for years. I have a Son that became an Opioid addict by buying from cancer patients. He became a heroin addict as the cancer patients died he became poorer and homeless. He is now in appointed drug court working on 180 days clean. I know there are legitimate patients but a lot of my family is on welfare and getting these scripts for free and turning right around making more money off the government. In the end we are paying for this stuff multiple times, plus. Something has got to give. We are swimming in a cesspool of perpetual complacency with everyone around us being on some kind of substance to numb ourselves in mind and body in one way or another which means we do not function at full capacity at all anymore. Personally it scares me because the whole world had become ”Comfortably Numb”.

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