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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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  • “…Today, Smith sticks to the recovery process. Expecting a baby in early July, …..”

    Gabapentin is NOT given to pregnant women…even pregnant women with epilepsy have a RISK of harming the child -fetus damage (bones, deformities) in animal studies:
    Teratogenic effects of gabapentin on the skeletal system of BALB/c mice fetuses
    https://www.researchgate.net/publication/47676403_Teratogenic_effects_of_gabapentin_on_the_skeletal_system_of_BALBc_mice_fetuses

  • Gabapentin was the best thing for me after so many times in detox and relapsing because of how I felt until i got prescribed that was when I got clean because it helped with the restless leg, hot flashes and sweats, and overall mood. Some people do take more becaise of the “happy” feeling i believe but that only last so long as your body becomes almost immune to them. Thats why I dont see how people continiously abuse them. Theyll almost stop working. Ive been taking 800mg 3x a day for a long time now and its like they dont do anything anymore even of i took extra. I dont because its like they may not change any feeling when i take them. But when i stop i realize how it effects how i feel physicay and my overall mood.

  • THE IDIOTS THAT SAY THEY GET HIGH ON GABAPENTIN. WILL TELL YOU THE BAG OF GRASS CLIPPINGS THEY BOUGHT FOR 100 DOLLARS WAS BEST WEED IN TOWN.AND ASK FOR MORE AND HAVE NAME FOR IT. LIKE PURPLE CAMEL HAIR INDICA. KEEP BUYIN MY WEED BOYS AND I GOT GABAPENTINS BRAND NAME 7 DOLLARS A PILL ALL DAY

  • I am 25 years old and had a plate in my neck. All my discs were fused together. I was on oxycodone for almost 4 months. I am still having problems with my neck and now seeing a Chiropractor to see if it helps. I am now sober and not on any pain killers. Last night I had a loved one give me a couple of these. I slept like a baby, helped with pain, and I felt amazing in the morning. There is a difference in an addict and someone who actually needs pain relief!!!!

  • A person who doesn’t want to actually get clean wont, they will find a way to get high on whatever they can. I am an addict in recovery, I take suboxone, I also take gabapentin. I take ONE 300mg pill at night to help me with restless legs when I sleep. I am serious about my recovery. I do NOT abuse my suboxone, I do NOT abuse ANY medication for the simple fact that I do NOT want to live my life in a fog anymore. There is always going to be something out there you can get high on. Where there’s a will, there’s a way. We need to spend more time trying to figure out why these people feel they can’t face reality than trying to find ways to make it harder for them to get high because they are just going to keep finding ways. Find them ways to not want to!

  • I am on 600 mgs of gabapentin 3 × a day I never take that much I may take 1 at night because they make me so drowsy I don’t fill mine early actually they have 2 remind me 2 fill them but I can understand the concern cause it will knock u the hell out if I take more than 1 I cant seem 2 wake completely up plz keep me posted & updated this concerns me very much.

  • I have been taking this medication for 4 years now. I don’t use it to get high, but I’m not an addict. It has given me relief from severe arthritis.

  • That’s her problem that she od. That doesn’t give the government the right to ruin it for the people that actually need it.. if someone od. It’s their fault no one else’s.

  • I was first given gabipenten of 100mg 3x a day for nerve pain after my radiation treatment… then with menapause, night sweats they said for me to go ahead and take 1 at night to see if it helps and it has but now reading this article I am kinda scared to take it, please talk to me…

    • Don’t let them fool you! It’s fear mongering! I don’t know why in the hell this moron wrote this article, but I can guarantee it has something to do with money! I’m so sick of the media and their propaganda! Fucking lies!

    • Shelli, 300mg per day is not high enough to cause the kind of problems they are talking about in the article. Doctors routinely prescribe up to twice that much just for restless leg syndrome.

      Your doctor is also correct that it has been shown to help for hot flashes and night sweats. If you start to have adverse symptoms like short term memory loss, then you can talk to your doctor about trying a lower dose, or trying different treatments for a month or so to see if it works as well.

      But if you have a medication that is working, don’t discontinue it until you talk to your doctor about your concerns.

    • Its all about money. I have been on meds for 15 years due to a workplace accident.
      Left the hospital on morphine. Have had the rounds on everything. Then they stopped Opana and switched me back to a morphine ER type called Embeda.
      Guess what?
      Morphine 30mg BID — $25.00
      Embeda 50mg BID — $725.00
      Same drug.

      Been on this med then switched back to Lyrica. These people here that say that they have been on this and that, but this Gabapentin is better than narcotics are posting bots designed to post to increase traffic on a web page.

      I think Ron and I are the only real people here because Gabapentin would not get m pecker high.

      The real reason is the government wants you to have 2 choices. Get clean or die trying or take heroin and just die.

  • James,
    1. What do you take it for?
    2. What dose do you take?
    3. Hpw do you know what withdrawal feels like?
    4. What does,it feels like when you stop taking it? Describe the symptoms.
    (Do you sweat, do you feel faint, etc)
    Thanks,
    Susan K

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