Popular Opioid Alternative Found In More Overdose Deaths

By Kelly Burch 03/29/18

Medical professionals are worried that the growing popularity of gabapentin is increasing the drug's potential for abuse.

New York ambulance

Gabapentin, an FDA-approved drug that is often publicized as a safer alternative to opioid pain relief, was found in the systems of a quarter of people who fatally overdosed in Louisville, Kentucky last year.

The finding reflects why more healthcare providers and narcotics experts are becoming concerned about the drug.

"It's becoming too popular," Dr. James Patrick Murphy, an addiction and pain management specialist, told The Courier Journal. "Unfortunately, we now need to worry about it because people are abusing it.”

Gabapentin was initially developed to treat epilepsy, but is increasingly being used to treat pain, especially in patients who have nerve damage. Although the drug didn't solely cause the overdose deaths, it may have contributed to the deaths. 

"Alone, it's not something that will stop your breathing or your heart," Murphy told the Courier. "But if you take it along with a drug like heroin or fentanyl, together it might be enough to make you stop breathing and put you over the edge."

Medical professionals are concerned that gabapentin, which is sold under the brand name Neurontin, is increasingly being abused.

"Amid the opioid epidemic, abuse of a different prescription painkiller has widely gone unnoticed,” according to a news release from the University of Louisville earlier this year. 

In 2016, gabapentin was present in one-third of all drug overdose deaths in Kentucky. More recently, the drug was listed as an "emerging threat" in a national bulletin given to narcotics officers. Nationally, the drug and its potential for abuse are getting more attention.

“Gabapentinoids are being prescribed excessively—partly in response to the opioid epidemic,” Drs. Christopher Goodman and Allan Brett, with the University of South Carolina School of Medicine, wrote in an article for the New England Journal of Medicine. "We believe there are several reasons to be concerned about this trend.”

In February, Dr. Scott Gottlieb, FDA commissioner, discussed his concern about the growing use, both legal and illegal, of gabapentinoids.

"We're concerned that the misuse and abuse of these drugs may result in serious adverse events, such as respiratory depression and death," he said. "We want to understand changes in how patients are using these medicines. We'll have more to say about our work on this challenge soon."

Although it isn’t a household name, gabapentin is the 10th most commonly prescribed drug in the country. It is commonly used to treat pain and even hot flashes, which are so-called “off-label” uses that it was not initially approved for.

Kristin Bieckert, a former drug user who has been in recovery for 16 months, said she was able to buy gabapentin cheaply on the street, and she became dependent on it.

"I think it's addicting too," she said. "I had to have it."

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.