Gabapentin Addiction Treatment & Rehab
- Gabapentin is one of the most commonly prescribed drugs in the US.
- An estimated 95% of gabapentin prescriptions are off-label.
- The risk of misuse/abuse in the absence of other drugs is unclear.
- Gabapentin is commonly co-used with drugs of abuse, primarily opioids.
- Rehab programs can evaluate whether gabapentin use has become problematic and provide options for treatment.
Understanding Gabapentin Addiction Treatment & Rehab
Gabapentin (brand name Neurontin) is one of the most prescribed drugs in the US. Gabapentin is FDA-approved as an anti-epileptic drug to manage pain associated with a subset of neuralgia disorders (pain caused by nerve damage). However, an estimated 95% of gabapentin prescriptions are “off-label” (that is, it is prescribed to treat disorders it’s not FDA-approved to treat). Between 2012-2016, gabapentin prescriptions increased by 64%, and in 2016, it was the 10th most prescribed drug in the US, with over 64 million prescriptions being written. It’s been used to treat everything from restless leg syndrome to menopausal conditions to drug and alcohol use disorders.
Gabapentin exerts its actions by mimicking signaling of an inhibitory neurotransmitter called γ-aminobutyric acid, also known as GABA (it is a “GABA-mimetic”). The function of GABA is to prevent hyperexcitation in brain cells. This is why gabapentin is so successful as an anti-seizure drug: If there is not enough endogenous GABA to quench hyperexcitability, gabapentin administration can supplement GABA and successfully prevent a seizure.
It is known that gabapentin use leads to tolerance (meaning that ever-increasing doses are required in order to achieve the same effect) and dependence (physical withdrawal symptoms occur when gabapentin use is reduced or eliminated), which are common predictors of misuse (use of gabapentin in any way other than as prescribed). However, whether gabapentin itself is associated with abuse (use of a drug with the intent to get high) remains controversial. It is also uncertain whether gabapentin use leads to addiction (an inability to control drug-seeking behaviors, even in the face of negative consequences).
In spite of the lack of clear evidence indicating that gabapentin alone is associated with misuse or abuse, it is undeniable that gabapentin is routinely abused among people who also abuse opioids. Like gabapentin, opioids increase GABA signaling, although they have a different mechanism of action. Supplementing opioids with gabapentin enhances the effects of opioids, resulting in a more intense high. Additionally, 4 out of 5 gabapentin-related deaths involve opioids. In light of these observations, at least seven states have taken steps to limit access to gabapentin.
Regardless of whether research can clearly define the potential for gabapentin use/misuse, anecdotal evidence indicates that it is widely co-abused with other substances. Due to its prevalence and the lack of regulation (gabapentin is not a federally controlled substance), it is inexpensive and readily available to people without a prescription.
Hallmark signs of misuse include taking gabapentin at higher doses or more frequently than directed. Signs of abuse include using gabapentin with the sole intent to get high, or taking it with opioids to enhance their effect. Either of these may cause dependence or even addiction that should be addressed by professionals.
Addiction Treatment Options
The specific treatment plan that should be pursued for gabapentin rehab is highly dependent on the context of misuse. If gabapentin is the only drug being misused, and the dependence is mild, many people can successfully overcome a gabapentin use disorder without significant intervention. For stronger dependencies or for people who prefer the support and guidance of professionals throughout early recovery, there are several options for treatment:
- Medical detox: For serious cases of gabapentin dependence, or when gabapentin is co-used with other drugs, medically assisted detox may be warranted. These programs offer 24/7 supervision by medical professionals who can intervene in the case of complications.
- Residential Rehab: The first weeks of recovery are often the most difficult. Residential programs allow clients to achieve early success without the risk of encountering triggers or succumbing to temptation.
- Outpatient Rehab: Many people with gabapentin dependence in the absence of other substance use disorders may find that outpatient rehab is sufficient as they begin their recovery. Other people will transition from residential programs to outpatient care. Outpatient programs vary from all-day/every-day programs to weekly or bi-weekly therapy sessions.
- Co-Occurring Disorders: Mental health is often overlooked in substance use disorders, but many people turn to drugs or alcohol to mask mental health disorders. Gabapentin is incredibly good at allowing people to ignore symptoms of a mental health disorder, including anxiety and depression. Most quality rehab programs can evaluate whether their clients are candidates for a dual diagnosis. These programs can develop treatment plans that address both mental health and substance use disorders.
- Aftercare: Recovery is often a lifelong pursuit that requires regular maintenance. Aftercare programs are a way for people in recovery to maintain long-term relationships with mentors and peers.
What Does Gabapentin Rehab Cost?
The cost of gabapentin rehab can be quite variable and depends on several factors. For someone who has developed a serious dependence on gabapentin, a detox period under the care of medical professionals may be warranted. Detox can cost up to $800/day.
A 30-day residential rehab program can range from several thousand dollars for a basic program to well over $25,000 for a luxury program, and a 30-day outpatient program may cost anywhere from $1,000 to over $10,000. Many rehab facilities charge an admission fee that may be several thousand dollars. Any medical care on top of what is provided in the program (e.g. pharmacotherapies or unanticipated medical complications) will be included in the cost.
Does Insurance Cover Rehab?
Several insurance policies (including Medicaid and Medicare) will cover at least some of the costs associated with rehab. Make sure your insurance policy considers the rehab facility you are evaluating to be in-network.
Oftentimes, rehab without insurance is possible. Many rehab facilities offer grants, scholarships, and sliding fee scales to help them accommodate people from all income brackets. Many states, including Ohio, offer some form of assistance to residents who are seeking rehab.
Choosing a Rehab Facility for Gabapentin Abuse
Gabapentin treatment programs should have a multidisciplinary staff that is equipped to deal with physical, psychological, and medical components of recovery. Gabapentin is often co-used with other drugs, so finding a facility that can treat other forms of substance use disorders in conjunction with gabapentin treatment may be important.
Furthermore, gabapentin is often misused because it can mask symptoms of mental health disorders (e.g. anxiety disorders, depression). Facilities that can diagnose co-occurring disorders (that is, diagnose both a substance use disorder and a mental health disorder) can maximize the odds of success in long-term recovery.
Other factors to consider when you are evaluating a rehab facility include:
- Location: While the closest facility may be the most convenient, it is not necessarily the best one for you.
- Cost: Cost is, unfortunately, a major factor when finding the right rehab program. Look for a facility that accepts your insurance and one that can offer grants, scholarships and a sliding fee scale to keep out-of-pocket costs within your range.
- Treatment Options: The most comprehensive rehab programs will be carried out in facilities that can provide medically assisted detox, short- and long-term residential and outpatient programs, and aftercare. Programs that treat gabapentin use disorders should have staff on hand who have experience with gabapentin as a drug of abuse.
- Success Rates: Many rehab facilities provide information about their success rates and offer endorsements from former clients. Be skeptical of any program stating that they have 100% success rates.
- Treatment Duration: Treatment duration should be based on your progress, not a predetermined amount of time. Look for programs that tailor the program to your needs.
- Staff-to-Patient Ratio: A low staff-to-patient ratio guarantees that you will have enough access to the staff to make sure your needs are met. This is especially important in a residential or intensive outpatient program.
- Accreditation: Finding a program that is accredited by either The Joint Commission or CARF International guarantees a certain standard of care.
What to Expect When You Go to Rehab
The first step in a rehab program is generally an intake and evaluation process. During the evaluation, you will discuss current and past drug use and medical history. It is important that you are as honest as possible in order for the facility to design the most effective program for you.
Throughout the program, you will participate in counseling sessions and group activities. Initially, you may be uncomfortable interacting with staff and peers, especially if you are experiencing withdrawal symptoms. However, being proactive about participating in these sessions is an important component of your long-term recovery. Especially if you have used gabapentin with other drugs, there may come a point where you need to face mistakes you made as a consequence of your drug use. This can be difficult, but the reward for accepting these mistakes and moving past them towards a healthy future is well worth it.
You can also expect to develop relationships with mentors, make new friends, and create a strong network of supportive people who are invested in your long-term success. By the time you’ve completed your rehab program, you will be equipped with new tools and techniques that will allow you to resist triggers and help you manage the stresses of everyday life without resorting to gabapentin and/or other drugs.
What Happens After Rehab?
It is important that you remain proactive after you complete your rehab program. Participate in aftercare programs that are offered by your rehab facility. In addition to the expected components of aftercare (therapy sessions, relapse prevention), many programs provide fun and educational opportunities and social events that can help you find healthy new activities and hobbies.
How Rehab Improves Recovery
Many people who develop gabapentin dependence are ashamed and embarrassed that they were unable to manage the disorder on their own. Participating in a rehab program shows you that you are not alone in your quest for recovery, and that can be very comforting for some people.
In addition, behavioral therapies like motivational interviewing can allow you to evaluate why you found gabapentin use to be necessary and identify goals for your future with the support and assistance of experts who offer guidance. If you received a dual diagnosis, a quality rehab center will develop a plan that addresses each disorder individually. These plans aim to give you a strong foundation for continued success in recovery.
Recovery is more than what happens in rehab. Aftercare programs that involve group activities are incredibly beneficial, and not only because of the support you receive. Many people who are in recovery find that giving support to others is one of the most rewarding and motivating aspects of their own recovery.
Gabapentin misuse or abuse can be challenging to overcome. The Recovery Village Columbus offers comprehensive rehab programs that are tailored to suit each client’s needs and get you on the road to recovery. Call us today to seek the help you or your loved one deserves.
- Smith, Rachel V; Havens, Jennifer R; Walsh, Sharon L. “Gabapentin misuse, abuse and diversion: a systematic review.” Addiction, August 2017. Accessed August 29, 2019.
- Peckham, Alyssa M; Evoy, Kirk E; Ochs, Leslie; Covvey, Jordan R. “Gabapentin for Off-Label Use: Evidence-Based or Cause for Concern?” Substance Abuse: Research and Treatment, September 2018. Accessed August 29, 2019.
- QuintilesIMS Institute. “Medicines Use and Spending in the U.S.: A Review of 2016 and Outlook to 2021.” May 2017. Accessed August 29, 2019.
- Mason, Barbara J; Quello, Susan; Shadan, Farhad. “Gabapentin for the treatment of alcohol use disorder.” Expert Opinion on Investigational Drugs, January 2019. Accessed August 29, 2019.
- Heredia Rodriguez, Carmen. “New on the streets: Gabapentin, a drug for nerve pain, and a new target of misuse.” Kaiser Health News, July 6, 2017. Accessed August 29, 2019.
- Vestal, Christine. “Abuse of Opioid Alternative Gabapentin Is on the Rise.” Pew Trusts: Stateline Article, May 10, 2018. Accessed August 29, 2019.
Medical Disclaimer: The Recovery Village Columbus aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.