Thursday, June 7, 2018

New on the Streets... Gabapentin (Neurontin) a Drug for Nerve Pain, and a New Target of Misuse UPDATED

UPDATE 
According to the Pain News Network
Gabapentin (Neurontin) – an anti-seizure drug widely prescribed off-label to treat pain -- was detected in over 21% of the prescription opioid deaths and in about 10% of the other overdoses.

UPDATE on Gabapentin (Neurontin) and Behavior Changes
RXlist.com doesn't list specifically list aggression under the Common Side Effects of Gabapentin. It does say "Other side effects of Neurontin include mood or behavior changes, depression, or anxiety".

Under Neurontin Consumer Information it says "Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), depressed, or have thoughts about suicide or hurting yourself'.

Original Post
This is a story about Gabapentin, a drug commonly prescribed for nerve pain that's the new drug of abuse... But first my personal experience with Gabapentin family and friends.

Last year a friend was in a high speed head-on accident. He was very lucky only cutting and bruising his face, bruising his ribs, breaking his ankle and crushing his heel. This guy is really laid back and just doesn't get upset about much. When he got back from seeing his doctor they had prescribed Hydrocodone and Gabapentin for pain.

He was in pain and I can understand being grouchy when you're in pain, but the second day on the Gabapentin he turned into a total jerk. He was complaining about everything, he was just mad. His girl friend who had been taking care of him since the accident could do nothing right. He was starting to get physical with her and he's a big guy, 6' 3" 300 pounds, this just wasn't like him.

A quick search online said some of the side effects of Gabapentin are changes in behavior, acting restless, hostile, or aggressive, memory problems, or trouble concentrating. He stopped taking the Gabapentin and in a couple days he was back to normal.....

My wife started taking Gabapentin a several months ago but her reaction to Gabapentin wasn't as dramatic as our friends reaction. In her case the reaction to Gabapentin took some time. The first couple weeks she was getting louder and was yelling at the dogs more. 

We've been together 14 years and had three what you could call fights or arguments. We respect each other so we talk and if she needs help with something she will ask me. The last few months she's been real tense and had a lot of anger, not at me she's was just mad in general.  

So when I mentioned what she was doing, she stepped back and took a look at how she had been acting. We have 3 Doberman's and we yell at them from time to time. But she realized she was yelling at me and the dogs a lot more than normal. She agreed she was having some kind of reaction to the Gabapentin and started lowering her dose. She's going to talk to her doctor about the problem next visit. Things are getting better since she lowered her dose.......

Ohio like other states is finding that a drug many physicians are prescribing as they lower opioid doses is the new drug of abuse. 


The CDC considers Gabapentin a non-addictive alternative to opioids for chronic pain. This story shows how even with the best intentions there are always unintended consequences...... 

NEWS ARTICLE New on the Streets... Gabapentin, a Drug for Nerve Pain, and a New Target of Misuse

An article in STAT News "New on the streets: Gabapentin, a drug for nerve pain, and a new target of misuse" says 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.

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.

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.


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.
One participant explained his attraction to Neurontin “It’s not a narcotic, but what it does, is, it intensifies your methadone … so if you take your methadone and you go buy 10 Neurontin® and you take all 10, it’s sort of like you tripled your dose.” Other participants described: “They give you a semi-euphoric feeling if you abuse it; I know people who over take it; It’s called ‘gabs’ and is more available because there is a demand; I give it two more years and it will be scheduled.”

A treatment provider reported, “It’s on the rise. I am hearing a lot more about it being on the streets and I got clients that are prescribed it. They say it’s awesome for withdrawals.” Another treatment provider commented, “Neurontin® seems to be the new high … they crush them up and snort them … especially used in the jail. Heroin addicts are prescribed it to treat [withdrawal] symptoms and they get a little bit of the high feeling and are hooked.” Law enforcement officers commented: “There seems to be a marked difference [availability increase] in Neurontin® in the last six months because doctors are prescribing it more; I am seeing a lot of gabapentin.”

NOTE
In 2011 West Virgina had 11 deaths from Gabapentin. 
In 2015 West Virgina had 182 deaths from Oxycodone, 180 deaths from Fentanyl, and 108 deaths from Gabapentin.  What changed?

As long as government is telling doctors how to practice medicine one of the unintended consequence will be forcing pain patients to the streets and more dangerous drugs.





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