Federal vs. State Regulation of Gabapentin
For many years, gabapentin (marketed under brand names like Neurontin) was prescribed with little concern for its potential for misuse, as it is not a federally controlled substance. This distinction, however, began to shift as more evidence emerged linking gabapentin to misuse and diversion, particularly in conjunction with the opioid epidemic. Gabapentin can produce a feeling of euphoria, especially at high doses or when mixed with other central nervous system depressants, which has fueled its recreational misuse.
In response to these public health concerns, individual states have implemented their own policies to regulate the drug. This has led to a split system where the rules for prescribing and dispensing gabapentin vary widely depending on the state. The two primary state-level actions are reclassification as a Schedule V controlled substance and mandated reporting to a Prescription Drug Monitoring Program (PDMP).
States Where Gabapentin is a Schedule V Controlled Substance in 2025
As of 2025, several states have reclassified gabapentin as a Schedule V controlled substance. Schedule V is the least restrictive category of controlled substances, indicating a lower potential for abuse than Schedule IV drugs but a higher risk than non-controlled substances. States that have adopted this classification in 2025 include:
- Alabama
- Kentucky
- Michigan
- Montana: Effective October 1, 2025
- North Dakota
- Tennessee
- Utah: Effective January 1, 2024, placing it into Schedule V
- Virginia
- West Virginia
States with Prescription Drug Monitoring Program (PDMP) Reporting
Other states have opted to require reporting of gabapentin prescriptions to their PDMP systems rather than classifying it as a controlled substance. A PDMP is an electronic database that collects information on dispensed controlled substances to help prescribers and pharmacists identify and prevent drug misuse. In these states, gabapentin is tracked in a manner similar to controlled substances without being officially classified as one.
States with mandated gabapentin reporting in 2025 include:
- Connecticut
- Indiana
- Kansas
- Massachusetts
- Minnesota
- Nebraska
- New Jersey
- North Carolina: Mandated reporting effective March 1, 2025
- Ohio: Mandated reporting continues
- Oregon
- Washington D.C.
- Wyoming
Why Are States Increasing Gabapentin Regulations?
State-level intervention regarding gabapentin is primarily driven by mounting evidence of its misuse and abuse. Although it is not an opioid, gabapentin can potentiate the effects of opioids when taken together, dramatically increasing the risk of respiratory depression and fatal overdose. The opioid crisis has prompted many states to look for regulatory tools to curb drug misuse, leading to the increased monitoring of non-opioid medications like gabapentin that can be abused.
Concerns over gabapentin also stem from its high volume of prescribing. It is one of the most frequently prescribed drugs in the US, and a significant portion of its use is considered "off-label" for conditions where evidence of effectiveness is limited. The potential for diversion—the transfer of the drug from its intended purpose to illegal uses—has further motivated regulatory action.
What State-Level Control Means for Patients and Prescribers
For healthcare professionals, knowing the specific rules in their state is paramount. Prescribing gabapentin in a state where it is a controlled substance means adhering to stricter guidelines. In Montana, for example, new rules effective October 1, 2025, require prescriptions to include a DEA number and have limits on refills and expiration. Similarly, in Schedule V states, prescriptions for gabapentin have a six-month expiration date and are limited to five refills.
For patients, these changes can affect their access to medication. It may require more frequent doctor visits for a new prescription and a valid photo ID for pickup at the pharmacy. While potentially inconvenient, these measures are intended to increase safety and awareness of gabapentin use, reducing the risk of misuse.
Comparison of Gabapentin Prescription Regulations
| Regulatory Aspect | In Schedule V States | In PDMP Reporting States | In States with No Regulations |
|---|---|---|---|
| Prescription Type | Requires controlled substance prescription | Requires standard prescription | Requires standard prescription |
| DEA Number | Required on prescription form | Not required (but may be reported with prescriber info) | Not required |
| Refills | Maximum of 5 refills within 6 months | No state-mandated limit | No state-mandated limit |
| Prescription Expiration | 6 months from issue date | Depends on state pharmacy law | Depends on state pharmacy law |
| Pharmacy Reporting | Reported to state PDMP | Reported to state PDMP | Generally not reported to PDMP |
| Patient Identification | Required for pickup | Varies by state pharmacy law | Varies by state pharmacy law |
Conclusion
While gabapentin is not controlled at the federal level, its regulatory status in 2025 is defined by individual state laws. States like Alabama, Kentucky, Michigan, Montana, North Dakota, Tennessee, Utah, Virginia, and West Virginia have moved to classify it as a Schedule V controlled substance, while others utilize PDMPs to monitor its use. These diverging policies reflect a nationwide debate about how to manage the risks of gabapentin misuse while maintaining access for patients who need it for legitimate medical conditions. For patients and healthcare providers, staying informed about the specific regulations in their state is crucial to ensure both compliance and patient safety.
