What is Gabapentin?
Gabapentin is an anticonvulsant medication primarily prescribed to treat epilepsy and nerve pain, such as postherpetic neuralgia which can follow a shingles infection [1.7.3, 1.10.4]. Marketed under brand names like Neurontin, Gralise, and Horizant, it's also used off-label for conditions like restless leg syndrome, fibromyalgia, and alcohol withdrawal [1.5.1, 1.7.2, 1.9.4]. Despite not being a federally controlled substance in the United States, its potential for misuse has led to increased scrutiny and regulation at the state level [1.9.1].
The Illicit Market: What is the Street Price of Gabapentin?
The street price of gabapentin fluctuates significantly based on several factors. Law enforcement reports and studies show a common price range of $1 to $2 per pill [1.2.1, 1.2.3]. However, this price is not uniform and can be influenced by multiple variables:
- Dosage: Higher milligram capsules (e.g., 600mg or 800mg) command higher prices than lower doses [1.3.1, 1.3.5]. Some reports cite a general cost of about $1.00 per 100 milligrams [1.3.3].
- Geographic Location: Prices can vary dramatically by jurisdiction. For instance, while a 600mg pill might sell for $0.75 in North Carolina, an 800mg pill could go for $8 in New York [1.2.5]. In some areas, prices have been reported as high as $5.00 to $10.00 per tablet [1.2.3].
- Availability and Legality: In states where gabapentin has been classified as a controlled substance, the reduced supply can drive up street prices [1.3.5]. Kentucky and Tennessee, for example, saw higher street prices after implementing scheduling laws [1.2.3].
- Demand: The demand for diverted gabapentin is often linked to its use in conjunction with other substances, particularly opioids [1.4.4]. Its street names include "gabbies" and "johnnies" [1.7.1, 1.7.2].
Why is Gabapentin Misused?
The demand for illicit gabapentin stems from several key motivations. A systematic review found that misuse is often for recreational purposes, self-medication, or intentional self-harm [1.5.3]. Users seek effects like euphoria, relaxation, and a sense of calm [1.5.5]. A primary driver of its abuse is its ability to potentiate, or enhance, the euphoric effects of opioids like heroin and methadone [1.6.5, 1.4.5]. This makes it attractive to individuals with a history of opioid abuse [1.5.1]. Some also use it to self-medicate for withdrawal symptoms from other drugs, such as alcohol or opioids [1.5.5, 1.3.3].
Comparison: Legitimate vs. Illicit Use
| Feature | Legitimate Prescription Use | Illicit Street Use |
|---|---|---|
| Source | Licensed pharmacy with a valid prescription [1.3.2]. | Diverted prescriptions, friends/family, or dealers [1.4.5]. |
| Cost | Insurance co-pay or retail pharmacy price [1.3.2]. | Variable street price, often $1-$2 per pill [1.2.1]. |
| Dosage | Medically supervised, prescribed amounts [1.5.1]. | High, uncontrolled doses, sometimes over 3,000mg [1.2.2]. |
| Purpose | Seizures, nerve pain, RLS [1.5.1]. | Get high, potentiate other drugs, self-medicate [1.5.3]. |
| Safety | Monitored by a healthcare provider [1.10.3]. | High risk of overdose and dangerous interactions [1.6.1]. |
| Legality | Legal with a prescription. | Illegal possession/distribution without a prescription [1.5.1]. |
Is Gabapentin a Controlled Substance?
Federally, the U.S. Drug Enforcement Administration (DEA) does not classify gabapentin as a controlled substance [1.9.3]. However, due to growing evidence of its misuse, numerous states have taken independent action [1.9.1]. As of recent reports, states including Alabama, Kentucky, Michigan, North Dakota, Tennessee, Virginia, and West Virginia have classified gabapentin as a Schedule V controlled substance [1.8.2, 1.9.4]. Other states like Ohio, Minnesota, and Wyoming require it to be reported to their Prescription Drug Monitoring Programs (PDMPs) to track its distribution and prevent diversion [1.3.1, 1.5.1].
Dangers of Non-Prescription Use
The non-medical use of gabapentin carries significant health risks. The most severe danger comes from combining it with other central nervous system depressants like opioids or alcohol [1.10.3]. The FDA has issued warnings about serious and potentially fatal respiratory depression when gabapentin is mixed with opioids [1.6.4, 1.6.1].
Other risks include:
- Overdose: Symptoms can include slurred speech, extreme drowsiness, and diarrhea [1.10.3]. The risk increases dramatically when combined with opioids [1.10.2].
- Dependence and Withdrawal: Abruptly stopping gabapentin can lead to withdrawal symptoms like anxiety, insomnia, sweating, confusion, and pain [1.11.1, 1.11.2]. In some cases, it can provoke seizures [1.10.4]. Withdrawal symptoms can begin within 12 hours to 7 days after the last dose [1.11.2].
- Adverse Side Effects: Common side effects are drowsiness, dizziness, and headache, but more severe reactions can include suicidal thoughts, memory problems, and movement issues [1.10.1, 1.10.3].
Conclusion
While gabapentin is a legitimate and effective medication for certain conditions, its widespread availability has created a significant illicit market. The street price, though generally low, reflects a complex interplay of geography, dosage, and local laws. The primary drivers of its misuse are its euphoric effects and its ability to enhance opioids, which creates substantial health risks, including fatal overdose from respiratory depression. The growing trend of states classifying it as a controlled substance highlights an increasing recognition of its potential for harm. Anyone using gabapentin without a prescription or considering doing so should be aware of these life-threatening dangers.
For more information on medication safety and substance abuse, you can visit the Substance Abuse and Mental Health Services Administration (SAMHSA).
