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We have just started a new urine screen and it records gabapentin.  What is the extent of abuse with gabapentin? Is it sold on the street? How does it interact with buprenorphine? Why should it be on the screen? It is not on OARRS.

2muellers@att.net

An interesting review: http://www.ncbi.nlm.nih.gov/pubmed/24760436

CNS Drugs. 2014 Jun;28(6):491-6. doi: 10.1007/s40263-014-0164-4. Misuse and abuse of pregabalin and gabapentin: cause for concern? Schifano F1.

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Abstract

Gabapentinoids (e.g. pregabalin and gabapentin) are widely used in neurology, psychiatry and primary healthcare but are increasingly being reported as possessing a potential for misuse. In fact, increasing levels of both prescriptions and related fatalities, together with an anecdotally growing black market, have been reported from a range of countries. This article reviews the current evidence base of this potential, in an attempt to answer the question of whether there is cause for concern about these drugs. Potent binding of pregabalin/gabapentin at the calcium channel results in a reduction in the release of excitatory molecules. Furthermore, gabapentinoids are thought to possess GABA-mimetic properties whilst possibly presenting with direct/indirect effects on the dopaminergic 'reward' system. Overall, pregabalin is characterized by higher potency, quicker absorption rates and greater bioavailability levels than gabapentin. Although at therapeutic dosages gabapentinoids may present with low addictive liability levels, misusers' perceptions for these molecules to constitute a valid substitute for most common illicit drugs may be a reason of concern. Gabapentinoid experimenters are profiled here as individuals with a history of recreational polydrug misuse, who self-administer with dosages clearly in excess (e.g. up to 3-20 times) of those that are clinically advisable. Physicians considering prescribing gabapentinoids for neurological/psychiatric disordersshould carefully evaluate a possible previous history of drug abuse, whilst being able to promptly identify signs of pregabalin/gabapentin misuse and provide possible assistance in tapering off the medication.

David Fiellin

Gabapentin has a growing following as a hallucinogen in high doses, especially when snorted.  Also some reports of the drug assisting with coming down from stimulants or methamphetamine.  Very little street value however.  As a pain management person, I like to see if the gabapentin is being used as part of multi-modal pain mgmt strategy versus the patient just using the opioid hence my interest in having it on our screen.

cherndon12@gmail.com

On behalf of Edward Kaufman:

"Gabapentin is abused among those in the community with addictive disorders. It is helpful to screen for it."

Info@PCSS-O.org

More specifics as to abuse potential :how is it psychoactive or is it “self treatment “?

Scott McNairy

The experience is so much setting and expectation. A patient at my rehab held a Neurontin party and six of them took a few 1000 mg and got a bit “stoned

kaufmanedward2@gmail.com

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Guest ScorpionMamma

What withdrawal symptoms could one have after using Gabapentin for 5 days once a day and quitting cold turkey? 

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16 hours ago, Guest ScorpionMamma said:

What withdrawal symptoms could one have after using Gabapentin for 5 days once a day and quitting cold turkey? 

Here is a thread where Lead Mentor Dr. Edwin Salsitz talks about some of the risks of abruptly stopping gabapentin: 

 

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