At least 5,000 people a year are dying in overdoses that involve gabapentin
December 29, 2025
Prescriptions for the nerve-pain drug have doubled in 15 years as doctors moved away from opioids and benzodiazepines.
Growing research links it to risks including dementia, suicidal behavior and dangerous breathing problems.
At least 5,000 people a year are dying in overdoses that involve gabapentin, often in combination with opioids.
Once considered safe, gabapentin is now under renewed scrutiny
Approved decades ago to treat seizures and the nerve pain that can follow shingles, gabapentin has quietly become one of the most widely used medications in the country. It was the seventh-most prescribed drug in the U.S. last year, according to the Iqvia Institute for Human Data Science, with about 15.5 million people receiving a prescription in 2024, a Centers for Disease Control and Prevention analysis found.
Many of those prescriptions are for conditions the drug was never evaluated for. Off-label prescribing is legal and common, but it means the Food and Drug Administration has not assessed gabapentins risks or benefits for those uses.
A go-to drug for a wide array of ailments
Some physicians say gabapentin can provide real relief for neuropathic pain caused by damaged nerves. But its use has expanded far beyond that niche. Doctors regularly turn to it for chronic back pain, anxiety, migraines, hot flashes in menopause, insomnia and even distorted sense of smell. according to a Wall Street Journal report. Veterinarians prescribe it to calm or ease pain in cats and dogs.
It seemed harmless, said John Avery who was quoted in the WSJ report. He took gabapentin believing it carried few risks.
Evidence mounts that the risks have been underestimated
Recent studies suggest gabapentin is not as benign as once believed. Research has tied the drug to higher risks of dementia, suicidal behavior, severe respiratory complications in people with lung disease, and swelling, along with well-known side effects such as dizziness.
A study published this year found that giving gabapentin to surgical patients did nothing to shorten hospital stays or reduce complicationsand more of those patients reported pain four months after surgery. For years, surgeons had viewed the drug as a tool to curb opioid use.
Dependence and withdrawal concerns emerge
While the medical establishment has long argued that gabapentin isnt habit-forming, some patients say tapering off the drug can be debilitating. Withdrawal symptoms, they say, make clear theyve developed a dependence despite taking it exactly as prescribed.
Still, demand continues to climb. Prescriptions have more than doubled in the past 15 years, a shift driven by efforts to steer patients away from opioids and anti-anxiety medications such as Xanax, which carry more widely recognized dangers.
Rising overdose deaths underscore the stakes
Gabapentin is often taken alongside opioidssometimes under medical supervision and sometimes not. The CDC warns that the combination can be deadly. At least 5,000 people have died from overdoses involving gabapentin in each of the past five years, federal and state data show.
Experts urge caution, not abandonment
Gabapentin remains a crucial therapy for many patients and is well tolerated by most, said Kirk Evoy, a clinical associate professor of pharmacotherapy and translational sciences at the University of Texas at Austin who studies gabapentin misuse. But its rapid spread into so many corners of medicine worries him.
We shouldnt be thinking of gabapentin as this safe drug we can just try for anything and see if it helps, he said.