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At least 5,000 people a year are dying in overdoses that involve gabapentin

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.

Consumers were cautious but ready to spend on deals and discounts

Holiday spending on track to top $1 trillion for first time

Early data shows roughly 4% growth heading into Christmas

Shoppers stay cautious but still spend on deals, discounts

U.S. holiday shopping is on pace to surpass $1 trillion for the first time, according to new projections and early spending data from major retail trackers. Despite lingering economic caution, the 2025 season is shaping up to be another year of steady, if moderate, growth.

Early results show about 4 percent growth

Visa and Mastercard reported this week that retail spending from early November through Dec. 21 rose about 4% over last year, with electronics, apparel, and online orders among the strongest categories. Adobe Analytics likewise forecasts that online holiday sales will pass $250 billion, up more than 5% year over year.

The National Retail Federation (NRF) has projected overall November-December sales growth between 3.7% and 4.2% enough to push total spending over the trillion-dollar mark for the first time.

Shoppers focus on value amid economic uncertainty

While totals are rising, analysts say the gains reflect a mix of bargain-hunting, deep discounting, and heightened price sensitivity rather than broad consumer exuberance. Surveys from Gallup and others show Americans budgeting carefully and planning to spend roughly the same amount on gifts as they did last year.

Consumers are shifting more purchases to discounters, off-price chains, and online platforms, while secondhand and resale markets have posted above-average growth. Retailers, anticipating cautious buyers, began rolling out aggressive promotions earlier in the season and continue to offer steep markdowns as Christmas passes.

Cyber Monday and early deal periods set the pace

Strong online performance helped drive the seasons momentum. Cyber Monday once again became the single biggest shopping day in U.S. history, with spending projected to reach as high as $14.2 billion. Retail analysts say the front-loaded surge has flattened some of the traditional last-minute rush, but stores still expect a lift from post-holiday clearance events.

Overall, economists see the 2025 holiday season as another year of cautious strength consumers still spending, but selectively and with more research and comparison shopping than in pre-pandemic years. Final sales totals will be released in January.

H3N2 developed after this season's vaccine was developed so it may not be as effective

• The flu is early this year, with cases reported throughout the U.S. and around the Western Hemisphere
• A new subvariant, H3N2, developed after this season's vaccine was formulated, which could affect its effectiveness
• Children were hard hit by the flu in Australia and other Southern Hemisphere countries this year

The flu is arriving a bit early this year, particularly the new H3N2 variant that's now being observed across the United States and elsewhere in the Northern Hemisphere.

Health reports indicate rising flu activity in numerous states, with increasing test positivity and respiratory illness visits in places like New York, Iowa, and New Hampshire, and outbreaks prompting school closures in some districts.Experts warn that flu activity is increasing in many regions across the U.S. and theres concern the season could be severe, similar to last years heavy H3N2-dominant season.

We are at the point now where were starting to see a sharp rise in flu cases. This is a few weeks earlier than we usually experience, but very much akin to what was seen in the Southern Hemispheres experience with flu during their winter, said Dr. Elizabeth Hudson, regional physician director of infectious diseases at Kaiser Permanente Southern California in a Los Angeles Times report.

Vaccine may not be as effective

The new variant officially H3N2 Flu A subclade K appeared toward the end of summer. That was months after officials decided which strains this falls flu vaccine would target, meaning the vaccine may not be as effective against the new subvariant as it is against others. However, datarecently released in Britain showed this seasons vaccines were 70% to 75% effective against hospitalization for children from the flu, and 30% to 40% effective in adults, which is within expectations, the U.S. Centers for Disease Control and Preventionnoted.

This suggests that influenza vaccination remains an effective tool in preventing influenza-related hospitalizations this season, according to the agency.

While flu rates remain low overall at this point, officials say the experience in other nations could indicate that the U.S. is in for a severe flu season. They note that Australia's season hit hard and early and was especially hard on children. Three flu-related pediatric deaths have been reported in the U.S. so far this season. During the last flu season, 280 children died from flu.

Early diagnosis of flu can help stave off the worst by giving those who are sick time to take antiviral medications such as Tamiflu. Three out of 5 children who died from the flu during the 2024-25 season never received antiviral medication.

What to watch for

Emergency warning signs of flu complicationsin children include trouble breathing; bluish lips or face; ribs pulling in with each breath; chest pain; severe muscle pain, in which a child may refuse to walk; dehydration, signs of which include no urine for eight hours or no tears when crying; seizures; fevers above 104 degrees that are not controlled by medication; fever or cough that improves but returns or worsens; and any fever in newborns younger than 12 weeks.

It's another blow for automotive affordability

• Nissan has ended U.S. production of the Versa, long the cheapest new car sold in America.

• The subcompact sedan will not return for the 2026 model year, leaving a higher price floor for new vehicles.

• Its exit underscores the steady disappearance of truly affordable new cars from the U.S. market.

Yet again, the cheapest new car in America is exiting stage left. The Nissan Versa will not see a 2026 model year, with production for the U.S. market officially ending this month.

In a brief statement, Nissan said the decision aligns with its broader product strategy. In line with Nissans product strategy, the Nissan Versa ended production in December 2025 for the U.S. market, the automaker said. Nissan remains committed to offering affordable and stylish vehicles in the sedan segment with models like Sentra and Altima, while also offering strong value in the compact SUV segment with the Kicks, Road & Track reported.

With the Versa gone, the 2026 Kia K4 sedan is currently positioned as the least expensive new car available, with a starting price around $23,385.

The cheapest new Nissan now costs more than $23,000

At the end of its run, the Versa started at $20,435 with an automatic transmission, the only version still in production after Nissan discontinued the manual earlier this year. With the Versa gone, the least expensive 2026 model-year Nissan will be the Sentra, which starts at $23,845. The subcompact Kicks crossover follows closely at $23,925.

No other new vehicle on sale today comes close to the Versas roughly $20,000 starting price. For the 2026 model year, the title of cheapest new car in America shifts to the Kia K4, which carries a base price of $23,385.

Affordable cars continue to disappear

Perhaps thanks to its bargain positioning, the Versa was selling relatively well earlier this year. Over time, it evolved into a good enough affordable sedan, offering a respectable amount of technology and a driving experience that was no longer the penalty box it once was especially compared with its late-2000s days, when it was famously marketed with a sub-$10,000 price tag.

What its departure highlights most sharply is the continued erosion of affordability in the new-car market. Each year, the cost of entry for a new vehicle with a factory warranty rises, and the loss of the Versa marks another step in the steady retreat of truly low-cost new cars in the United States.