Gabapentin is a prescription medication, not a traditional “street drug,” but it has become increasingly common in illicit drug markets over the past decade. Originally developed to treat seizures and nerve pain, gabapentin is now bought and sold outside the prescription system, sometimes for as little as $1 to $2 per pill, with prices reaching $10 in some areas. Its rise as a drug of misuse has been significant enough that several U.S. states have reclassified it as a controlled substance, even though the federal government has not.
Why Gabapentin Shows Up on the Street
Gabapentin produces mild euphoria, relaxation, and sedation at high doses. On its own, these effects are relatively subtle compared to opioids or benzodiazepines. But the real draw for many people who misuse it is what it does in combination with other drugs, particularly opioids. When taken together, gabapentin can intensify the high from opioids, making the combination more appealing and more dangerous.
The biological reason for this involves how gabapentin affects calcium channels in nerve cells. By blocking certain calcium pathways, gabapentin changes how the body responds to opioids, essentially making nerve cells more sensitive to opioid effects. This is why gabapentin has earned street names like “johnnies” or “gabbies” and is often sought out specifically as a booster for other substances.
Among people who misuse opioids, gabapentin use is strikingly common. Estimates from 2016 found that 15% to 22% of people who engaged in nonmedical opioid use also reported nonmedical gabapentin use. In one long-term study of people who use drugs in rural Appalachia, nonmedical gabapentin use went from 0% in 2008 to 56% in 2020. That’s not a fringe trend.
Federal vs. State Legal Status
Gabapentin is not a controlled substance under the federal Controlled Substances Act. The DEA does not schedule it, which means at the federal level it’s treated more like blood pressure medication than like Xanax or Vicodin. This makes it far easier to prescribe, refill, and obtain than most drugs with abuse potential.
Several states have stepped in to fill that gap. States including Kentucky, West Virginia, Virginia, Tennessee, Michigan, and others have independently classified gabapentin as a Schedule V controlled substance (the lowest tier of controlled drugs). This means prescriptions in those states are tracked through prescription drug monitoring programs, and pharmacists flag patients who appear to be getting gabapentin from multiple doctors. The patchwork of state laws means that gabapentin is treated very differently depending on where you live.
How People Get It
Because gabapentin is not federally controlled, it’s one of the easier prescription drugs to obtain. Doctors prescribe it frequently, not just for its two FDA-approved uses (nerve pain after shingles and partial seizures) but also off-label for anxiety, insomnia, migraines, and general chronic pain. It’s one of the most commonly prescribed medications in the United States, which means there’s a large supply in circulation.
Some people accumulate extra pills from their own prescriptions and sell or share them. Others visit multiple providers to get several prescriptions. In states without monitoring requirements, this is relatively easy to do. Street prices between $1 and $2 per tablet make it an affordable option compared to most other recreational drugs, further driving demand.
Risks of Misuse
The most serious risk of gabapentin misuse is respiratory depression, where breathing becomes dangerously slow and shallow. This risk is highest when gabapentin is combined with other substances that depress the central nervous system: opioids, anti-anxiety medications, antidepressants, or even antihistamines. A review of cases reported to the FDA between 2012 and 2017 identified 49 cases of respiratory depression linked to gabapentin or its close relative pregabalin, with 12 of those cases resulting in death. In 92% of those cases, the person had additional risk factors like older age, lung problems, or concurrent use of other depressants.
Signs of respiratory depression include slow or shallow breathing, bluish skin, confusion, extreme drowsiness, and unresponsiveness. People over 65 and those with existing lung conditions are at the highest risk.
Withdrawal After Regular Use
People who take gabapentin regularly at high doses, whether prescribed or not, can develop physical dependence. Stopping abruptly can trigger withdrawal symptoms that are uncomfortable and sometimes medically concerning. Physical symptoms typically include nausea, vomiting, headaches, dizziness, sweating, chills, muscle pain, and fatigue. Psychological symptoms can include anxiety, panic, irritability, restlessness, mood swings, and difficulty concentrating.
For someone who has been taking gabapentin daily for an extended period, a gradual taper under medical supervision is the standard approach to minimize these symptoms. Quitting cold turkey is not recommended, particularly for people taking high doses or those who also use other substances.
The Bottom Line on Its Status
Gabapentin occupies an unusual middle ground. It’s a legitimate, widely prescribed medication that also has a growing presence in illicit drug markets. It’s not a “street drug” in the way heroin or methamphetamine is, but calling it purely a medical drug ignores the reality of how it’s used. The fact that nonmedical use increased more than fiftyfold in one studied population over 12 years reflects a genuine shift. If you’ve encountered gabapentin being sold or traded outside a pharmacy, that’s consistent with a well-documented national pattern, not an isolated situation.