A Qualitative Examination of Gabapentin Misuse Inside of Treatment and Recovery Settings

Gabapentin, an anti-convulsant medication used to treat seizures and neuralgia, is also prescribed off-label for the treatment of substance use disorders and withdrawal symptoms in treatment settings. Yet, reports of gabapentin misuse are increasing in the United States. The present study examines the misuse of gabapentin in treatment and transitional living facility settings.

Data are drawn from a study examining gabapentin misuse in South Florida. The sample includes 34 adult participants who reported past-year use of illicit opioids and/or the misuse of prescription opioid medications, as well as histories of gabapentin misuse and treatment for substance use disorder. Data analyses included descriptive and in vivo coding schemes and used a descriptive qualitative approach.

Participants were female (26.5%), White (67.6%), African American/Black (5.9%), Hispanic (20.6%), Asian (2.9%), and other race/ethnicity (2.9%). Mean age was 31.6 years. Findings indicate that inside of treatment and recovery settings, gabapentin misuse occurs as individuals attempt to get high or cope with withdrawal or mental distress symptoms, and one quarter of participants perceived no benefit in misusing gabapentin. Participants also described the concept of "freelapse" (i.e., justifying the misuse of prescribed gabapentin and still considering oneself to be sober). Gabapentin misuse inside of transitional living facilities is common because of limited supervision and screening.

Continued research is needed to understand the risk factors for gabapentin misuse and any potential benefits for continued gabapentin administration among treatment patients. Efforts to mitigate gabapentin misuse, including increased supervision and screening in treatment facilities, appear warranted.