Is Gabapentin a Controlled Substance? In Some States, Yes

In 2019, U.S. pharmacies dispensed 69 million prescriptions for gabapentin (Neurontin, Gralise). Gabapentin is a medication that’s used in many medical health conditions. These include nerve pain and seizures. In 2021, it was one of the most commonly used medications in the U.S. 

Gabapentin was originally FDA-approved in 1993. At that time, it wasn’t known to cause addiction or dependence. But several studies have shown that gabapentin might be riskier than originally thought. It’s estimated that around 1% of people in the U.S. misuse gabapentin. 

With rising rates of misuse and addiction, several states have made gabapentin a controlled substance. A controlled substance is a substance with a higher likelihood for addiction and dependence. Here, we’ll talk about the risks associated with gabapentin and why some states consider it a controlled substance.

What’s gabapentin?

Gabapentin is FDA-approved to treat a certain type of nerve pain (postherpetic neuralgia). It’s also approved to treat certain types of seizure disorders.

And gabapentin is used to treat other conditions it’s not FDA-approved for (off-label uses) as well.

These include:

• Anxiety

• Alcohol withdrawal

• Postoperative pain (pain after surgery)

• Nerve pain caused by diabetes

• Cannabis use disorders

We don’t fully understand how gabapentin works for all these health conditions. But it has a similar structure to a chemical in the brain called gamma-aminobutyric acid (GABA). GABA causes drowsiness and relaxation. 

Is gabapentin a controlled substance?

Gabapentin isn’t considered a controlled substance by the federal government as of July 2022. But several states consider gabapentin a schedule V (schedule 5) controlled substance. In states where gabapentin is a controlled substance, there’s stricter laws regarding prescribing and dispensing it from pharmacies. 

There are five groups of controlled substances. Schedule V substances are the least likely of the controlled substances to cause addiction or dependence. But they’re more likely than non-controlled substances to cause these problems.

Some states have even included gabapentin in their prescription drug monitoring programs (PDMPs). A PDMP is an online database that tracks refills of controlled substance medications. For example, it allows prescribers and pharmacists to see if someone refills a controlled substance at more than one pharmacy. This helps providers and pharmacists notice who may be taking too much of a certain medication and who may be at risk of overdose. 

What states consider gabapentin a controlled substance?

As of July 2022, these states consider gabapentin a schedule V controlled substance: 

• Alabama

• Kentucky

• Michigan

• North Dakota

• Tennessee

• Virginia

• West Virginia

Other states have mandated gabapentin reporting. Every time you fill a gabapentin prescription, it’s added to the PDMP system. These include: 

• Connecticut

• Kansas

• Massachusetts

• Indiana

• Washington D.C.

• New Jersey

• Minnesota

• Nebraska

• Ohio

• Utah

• Wyoming

• Oregon

Why have some states made gabapentin a controlled substance?

Some states believe that gabapentin use has significant risks. Gabapentin can cause euphoria (an extremely good feeling) or a “high.” It can also cause you to feel very relaxed. This is especially true with higher doses. 

As mentioned above, gabapentin is classified as a schedule V medication in states where it’s a controlled substance. This means the risk of addiction is low compared to other controlled substances. But it’s higher compared to non-controlled substances.

I have a gabapentin prescription. How can I keep myself safe? 

You can limit the side effects and risks of taking gabapentin by: 

• Taking the lowest dose possible

• Following the directions given by your healthcare provider

• Avoiding alcohol or other central nervous system (CNS) depressants, like benzodiazepines

• Avoiding gabapentin if you have a history of substance use disorder

It’s also important to avoid combining gabapentin and opioids. Studies have found that this combination can be dangerous. Opioids are controlled substances used to treat pain. They’re powerful medications that can cause dependence and addiction.

An opioid overdose is more likely if gabapentin and opioids are used together. According to the CDC, gabapentin was detected in almost 10% of overdose cases from 2019 to 2020.

We’re not sure exactly why this occurs. It may be that combining gabapentin and opioids can raise the risk of breathing problems. It may also be that the presence of opioids raises gabapentin levels to a dangerous amount in the body. 

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Written by:

Makaela Premont, PharmD

Makaela Premont, PharmD, is a pharmacist and the founder of uniquelymickie.com, a website dedicated to helping pharmacy students and pharmacists create a life that they enjoy. She received her Doctorate of Pharmacy from the University of South Carolina and is a licensed pharmacist in North Carolina.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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