Is gabapentin a controlled substance?

In this article:

• Is gabapentin a controlled substance?
• Is gabapentin a narcotic?
• The difference between drug scheduling and prescription monitoring
• States where gabapentin is a controlled substance
• States that require PDMP reporting of gabapentin
• Gabapentin refill laws and requirements
• Why have some states tightened gabapentin regulations?
• Tips for patients on managing gabapentin refills
• Future of gabapentin regulation

In this article

• Is gabapentin a controlled substance?
• Is gabapentin a narcotic?
• The difference between drug scheduling and prescription monitoring
• States where gabapentin is a controlled substance
• States that require PDMP reporting of gabapentin
• Gabapentin refill laws and requirements
• Why have some states tightened gabapentin regulations?
• Tips for patients on managing gabapentin refills
• Future of gabapentin regulation

Gabapentin is an anticonvulsant approved by the Food and Drug Administration (FDA) for certain types of nerve pain and seizures. Healthcare providers prescribe gabapentin off-label for several other medical conditions, including general neuropathic pain, bipolar disorder, anxiety, restless legs syndrome, fibromyalgia, and migraines. After its approval in 1993, there was no known risk of misuse or addiction to gabapentin. However, there are growing concerns that gabapentin may have more risks than people realize. 

Is gabapentin a controlled substance?

Gabapentin isn’t a federally controlled substance, but several U.S. states classify it as Schedule V or require prescription monitoring due to concerns about misuse. 

Controlled substances are classified into five categories, or schedules, by the U.S. Drug Enforcement Administration (DEA). The schedule depends on the drug’s potential for abuse or dependency. Schedule V drugs have a lower potential for abuse than all other controlled substances. This means gabapentin has a lower risk of abuse compared to OxyContin (oxycodone), which is a Schedule II opioid medication. 

Is gabapentin a narcotic?

Gabapentin is not a narcotic, and it is not an opioid. It is an anticonvulsant medication that works by calming overactive nerve signals. Even though it may cause sedation and be misused in some cases, it does not cause the same effects as narcotic pain medications or opioids.

The difference between drug scheduling and prescription monitoring

Drug scheduling refers to whether a medication is legally classified as a controlled substance at the federal or state level. This determines how it can be prescribed, dispensed, and refilled. The process of drug monitoring, such as reporting to a prescription drug monitoring program (PDMP), allows states to track the prescribing and dispensing of drugs to help identify the potential for misuse, even if the drug is not a controlled substance. 

States where gabapentin is a controlled substance

At this time, seven states label gabapentin as a controlled substance. These include:

• Alabama
• Kentucky
• Montana
• North Dakota
• Tennessee
• Virginia 
• West Virginia

States that require PDMP reporting of gabapentin

Certain other states require that gabapentin prescriptions be reported to a PDMP as a drug of concern or monitored drug. These states include: 

• Connecticut
• Indiana
• Kansas
• Massachusetts
• Michigan
• Minnesota
• New Mexico
• New Jersey
• North Carolina
• Ohio
• Oregon
• Utah
• Washington D.C. 
• Wisconsin
• Wyoming

Gabapentin refill laws and requirements

Because gabapentin isn’t labeled as a controlled substance at the federal level, its prescribing and dispensing laws are the same as those for non-controlled substances unless state law says otherwise. In states that classify it as a controlled substance, there may be specific prescription requirements, as well as limits on the quantity prescribed or refills available. 

As an example, Virginia passed a law in 2019 to classify gabapentin as a Schedule V controlled substance. This means Virginia pharmacies must comply with the state’s controlled substance laws when dispensing and refilling gabapentin prescriptions. Some of the Virginia laws for Schedule V controlled substances include:

• The drug shall not be dispensed or refilled more than six months after the original prescription date. 
• The prescription may not be refilled more than five times. 

Why have some states tightened gabapentin regulations?

According to the Centers for Disease Control and Prevention (CDC), people may use gabapentin to strengthen the effects of illegal opioids. Reports of intentional abuse, misuse, or unknown exposures to gabapentin have increased by 104% from 2013 to 2017. Gabapentin is increasingly detected in overdose deaths, often in combination with opioids rather than as a sole cause of overdose deaths, according to CDC data. 

The DEA also associates gabapentin with sedative and psychedelic effects and recognizes that the drug can intensify the euphoric (“high”) effects of opioids. There are concerns that this is contributing to the opioid epidemic. Although gabapentin is typically safe when taken on its own, when it’s used in combination with other drugs that depress the central nervous system or alcohol, the risk of respiratory depression and potentially death increases significantly. 

As a result, several states have taken regulatory action to reduce these risks by making gabapentin a controlled substance. In these states, there are stricter regulations on prescribing and dispensing gabapentin. Each state may regulate gabapentin slightly differently, setting its own time, quantity, or dosage limits to minimize the risk of drug misuse and abuse. For example, Rhode Island law only allows up to a 90-day supply for prescriptions for Schedule V controlled substances.  

Tips for patients on managing gabapentin refills

Whether you’re taking gabapentin for nerve pain, seizures, fibromyalgia, or anxiety, you must follow the directions of your medical professional. Taking more gabapentin than prescribed can increase your risk of serious side effects, including sleepiness and dizziness. On the other hand, you should not stop taking gabapentin without talking to your healthcare provider first. Abruptly stopping the medication can lead to withdrawal symptoms or more frequent seizures if you’re taking the drug for seizure disorders. With that being said, it’s also important to stay on top of gabapentin refills so you don’t run out of medication. To do so, consider enrolling in automatic refills at your pharmacy. That way, your pharmacy can refill your medication automatically when running low. 

Other ways to limit gabapentin side effects and the potential for drug abuse and misuse include:

• Take gabapentin exactly as prescribed.
• Check with a healthcare provider before starting new medications, supplements, or vitamins.  
• Avoid alcohol use during gabapentin treatment.
• Avoid other central nervous system depressants, including drugs that make you sleepy or dizzy.

Future of gabapentin regulation

As of June 2024, gabapentin remains a non-controlled substance under the U.S. federal government. With mounting evidence of misuse and abuse of gabapentin use, certain states have implemented regulations or policies to limit or monitor the use of the drug, especially given its potential to enhance the effects of opioids. Some experts and nonprofit groups have called for national reclassification of gabapentin as a controlled substance. 

Despite these efforts to reclassify the drug, gabapentin is only regulated in some states as a controlled substance. Concerns remain about its risk of misuse and abuse, especially when taken with opioids.