The People's Perspective on Medicine

Substitute Pain Relievers Appear in Suicide Attempts

As doctors turn away from opioids for pain relief, the drugs they are prescribing instead are implicated in more suicide attempts.
Bottle of Gabapentin Pills

Public health authorities have been working hard to control the opioid epidemic and reduce the number of people dying from narcotic overdoses. This effort has had some success, but it has also had some unanticipated and unwanted consequences, among them a change in suicide attempts.

Gabapentin Now Being Used in Suicide Attempts:

Opioid prescriptions have been dramatically curtailed because doctors have become reluctant to prescribe such medications. People in pain still need treatment, however, and many physicians have turned to an anticonvulsant called gabapentin (Neurontin). It is approved to treat epilepsy and the pain lingering after a shingles attack. Most prescriptions, however, are written for off-label uses such as neuropathic pain, migraines, fibromyalgia, bipolar disorder and hot flashes.

Now, a study published in the journal Clinical Toxicology shows an alarming increase in suicide attempts associated with gabapentin (Dec. 1, 2019). An analysis of calls to US Poison Centers found a 72% increase in toxic exposures to gabapentin. People abusing gabapentin to get high or in suicide attempts increased by 80% bwtween 2013 and 2017. Minnesota and South Dakota have been especially hard hit. Gabapentin can trigger depression or suicidal thoughts, and doctors should warn people of this possibility when they prescribe the drug. 

Baclofen Misuse Also on the Rise:

Doctors have also turned to another drug that works on GABA receptors, much as gabapentin does. Baclofen is a muscle relaxant that is now also being used for pain relief. Between 2013 and 2017, US Poison Centers logged 31% more calls regarding baclofen use or misuse, including suicide attempts. At least half of the people who had taken too much baclofen landed in a hospital or convalescent home as a result.  

A previous study in Sweden demonstrated a link between gabapentinoids (gabapentin and pregabalin) and suicide attempts (BMJ, June 12, 2019). Results of that research suggest that pregabalin (Lyrica) might cause even more trouble in this regard than gabapentin does. As a result, physicians should consider such risks carefully when prescribing non-opioid pain relievers.

Learn More:

If you are interested in the pros and cons of gabapentin, you may wish to read what we have written about this drug. The current study is not the first one to warn of a link between gabapentin and suicide attempts.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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Citations
  • Reynolds K et al, "Trends in gabapentin and baclofen exposures reported to U.S. poison centers." Clinical Toxicology, Dec. 1, 2019. https://doi.org/10.1080/15563650.2019.1687902
  • Molero Y et al, "Associations between gabapentinoids and suicidal behaviour, unintentional overdoses, injuries, road traffic incidents, and violent crime: population based cohort study in Sweden." BMJ, June 12, 2019. https://doi.org/10.1136/bmj.l2147
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I just read all of your article on Gabapentin and can add that while I was taking it I broke out in a rash on my torso that most closely resembled hives. Also, for as long as I was taking it I never slept longer than about 45 minutes at a time. I just blamed the pain. This, after a lifetime of describing myself as an Olympic sleeper. I just never made the connection.

I was prescribed Gabapentin for spondylolisthesis pain. I was also taking a low dose of oxycodone (5mg) and Motrin. The oxy seemed to have little or no effect, and I found out I have a variant to my opioid receptor gene, so it’s no surprise. It did nauseate me something horrid in spite of always taking it with food. But the Gabapentin was giving me hallucinations. I was prescribed 300mg 3 times a day. I was extremely careful to keep time charts on all of these drugs, and never once took too much or took a dose too early. I have been told by my doctor that I don’t have an addictive personality. But I was having conversations with someone who I know was not in the house. I mentioned it to my husband who said I was likely taking little naps and having dreams. I just quit everything except the occasional Motrin when I had a shot in the spine. Overall I lost 20 pounds, and all my hair fell out. Now I just use PT and minoxidil.

Pain? right treatment for the right problem. Doc wanted a CT scan due to right-sided chest pain. It was pretty bad, and I found out it was produced when I picked up the dog leash, and he started to tug. Saw the PTs and OTs I work with. Learned the trick to release a trapped shoulder muscle in 5 minutes with 90% pain relief; also learned about taping and got taped again. It worked. I didn’t even need to take any pills. It’s wonderful!

So because people abuse drugs those who truly need them have to go without what they need? Soon we’ll be down to nothing but aspirin. That is, until someone figures out how to abuse it. This is crazy. There will always be addicts; treat them as the medical problem they are, and give those of us who need pain relief the drugs they need

I took the thing for 4 days, and it killed my stomach. That was enough. Seems like everything I tried to take (that they recommended) made me feel suicidal, especially cymbalta. Am now weening off escitalopram, and that is it. No more antidepressants to treat pain. My doc is now trying low dose ketamin which in very low dose .25 of 1 mg is working. But everything seems to come with side effects.

I am grateful to have gabapentin. I take only 100 mg at night to relieve pain that would otherwise keep me from sleeping well. With gabapentin and SAMe I have been able to quit taking Aleve and high blood pressure medicine.

A drug company looking for a new cash cow. Didn’t do a thing for my surgically-induced neuropathy.

I can only hope that these negative articles do not make it more difficult for people with neuropathy such as myself to get this much-needed drug. I have never experienced any “high” from taking gabapentin, and I believe that if someone truly wants to commit suicide they will always find a way. The suicide problem lies with the person not the method.

I have been prescribed 300mg of Gabapentin 3 x a day for my migraine headaches. The med is useless for this pain. I have not noticed any signs of depression but I am stopping this drug. It’s incredible the current level of fear within the medical profession when prescribing pain meds.

Thank heaven I’m not in a profession that is fear-based about being jailed or tracked by the DEA or local police. Their solution for this fear is to prescribe drugs that don’t work for most pain.

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