A study published in March 2020 in the Journal of the American Medical Association – Internal Medicine[1] shows the use of the nerve pain reliever gabapentin—with brand names such as Neurontin, Gralise, and Horizant—may be helpful in treating people with acute alcohol withdrawal symptoms. The study’s results also demonstrated gabapentin is effective in promoting abstinence and reducing drinking in those with alcohol use disorder (aka alcohol dependency), especially people presenting with more severe withdrawal symptoms.
While there are an estimated 30 million Americans who suffer from an alcohol use disorder[2], unfortunately very few people (14%) actually receive treatment for this affliction, per the National Institute on Alcohol and Alcohol Abuse.[3]
Finding pharmacological therapies to help people abstain from alcohol, get into treatment and onto a path of recovery can bring hope and encouragement to people who suffer with alcohol abuse issues.
The authors of the study used a randomized clinical trial to determine whether gabapentin was beneficial in the treatment of people with alcohol use disorder with a history of alcohol withdrawal symptoms. Their intention was to see if this “more personalized, symptom-specific approach” could significantly increase the number of people with total abstinence and reduced drinking.
The results of the study demonstrated a substantial effect in those with greater pretreatment alcohol withdrawal symptoms. In fact, they found 41% of the participants with high alcohol withdrawal symptoms had total abstinence on gabapentin, compared with 1% of participants using the placebo.
Approved for use in the United States in 1993, gabapentin was originally prescribed as a muscle relaxer and antispasmodic medication. However, in time it drew attention as a possible aid in the reduction of more severe withdrawal symptoms in alcoholics.
Dr. Robert Anton, the study’s main author and a professor of medicine at the Medical University of South Carolina in Charleston, stated, “It has been used for detoxification — alcohol withdrawal — for many years. For relapse prevention, other clinical trials have had mixed results. We had published several studies suggesting it would be added to other medications with some success, but it looked like only in those with alcohol withdrawal symptoms prior to treatment.”
Anton points out, “This study proved that gabapentin could work by itself as a relapse prevention medication, but only in this with the higher alcohol withdrawal symptoms, as predicted.”[4]
It should be noted, this study found mild to moderate side effects, including dizziness and some fatigue. However, according to Anton, “Very few people had significant enough side effects to stop treatment. It also improved sleep.”
As the majority of the medical establishment considers alcohol use disorder (alcoholism) to be a treatable disease, the prevalence of treatment centers staffed with medical professionals who specialize in alcohol and substance use disorders gives those who are afflicted ever-increasing effective, evidence-based options to help them recover. And while one’s recovery may indeed be viewed as a lifelong journey, the first step—abstaining and detoxing from alcohol (and/or drug abuse)—can now be taken with pharmacological therapeutic assistance, with medical monitoring and support to ensure the safest, smoothest progress forward toward a life of sobriety, one day at a time.
In conclusion, the recent research described above on gabapentin, a medication originally used for nerve pain and partial seizures, adds another “tool” to the tool chest for addiction treatment professionals, rehab centers and alcohol treatment program providers to help ease the symptoms of alcohol withdrawal for those seeking assistance.
[1] JAMA Intern Med. 2020;180(5):728-736. doi:10.1001/jamainternmed.2020.0249
[2] Ibid.
[3] https://pubs.niaaa.nih.gov/publications/AA81/AA81.htm
[4] https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2762700
