THE HIDDEN RISKS OF AMERICA'S MOST POPULAR PRESCRIPTION PAINKILLER

Gabapentin has soared in popularity as an alternative to opioids, but patients are finding it can cause harm

- Betsy McKay & Shalini Ramachandran

John Avery was just back from a guys’ golfing weekend and doing dead lifts at the gym in 2023 when he felt a pop in his lower back. A disc had slipped and was pressing on a nerve.

After months of rest, physical therapy and steroids, he was prescribed a drug called gabapentin by a pain management specialist who told Avery that it could help calm his nerve pain and that it was “nonaddictive,” Avery recalled. He took the medicine for a few days, then had surgery, and took it again for a little more than three weeks.

The 33-year-old former high-school physical education teacher in Newark, Ill., said he experienced a severe protracted withdrawal when he stopped, which led to neurological symptoms now that make his original back problem seem like “a paper cut” by comparison.

His symptoms include shaking and a burning sensation throughout his body, muscle spasms and a racing pulse. He can’t sleep for more than a half-hour at a time, and has lost so much weight that his wife said his calves are the size of her arms.

The change in his life, he said, is “beyond dramatic.”

Approved by the Food and Drug Administration decades ago for seizures and nerve pain from shingles, gabapentin is now the seventh-most widely prescribed drug in the U.S., according to the Iqvia Institute for Human Data Science. About 15.5 million people were prescribed gabapentin in 2024, according to an analysis by Centers for Disease Control and Prevention researchers.

Studies show that most of the prescriptions are written to treat conditions that it wasn't approved for—a practice that is legal and common, but means the FDA hasn't vetted its risks and benefits for those purposes.