Rising drug abuse concern: gabapentin linked to impaired driving and deaths

This seven-year forensic analysis from Dallas County examines gabapentin's presence in driving while intoxicated (DWI) and postmortem cases between 2018 and 2025. Researchers identified gabapentin in 3,189 cases—87 DWI and 2,973 postmortem—representing approximately 5% of annual casework. Blood concentrations varied significantly, with DWI cases averaging 3,798 ng/mL and postmortem cases averaging 8,984 ng/mL, indicating wide variation in usage patterns and exposure levels across different populations.

The study reveals important patterns in gabapentin misuse and its interaction with other substances. The typical gabapentin user was a white male in their 40s-50s, and the drug was frequently found alongside other compounds: in postmortem cases, gabapentin commonly appeared with opioids, ethanol, and stimulants, while DWI cases showed concurrent use with stimulants, benzodiazepines, and THC and its metabolites. This polydrug use pattern is significant for understanding how gabapentin contributes to impairment and adverse outcomes.

Perhaps most concerning, nearly half (47%) of postmortem cases involving gabapentin were ruled natural deaths, though gabapentin was listed as a contributing cause in 5.2% of cases (155 total), typically in combination with other drugs. These findings highlight gabapentin's emerging role in forensic toxicology and raise questions about safe prescribing practices, particularly when combined with cannabis and other central nervous system depressants. The consistent presence of gabapentin across seven years suggests ongoing public health significance that warrants continued monitoring and physician awareness.