America’s New Pain Drug Problem

William Faloon

In 1995, the FDA approved the drug OxyContin^® as a treatment for chronic pain that was less prone to abuse and addiction.

It was not!

Millions got addicted, and over 800,000 people lost their lives to overdoses as FDA approved widespread availability of other opioid drugs… and then restricted them, forcing addicts to turn to more dangerous opioids like heroin and fentanyl.²

We at Life Extension^® have long been outspoken against the FDA’s approval of OxyContin^® as a safe treatment for chronic pain.

Its manufacturer, Purdue Pharma, filed for bankruptcy in 2019. They, along with the Sackler family, faced a combined criminal and civil penalty of $8.3 billion in 20203 and a national civil lawsuit settlement of $7.4 billion in 2025 over their role in the opioid crisis.⁴

With opiod drug access heavily restricted today, prescriptions for alternative pain pills in the class of gabapentinoids have dramatically increased.⁵

Gabapentin and pregabalin are two gabapentin-oid generics. They were broadly marketed under brand names Neurontin^® and Lyrica^® , respectively.⁶

Whereas OxyContin was approved for general pain, gabapentinoids are approved for the treatment of nerve pain and a few other conditions. Doctors have been prescribing gabapentinoids off-label for various other pains.⁷

Gabapentin is prescribed signi-ficantly more than pregabalin.⁸ In 2024, it was the fifth most widely prescribed drug in the U.S., used by about 15.5 million people.⁹

Doctors have touted these drugs as safer alternatives to opioids with a low risk of addiction. New research has shown that the risks are far greater than previously believed.⁷

Gabapentin,¹⁰ pregabalin,¹¹ or both have been associated with common side effects of:

• Withdrawal,^10-12
• Depression,^10,11,13
• Psychosis,^10-12
• Suicide, suicidal thoughts and behavior, and self-injury,^10,11,13-15
• Peripheral edema,^10,11,16
• Sleepiness,^10,11,16
• Blurred vision,^10,11,16
• Dizziness, ^10,11,16
• Weight gain,^10,11,15
• Dementia,^10,11,17 and
• Heart failure^.18

In addition, patients often report worsening symptoms when discontinuing these drugs.

For example, a front-page Wall Street Journal article reported a patient with a herniated disc experienced severe withdrawal symptoms after stopping the medication, making his original back pain seem like a “paper cut” by comparison.¹⁴

What’s worse is that every year for the last five years there have been about 5,000 gabapentin-involved deaths.¹⁴

Pain management treatment is very difficult, and doctors want to help their patients but feel their options are limited. Recent evidence has shown that other approaches may offer some relief from lower back pain without side effects.

These include physical therapy sessions that are often covered for Medicare participants.¹⁹

Physical therapy is considered as a first line option for chronic low back pain by improving pain, strength, mobility, function, and quality of life while reducing pain medication use.^20,21

The article, Botanical Solutions for Low Back Pain of this month’s issue describes a plant extract combination that was shown to provide a non-drug option for people experiencing low back pain.

For longer life,

William Faloon, Co-Founder, Life Extension®

References

1. Cicero TJ, Inciardi JA, Munoz A. Trends in abuse of Oxycontin and other opioid analgesics in the United States: 2002-2004. J Pain. 2005 Oct;6(10):662-72.
2. Available at: https://www.cdc.gov/overdose-prevention/about/understanding-the-opioid-overdose-epidemic.html. Accessed January 15, 2026.
3. Available at: https://www.statnews.com/pharmalot/2020/10/21/purdue-opioids-sacklers-guilty-oxycontin/. Accessed January 9th, 2026.
4. Available at: https://www.reuters.com/business/healthcare-pharmaceuticals/all-us-state-attorneys-general-agree-74-billion-purdue-pharma-settlement-2025-06-16/. Accessed January 6, 2026.
5. Kim E, Raji MA, Westra J, et al. Comparative effectiveness of pain control between opioids and gabapentinoids in older patients with chronic pain. Pain. 2024 Jan 1;165(1):144-52.
6. Senderovich H, Jeyapragasan G. Is there a role for combined use of gabapentin and pregabalin in pain control? Too good to be true? Curr Med Res Opin. 2018 Apr;34(4):677-82.
7. Goodman CW, Brett AS. A Clinical Overview of Off-label Use of Gabapentinoid Drugs. JAMA Intern Med. 2019 May 1;179(5):695-701.
8. Karami S, Yoo JW, Woods C, et al. Gabapentin utilization and nontherapeutic use relative to select comparator drugs, United States 2013-2022. Drug Alcohol Depend. 2026 Jan 7;279:113026.
9. Strahan AE, Rikard SM, Schmit K, et al. Trends in Dispensed Gabapentin Prescriptions in the United States, 2010 to 2024. Ann Intern Med. 2025 Dec;178(12):1816-8.
10. Available at: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=08880902-bd44-41b6-866b-2cbad4c3f2b1. Accessed January 20, 2026.
11. Available at: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=cf7b4b67-b017-47ac-af3f-bde5bd07bb0c. Accessed January 20, 2026.
12. McNeilage AG, Gholamrezaei A, Murnion B, et al. Pregabalin dependence, withdrawal, suicidality and psychosis reports: A disproportionality analysis of the Australian adverse events database. Br J Clin Pharmacol. 2025 Sep 26.
13. Zhang H, Huang H, Ou H, et al. Correlation between gabapentin and depression: A study from the NHANES and FAERS databases. Medicine (Baltimore). 2025 Aug 22;104(34):e44010.
14. Available at: https://www.wsj.com/health/gabapentin-painkiller-hidden-risks-603e6130. Accessed January 6, 2026.
15. Kaye AD, Cassagne G, Abbott BM, et al. Emerging Clinical Roles of Gabapentin and Adverse Effects, Including Weight Gain, Obesity, Depression, Suicidal Thoughts and Increased Risk of Opioid-Related Overdose and Respiratory Depression: A Narrative Review. Curr Pain Headache Rep. 2025 Jun 20;29(1):95.
16. Joao RB, Tagore Chan JO, Huang ES, et al. Gabapentinoids for Neuropathic Pain After Spinal Cord Injury: An Updated Meta-Analysis of Randomized Controlled Trials. Pain Pract. 2025 Sep;25(7):e70060.
17. Huang YH, Pan MH, Yang HI. The association between Gabapentin or Pregabalin use and the risk of dementia: an analysis of the National Health Insurance Research Database in Taiwan. Front Pharmacol. 2023;14:1128601.
18. Park EE, Daniel LL, Dickson AL, et al. Initiation of Pregabalin vs Gabapentin and Development of Heart Failure. JAMA Netw Open. 2025 Aug 1;8(8):e2524451.
19. Available at: https://www.medicare.gov/coverage/physical-therapy-services. Accessed January 8, 2026.
20. Wang XQ, Wang YL, Witchalls J, et al. Physical therapy for acute and sub-acute low back pain: A systematic review and expert consensus. Clin Rehabil. 2024 Jun;38(6):715-31.
21. Qaseem A, Wilt TJ, McLean RM, et al. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017 Apr 4;166(7):514-30.