Walking through Weymouth’s Webb Park early one morning recently, Doug Crowley said that’s when life is most still.
“I enjoy myself, I look around,” he said. “It’s just a calmness.”
That calmness is drug-induced. But it’s not the Suboxone he’s prescribed to help with his withdrawal from heroin. The 25-year-old is abusing another drug: gabapentin. The pills are called "Johnnys" on the street.
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“It just gives you a sense of togetherness and wholeness like you have a core,” he said.
Gabapentin is an anti-seizure and nerve pain medication, doctors prescribe it as a safe alternative to opioids. But addicts have figured out -- in high doses or mixed with other drugs -- it can mimic an opioid euphoria.
“One pill isn’t going to do it,” Crowley said. “You need to take six, seven, eight in a day in order to get the effect.”
That effect was such a draw Crowley uses most of his day to get into Boston to try and score.
“They’re a dollar apiece for 800 milligrams, which is as big as they come,” he said.
Johnnys are cheaper than other prescription drugs sold on the street. Xanax can go for $5 a pill, OxyContin for $30. Addicts say it’s easy to get doctors to write a prescription. And the pills they get are even easier to sell.
“I’ve never felt in danger taking Johnnys,” Crowley said. “I’ve never felt like I was hurting myself. And I really don’t think anyone on the street does either.”
But abuse of the drug is killing more people than ever before. The state medical examiner’s office ruled gabapentin as the cause of death in 52 overdoses last year, more than triple two years earlier.
Dr. Dan Muse works in Brockton Hospital’s Emergency Department. He said gabapentin is a downer, and in high doses or when combined with other depressants like heroin, it can suppress a user’s breathing.
“You become lethargic, sleepy, your breathing starts to be more shallow,” he said. “At some point if you took enough you stop breathing altogether.”
Muse said gabapentin abuse caught the medical community off guard.
“The drug companies, who I refer to as the real cartels, have been pushing their drugs” for off-label uses running the gamut from alcohol withdrawal to anxiety,” he said.
The most recent data from the Institute for Healthcare Informatics shows gabapentin as the country’s 10th most-commonly prescribed medication.
Nationally, prescriptions jumped from 39 million in 2012 to 64 million in 2016.
In Massachusetts, prescriptions have steadily increased for years, according to federal Medicaid data. Prescriptions that Medicaid paid out, which would only cover a portion of the total prescriptions written in Massachusetts, nearly doubled in just a few years, from 187,390 in 2012 to 346,429 in 2016.
Drug maker Pfizer produces Neurontin, a brand-name version of gabapentin. In a statement to Stateline, a news site affiliated with Pew Charitable Trust, Pfizer communications director Steven Danehy said, “Reports of misuse and abuse with this class of medicines are limited and typically involve patients with a prior history of substance abuse, including opioids.”