A new wave of concern is emerging among doctors, researchers, and patients after a large national study revealed a troubling association between one of the most commonly prescribed medications for chronic back pain and an increased risk of future cognitive decline.

For years, gabapentin has been viewed as a relatively safe option for nerve-related pain — a drug widely prescribed across the United States, often considered a gentler alternative to opioids. Its use has therefore exploded in popularity, becoming a staple in pain management clinics and primary care offices alike.

But now, an analysis of more than two dozen health systems suggests that long-term exposure to this medication may be connected to a higher likelihood of developing dementia or other forms of cognitive impairment in the years that follow.

The findings, while not definitive proof of causation, have sparked a renewed conversation about how medications shape long-term brain health and what patients should know before relying on a drug for years at a time.