Can I Take Opioids With Gabapentin?

Dr. Ximena Sanchez-Samper

Ximena Sanchez-Samper, MD is a Board- Certified Addiction Psychiatrist who obtained her degree as a psychiatrist at the Mayo Clinic in Rochester, MN and completed her Addictions Fellowship through the combined Massachusetts General Hospital, McLean Hospital / Brigham and Women’s Hospital Addictions Fellowship program in 2004.

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Mixing Opioids With Gabapentin

Opioid abuse is a major problem in the United States. Out of every 550 people who use opioids on a chronic basis, one of them passes away within 2.5 years of receiving the first opioid prescription. Many of these deaths come as a result of mixing opioids with other medications. One such medication is gabapentin. Please keep in mind that this article contains no professional medical advice and is solely for informational purposes.

What Are Opioids?

Opioids, a family of powerful pain-relieving medications, encompass both naturally occurring and synthetically produced compounds. These medications, whether naturally occurring in opium poppies or artificially produced in labs, are painkillers that bind to opioid receptors in the brain and spinal cord, significantly reducing physical pain. Although opioids help alleviate severe pain, their usage has become a major healthcare and public health concern because of the risks of dependency, addiction, and overdose.


Heroin is an opioid substance that is illicitly produced from morphine, which comes from the opium poppy plant. Most countries outlaw heroin because it has no legitimate medicinal uses and has a significant risk of addiction, overdose, and other health effects.


Doctors prescribe oxycodone, a semi-synthetic opioid analgesic, to clients suffering from persistent pain who don’t respond well to other treatments. Available in several forms, including immediate-release and extended-release, oxycodone delivers relief over varied periods of time. Even though oxycodone provides significant pain relief, it comes with a strong potential for misuse and dependency.


In medicine, morphine has several applications. The binding of morphine to opioid receptors in the brain and spinal cord is responsible for its analgesic effects. In cases of extreme pain, such as those experienced by clients before and after surgery, those suffering from cancer, and those in need of palliative care, doctors often prescribe morphine. Despite its usefulness in medicine, morphine usage must be closely monitored to prevent adverse effects such as respiratory depression, drowsiness, and addiction.


Fentanyl is a potent synthetic opioid used for pain control in medical settings, most notably before and after invasive procedures, cancer therapy, and the management of chronic pain. Compared to other opioids like morphine and oxycodone, it is quite powerful. 

Fentanyl’s ability to change pain perception is due to the drug’s interaction with opioid receptors in the brain. It comes in a variety of forms, including transdermal patches, lozenges, and injections. Due to its strength, it is usually reserved for usage in situations where other opioids may be inadequate, and cautious administration is essential. However, fentanyl’s unlawful production and usage have made it infamous for contributing to opiate overdoses.

What Is Gabapentin?

To alleviate symptoms of nerve damage, epilepsy, and certain forms of pain, doctors often prescribe gabapentin. It reduces pain by modulating the transmission of messages along the nerves and regulating the brain’s electrical activity. 

Gabapentin is not an opioid. It has a different mode of action than opioids and does not interact with opioid receptors in the brain. For certain medical issues, such as neuropathic pain, gabapentin is preferable since it does not carry the same dangers of addiction as opioids but still provides relief.

Mixing Opioids With Gabapentin

Gabapentin is the seventh most prescribed drug in the United States, with 69 million prescriptions written for it in 2019. Some people use gabapentin to further activate the effects of illicit opioids. In fact, from 2013 through 2017, this type of use increased by 104%. 

Increased Central Nervous System Depression

Opioids and gabapentin both have a sedative effect on the brain and neurological system. When used together, the possibility of overdose from respiratory depression, sedation, and other effects on the central nervous system increases greatly.

The FDA released a warning in 2019 detailing the increased risk of serious breathing difficulties in those who combine gabapentin with central nervous system depressants like opioids. Other CNS depressants that can lead to harmful side effects when combined with gabapentin include some antihistamines, anxiety medicines, and antidepressant medications. 

Enhanced Sedation and Drowsiness

Gabapentin amplifies the sedative and sleep-inducing effects of opioids. That’s why using these medicines safely requires careful medical supervision. The combination of these drugs increases the potential for sleepiness, mental impairment, and reduced attentiveness, which can lead to major accidents and injuries.

Additive Side Effects

Additive side effects occur when a person takes two or more drugs that share similar properties. Mixing gabapentin and opioids leads to a variety of additive side effects, including dizziness, fainting, and clumsiness. The compounded effects result in a higher chance of falls and mishaps because it’s very common for both substances to make a person feel extremely tired and confused. 

Increased Risk of Respiratory Depression

Mixing gabapentin with opioids results in a sedative effect on the brain and nervous system, which slows breathing. Combining these substances may amplify this effect, resulting in even slower breathing rates. Anoxia and respiratory failure may ensue from respiratory depression, resulting in a life-threatening condition. The increased risk of respiratory depression when mixing gabapentin with opioids makes it crucial to take these drugs carefully and under medical supervision.

Higher Potential for Dependence and Addiction

Adding gabapentin to opioids raises the risk of addiction to both substances. When used together, these chemicals may have a multiplied and synergistic impact on the brain’s reward system, hastening the onset of addiction. This may increase the opioid’s reinforcing effects and make users more vulnerable to the drug’s addictive potential. 

Because of this increased risk, you should never combine gabapentin with opioids unless your doctor instructs you to do so. It’s also important to have open discussions with your healthcare experts to reduce the likelihood of developing a drug use problem and its related repercussions.

Complications in Medical Conditions

For certain clients, the combination of gabapentin and opioids may be dangerous. Individuals with respiratory or cardiovascular disorders are more vulnerable to the effects of these drugs. It’s also possible that the combination will have a detrimental effect when used in conjunction with other drugs. It is especially important for clients with compromised liver or renal function to be careful with these substances because they increase a person’s susceptibility to adverse consequences.

Is Gabapentin Addictive?

The abuse of gabapentin continues to increase even though it doesn’t create the same rush or intense cravings that opioids create. However, gabapentin abuse and dependency are possible, particularly at higher than recommended dosages. Because of the risk of withdrawal symptoms, it is important to taper off gabapentin under medical supervision.

Are Opioids Addictive?

Opioids have a significant potential for addiction. Pain relievers like oxycodone and morphine, as well as illegal substances like heroin, connect to opioid receptors in the brain to produce their analgesic and pleasurable effects. With continued use, it’s possible for someone to develop a strong physical dependency, tolerance, and addiction. Changes that occur in the brain cause the reward system to encourage drug abuse. Avoiding addiction and its negative health effects requires careful and supervised usage.

Treating Opioid Addiction

Opioid and gabapentin addicts may choose from a wide variety of inpatient and outpatient treatment options. Residential programs provide round-the-clock supervision, guidance, and therapy to those who need it. Individuals enrolled in outpatient programs have the convenience of being able to continue living at home while still participating in their treatment.

Those enrolled in intensive outpatient or partial hospitalization programs experience a high degree of therapeutic structure while maintaining their independence at home. Tailored treatment plans, counseling, group therapy, and support groups are key components of these programs, providing varied possibilities for those seeking recovery.

Medication-assisted therapy (MAT) programs use a holistic strategy by combining medication with counseling. Treatment for withdrawal symptoms is the primary emphasis of inpatient detoxification programs. Some of the main drugs that MATs and detox centers offer include methadone, buprenorphine, and naltrexone.


The opioid addiction therapy methadone is a long-acting synthetic opioid. It works by attaching to the same brain receptors as other opioids, lowering cravings, and easing withdrawal symptoms without inducing pleasure. It reduces the negative effects of withdrawal, making it easier for people to participate in counseling and behavioral treatments that will help them find stability in their lives. Methadone maintenance is a well-established strategy, offering a regulated and supervised means to treat opioid addiction.


The opioid addiction therapy drug buprenorphine reduces cravings and withdrawal symptoms by activating the same brain receptors as opioids but at a lower concentration. Medication-assisted therapy (MAT) programs often include buprenorphine in their treatment modalities. It helps people deal with the difficulties of addiction by regulating their opioid receptors without producing the same bliss as full opioids. Buprenorphine, given sublingually or as implants, also facilitates rehabilitation by reducing the need for medical supervision during counseling and behavioral therapy.


Naltrexone, an opioid antagonist that blocks opioid receptors, counteracts the pleasurable effects of opioids and helps reduce cravings. In contrast to agonist medicines, Naltrexone does not stimulate the receptors. Medication-assisted therapy (MAT) regimens often include the use of naltrexone, either in oral or extended-release injectable forms. 

By reducing opioids’ addictive effects, naltrexone promotes long-term sobriety. It is especially effective following detoxification, giving a non-addictive choice for people devoted to recovery. Providers must carefully evaluate each client’s eligibility for this treatment method, and rigorous adherence is necessary.

Get Help Today

Both gabapentin and opioids are miraculous medications that can drastically reduce a person’s experience of physical pain. However, it is very risky to use both of these substances together. It’s always best to speak with your healthcare providers about all of the medicines you take. 

If you need assistance communicating with a medical expert, Charles River Recovery is available to answer any questions you may have. We provide a wide range of addiction treatment options, including help for alcohol, opioids, crystal meth, crack cocaine, and more. Our facility also offers methamphetamine, Xanax, and alcohol detox. Get in touch with us today to learn about the different options we provide for dealing with opioid addiction.