If you’ve ever looked for alternative pain medications, you’ve likely heard of gabapentin. This medication is one of the most prescribed in the United States, but growing research suggests people may need to be careful using it — especially those with a history of opioid use disorder (OUD).

Keep reading to learn about gabapentin, what it’s used for, and how it impacts the body compared with opioids. You’ll also learn what to discuss with your doctor before taking gabapentin and what side effects to look out for to stay safe.

Is Gabapentin an Opioid?

Gabapentin is not an opioid. It helps manage pain like an opioid, but gabapentin and opioids target pain in different ways.

Gabapentin belongs to a drug class called gabapentinoids. Researchers are still trying to understand how gabapentinoids work, but some believe medicines in this drug class encourage the brain to produce more of a chemical called GABA. This chemical slows down overactive nerves that make people more sensitive to pain or cause other symptoms, like anxiety or restlessness.

Opioids are a class of drugs that work differently. They attach to opioid receptors on nerve cells in the central nervous system (brain and spinal cord) and other parts of the body. When they attach, they block pain signals from traveling to the brain.

Gabapentinoids are often prescribed for long-term conditions like epilepsy (a seizure disorder) or stubborn nerve pain. Opioids are usually reserved for severe pain, like from a surgery or an injury, but there are times when doctors will prescribe opioids for long-term painful conditions.

Doctors tend to be more careful when prescribing opioids because of the known risk of substance use disorder.

Is Gabapentin Addictive?

Research has shown a rise in gabapentin abuse as healthcare providers prescribe fewer opioids. The FDA doesn’t consider it a controlled substance like an opioid, but some research suggests it might cause more cases of addiction or dependence than health experts originally believed.

Research also suggests that a history of OUD is a risk factor for misusing gabapentin.

For this reason, certain states have decided to group gabapentin as a Schedule 5 controlled substance. Schedule 5 is the group of drugs with the lowest chance of abuse or dependency, but higher than other medications not classified as controlled substances. These states include:

• Alabama
• Kentucky
• North Dakota
• Tennessee
• Utah
• Virginia
• West Virginia

Some states include gabapentin in their prescription drug monitoring program (PDMP). This program tracks where people are refilling certain medications and how often, which helps oversee medication use and prevent cases of overdose.

The states and regions that list gabapentin in their PDMPs include the ones listed above and:

• Connecticut
• Illinois
• Indiana
• Kansas
• Louisiana
• Massachusetts
• Minnesota
• Mississippi
• Nebraska
• New Jersey
• New Mexico
• North Carolina
• Ohio
• Oregon
• Washington, D.C.
• Wyoming
• Wisconsin

Other Risks of Taking Gabapentin

Gabapentin comes with other risks aside from potential misuse. These risks include side effects, serious drug interactions (especially with opioids), and overdose when not used carefully.

Side Effects

Common side effects of gabapentin include:

• Drowsiness or dizziness
• Nausea or vomiting
• Diarrhea or constipation
• Dry mouth
• Weight gain
• Hand, foot, or ankle swelling
• Back or joint pain
• Body aches

More rare but serious side effects include:

• Skin changes, like yellowing or rashes
• Face or throat swelling, an allergic reaction known as angioedema
• Cognitive changes, like issues concentrating or remembering
• Trouble speaking or swallowing
• Mood changes, like depression or uncontrolled anger
• Suicidal thoughts or behaviors

Note: If you or someone you know needs help, you can contact the 988 Suicide & Crisis Lifeline by calling or texting 988 or chatting online.

Drug Interactions

Gabapentin interacts with many other substances, including:

• Alcohol
• Products containing antihistamines
• Some medications for anxiety or depression
• Some sleep medications
• Certain anti-seizure medications
• Anesthetics or muscle relaxants before surgery
• Some antacids and other stomach-related medicines

One of the most dangerous drug combinations is gabapentin with opioids. Opioids have similar side effects to gabapentin, like drowsiness. Taking both together increases the risk of:

• Cognitive changes (alterations in mental processes such as memory, thinking speed, attention, and decision-making)
• Respiratory depression (slow or shallow breathing)
• Opioid overdose
• Death

Overdose

You can overdose on gabapentin. Symptoms of an overdose include:

• Slowed breathing
• Drowsiness
• Dizziness
• Double vision
• Tremor
• Slurred speech
• Diarrhea
• Cognition changes

Withdrawal

Stopping gabapentin can also come with negative effects. Doctors often advise tapering (slowly lowering your dose over time) to reduce the risk of experiencing negative effects. Tapering schedules usually span about a week but depend on the person and their situation.

People who have grown dependent on gabapentin might develop withdrawal symptoms within 12 hours and seven days after stopping the medication. Symptoms can last up to 10 days. These include:

• Anxiety
• Irritability
• Trouble sleeping
• Restlessness
• Fatigue
• Nausea
• Sweating

If you stop the medication suddenly instead of tapering it, there is also a risk of having seizures.

Talk to Your Doctor

Tell your healthcare team about your history of OUD before taking gabapentin. Your doctor should know your full substance use and medical history in order to prescribe the safest medications to manage pain.

Sharing your full history will also help prevent polysubstance use disorder, which is when someone regularly takes multiple substances that can create dependence or affect quality of life.

Also make sure you’re clear on your prescribed dose and frequency and follow it closely. Ask your doctor what to do if you miss a dose or accidentally take more than you should have.

For some members of MyOpioidRecoveryTeam, gabapentin is one of several non-opioid alternatives they’re trying to control their pain. Some are nervous to try it. “My son took it for his epilepsy when he was a child, but he developed serious side effects,” wrote one member.

If you try gabapentin as an alternative to opioids or if you want to keep a close eye on how you feel while on it, keep a symptom journal. Write down your daily dose, when you take it each day, and how you feel throughout the day. A journal can help you identify positive changes or catch negative patterns before they impact your life significantly.

Join the Conversation

On MyOpioidRecoveryTeam, people share their experiences with opioids, get advice, and find support from others who understand.

Have you taken gabapentin to help control your pain? What was your experience? Let others know in the comments below.