Is Gabapentin an Opioid? Exploring Key Differences

What is Gabapentin?

Gabapentin is a medication classified as a gabapentinoid. The Food and Drug Administration (FDA) approves gabapentin for treating neuropathic pain — pain arising from nerve damage — and postherpetic neuralgia, which is persistent pain after shingles. It’s also prescribed gabapentin off-label for restless legs syndrome and sometimes for epilepsy.

The effect of gabapentin on the nervous system is not completely understood, but it is known to modulate calcium channels in nerve cells, thereby reducing abnormal nerve activity and pain signals. Unlike opioids, it does not bind to opioid receptors in the brain. This difference in mechanism leads to different benefits and risks.

Gabapentin typically starts at low doses to minimize side effects, with the dose of gabapentin being carefully increased under medical supervision. In 2023, gabapentin became one of the most prescribed medications in the United States, reflecting its broad use beyond just neuropathic conditions.

Is Gabapentin an Opioid?

To answer the question directly: Gabapentin is not an opioid. Although gabapentin is sometimes mistakenly thought of as an opioid because it is used for certain types of pain and can be prescribed alongside opioids, it is chemically and pharmacologically distinct.

Gabapentin does not produce the euphoric “high” associated with opioids and has a much lower potential for addiction. However, misuse can still occur, especially when gabapentin is combined with opioids, intensifying respiratory depression and increasing the risk of overdose.

What are Opioids?

Opioids are a class of drugs primarily used for pain relief. They work by binding to opioid receptors in the brain and spinal cord, dramatically blocking pain signals. Common opioids include morphine, oxycodone, hydrocodone, and fentanyl.

Although effective for acute and severe pain, opioids come with significant risks. Chronic use can lead to tolerance, dependence, and eventually opioid use disorder. Opioid addiction has been a serious public health issue documented extensively by the Centers for Disease Control and Prevention (CDC).

Differences Between Gabapentin and Opioids

Understanding the differences between gabapentin and opioids helps clarify why they are prescribed differently and have varying risks:

• Drug Class and Chemical Structure: Gabapentin is a gabapentinoid designed to affect nerve signaling, while opioids are derived from natural opium or synthetically created to target opioid receptors.
• Mechanism of Action: Gabapentin modulates calcium channels to reduce nerve excitability; opioids block pain signals by binding opioid receptors.
• Approved Uses: Gabapentin treats neuropathic pain and conditions like postherpetic neuralgia and restless legs syndrome. Opioids treat acute to severe pain, including surgical and cancer-related pain.
• Risk of Dependence: Opioids have a high risk of addiction and withdrawal symptoms such as agitation and nausea. Gabapentin can cause some withdrawal symptoms if used long-term, but has a lower addiction potential.
• Side Effects: Opioids can cause respiratory depression and severe breathing problems, which are especially dangerous for individuals with chronic obstructive pulmonary disease (COPD). Gabapentin side effects may include dizziness and fatigue, but rarely cause severe breathing problems when used alone.

Similarities Between Gabapentin and Opioids

Despite their differences, gabapentin and opioids share some overlapping characteristics:

• Both are used in managing pain, including neuropathic pain that doesn’t respond well to standard painkillers.
• Both may be prescribed together to improve pain relief, though care must be taken due to increased risk.
• Both can cause side effects impacting the nervous system, such as dizziness and sedation.
• There is an increased risk of respiratory depression when gabapentin is combined with opioids, which can seriously affect breathing, especially in people with chronic obstructive pulmonary disease (COPD).

Why Understanding These Differences and Similarities Matters

Given the opioid crisis in the United States, particularly in states like West Virginia with higher opioid use disorder rates, clear knowledge about medications like gabapentin is essential. Prescribing gabapentin as an alternative to opioids for pain can help reduce opioid use, but there are significant downsides if patients mix these drugs without appropriate medical guidance.

Healthcare providers must closely monitor patients when gabapentin is combined with opioids to prevent dangerous side effects such as respiratory depression, which can cause life-threatening breathing problems.

Why Gabapentin is Sometimes Misused Like an Opioid

Gabapentin has gained popularity as a drug of misuse. People sometimes take high doses of gabapentin to feel relaxed, euphoric, or intoxicated.

Studies have shown that 15–22% of people with opioid use disorder also misuse gabapentin. This is because gabapentin can enhance the effects of opioids when taken together. Unfortunately, this combination raises the risk of respiratory depression and overdose.

The CDC has reported increased hospitalizations and deaths when gabapentin is found in toxicology reports alongside opioids. Public health officials are paying closer attention to gabapentin misuse. This is why some states regulate prescriptions more strictly.

Is Gabapentin Addictive?

Gabapentin is not considered addictive in the same way opioids are. However, cases of dependence have been reported. People who misuse high doses of gabapentin may develop tolerance and experience withdrawal symptoms when they stop taking it.

Withdrawal may include:

• Anxiety
• Insomnia
• Nausea
• Sweating
• Irritability

These symptoms are usually milder than opioid withdrawal but can still cause discomfort.

Rehab For Substance Abuse

Gabapentin is not an opioid but a gabapentinoid medication used primarily for neuropathic pain and postherpetic neuralgia. It works differently from opioids and has a different safety profile, with a lower risk of addiction. However, when combined with opioids, there is an increased risk of respiratory depression and overdose.

If prescribed gabapentin or opioids, patients should take medications exactly as directed by healthcare providers and be aware of potential side effects and withdrawal symptoms.

Struggling with substance use disorder can feel overwhelming, but recovery is possible with the right support. Professional treatment often includes medical detox, behavioral therapy, and medication-assisted care to ensure a safe and lasting recovery. If you or someone you love is facing this challenge, reaching out to an addiction specialist or rehab program is a vital first step.

At our Scottsdale, Arizona treatment centers, we provide compassionate care for individuals battling alcohol and substance use disorders. Our team is here to guide you with personalized programs tailored to your unique needs. Contact us today to begin your journey toward healing and long-term wellness.