Nonmedical use of gabapentin and opioid agonist medications in treatment-seeking individuals with opioid use disorder

Drug Alcohol Depend. 2022 May 1;234:109400. doi: 10.1016/j.drugalcdep.2022.109400. Epub 2022 Mar 9.


Background: As prescriptions for gabapentin have increased in recent years, nonmedical use and risk of adverse outcomes (e.g., hospitalizations and overdose) have been identified, particularly in association with opioids, including opioid agonist medications (OAMs) buprenorphine and methadone. However, there is a lack of systematic, nationwide data assessing the relationship between the nonmedical use of gabapentin and OAMs.

Methods: Data were sourced from two nationwide opioid surveillance programs of treatment-seeking individuals with opioid use disorder (OUD). Both programs utilized an identical serial, cross sectional survey of 12,792 new entrants to one of 163 substance use treatment programs for OUD in 46 states and the District of Columbia from January 2019 to December 2020.

Results: Past month nonmedical use of gabapentin was endorsed by 9.3% of the sample. Of those using gabapentin nonmedically, 64.1% also endorsed nonmedical use of an OAM, including concomitant use of methadone (35.3%), and buprenorphine (49.0%). Concomitant nonmedical use of gabapentin and OAMs was more prevalent (versus nonmedical use of gabapentin alone) in the Southern region, among those living in a street dwelling, those with chronic pain and healthcare professionals.

Conclusions: Nonmedical use of gabapentin in people with OUD appears to frequently coincide with nonmedical use of OAMs. As prescriptions and off-label use of gabapentin increase, provider education should include the risks of concomitant gabapentin and OAM use, particularly amongst buprenorphine prescribers. Future research should investigate motivations (e.g., OUD self-management) for nonmedical use of gabapentin and OAMs within the context of OUD treatment access and retention.

Keywords: Buprenorphine; Gabapentin; Methadone; Nonmedical use; Opioid agonist medications; Opioid use disorder.

MeSH terms

  • Analgesics, Opioid / adverse effects
  • Buprenorphine* / therapeutic use
  • Cross-Sectional Studies
  • Gabapentin / therapeutic use
  • Humans
  • Methadone / therapeutic use
  • Opiate Substitution Treatment
  • Opioid-Related Disorders* / drug therapy
  • Opioid-Related Disorders* / epidemiology
  • Opioid-Related Disorders* / rehabilitation


  • Analgesics, Opioid
  • Buprenorphine
  • Gabapentin
  • Methadone