Smoking Marijuana and Taking Gabapentin: Potential Risks and Benefits

gabapentin and marijuana risks and interaction
By Rebecca Olmos Updated January 6th

Medically reviewed by Dr. Brian Kessler, MD

Cannabis is a substance that has both recreational and medicinal benefits. It can be viewed as a less harmful alternative to many medications and is often assumed safe to combine with them as well. However, just like traditional pharmaceutical prescriptions, it has the potential to interact and cause side effects if combined with other drugs. 

Many users have asked, “is it safe to smoke marijuana while taking gabapentin?”

Research is still ongoing on how cannabis interacts with different medications, so it’s always best to consult your doctor beforehand. This article will discuss the current research and understanding between gabapentin and cannabis. 

What is Gabapentin Used For?

Gabapentin is a prescription medication that targets and reduces the activity of neurons in the brain. It can come in the form of capsules, tablets, and oral solutions. Gabapentin belongs to a class of drugs called anticonvulsants. As their name suggests, they’re formulated to control or prevent convulsions, like seizures in epilepsy. 

Epilepsy is one of the main conditions that gabapentin has historically treated, but it can also help treat other ailments that cause nerve pain, including postherpetic neuralgia (PHN) and restless leg syndrome. Depending on the symptoms, it can even be prescribed to treat conditions like menopause and general anxiety.

Potential side effects can come about after taking gabapentin, although they are not too common. Side effects occur in about 1 in 100 people. 

Mild side effects include:

  • Nausea
  • Vomiting
  • Diarrhea
  • Fatigue
  • Mood changes
  • Swollen arms and legs
  • Blurry vision
  • Trouble speaking
  • Dry mouth
  • Difficulty with arousal
  • Weight gain
  • Memory problems
  • Headaches 
  • Increase in infections

More severe side effects include:

  • Suicidal thoughts
  • Serious reactions to the body (fever, swollen glands, bruises or bleeding, extreme fatigue, or rash)
  • Liver abnormalities (yellow skin or eyes, dark urine)
  • Kidney abnormalities (trouble urinating, swelling of legs and feet)
  • Long-lasting stomach pain or feelings of illness
  • Muscle pain or weakness
  • Hallucinations
  • Anaphylaxis or allergic reaction

If you’re experiencing any of these side effects while taking gabapentin, speak with your doctor as soon as possible. 

Side effects can also occur if you are taking gabapentin along with other medications that cause sleepiness or affect awareness like:

  • Opioids or narcotics
  • Anti-anxiety medications
  • Antidepressant medications
  • Antihistamines
  • Medications for stomach issues
  • Other seizure medications

Gabapentin should not be mixed with alcohol.

There is also an increased risk of breathing problems for people over 65 and those with chronic obstructive pulmonary disease (COPD). If you are experiencing any breathing problems, confusion, dizziness, or changes in the skin color of the lips, fingers, or toes, seek medical attention immediately. 

Gabapentin is prescribed to treat and reduce the symptoms related to nerve pain and epilepsy, but it is not a cure. 

Potential Benefits of Mixing Marijuana and Gabapentin

gabapentin and marijuana

Further analyses are needed, but recent studies suggest that when taken together, cannabis and gabapentin may complement one another in treating neuropathic pain.

In 2019, a study was conducted on mice over eight days in which the researchers administered a fixed dose of THC and gabapentin. Their findings indicate that when combined, THC and gabapentin can create a larger therapeutic window than just THC alone, leading researchers to conclude that THC may be a complementary substance when taken with neuropathic medications like gabapentin.¹

A more recent 2022 study in Denmark observed about 1800 individuals using cannabis for neuropathic pain and other unspecified pain. Researchers concluded that cannabis is generally safe for those with neuropathic pain but may not be as safe for those with unspecified pain disorders.² Specifically, individuals who consumed THC were found to use more opioids, but those with neuropathic pain who consumed THC, CBD, or both were found to use less gabapentin. 

Controlled research studies regarding how cannabis and gabapentin interact are still minimal.

Gabapentin has been predominantly prescribed for treating and reducing seizures, and cannabis has been studied for those same benefits. It’s not surprising to see that, despite a lack of clinical research, individuals often attribute cannabis to reducing their need for medications like gabapentin. 

Personal stories on websites like Reddit catalog unique experiences describing how cannabis usage has not only drastically reduced their number of seizures per month but also helped them to remove gabapentin from their list of needed medications. 

Further research is required to understand how gabapentin and cannabis interact with the human neurological system.

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Potential Risks of Mixing Marijuana and Gabapentin

It is still unclear how cannabis and gabapentin work in unison with one another. So far, researchers and individuals have mainly found that cannabis helps to reduce the need for neuropathic medications like gabapentin in some situations. 

Gabapentin has been studied for its ability to alleviate withdrawal symptoms from cannabis dependence. This evidence may indicate that gabapentin operates on similar neural pathways as THC, suggesting that it may decrease the endocannabinoid system’s reliance on cannabis. 

Researchers in 2012 observed 50 people aged 18-65 with cannabis dependence. They found that gabapentin was an acceptable and safe treatment method for cannabis withdrawal symptoms but noted several limitations which call for further studies to confirm the findings.³  

While gabapentin may reduce withdrawal symptoms, there is still little research regarding how cannabis and gabapentin interact in the body, and combining substances under any circumstance has the potential for adverse outcomes. 

According to the National Health Services, gabapentin can intensify the psychoactive effects of cannabis. Combining the two substances increases the likelihood of experiencing panic attacks, anxiety attacks, and memory loss.⁴

More research is needed to understand better the potentially harmful side effects of combining gabapentin and cannabis. 

How Does Gabapentin Interact with CBD

gabapentin and marajuana interaction

THC is the prominent cannabinoid responsible for the psychoactive experience that happens when you consume cannabis. 

CBD is another widely known cannabinoid that does not produce an intoxicating effect. While both have therapeutic benefits, CBD has become a more common introductory compound for those beginning to use cannabis for medicinal purposes. Seizures and epilepsy are among the most common conditions that CBD has been studied to treat. 

Just as the evidence is limited and conflicting for THC, the same goes for CBD. And, just as THC can be both therapeutic and cause unwanted negative effects, so can CBD. It has the potential to cause sleepiness and mild psychoactive effects.

A 2020 study reviewed how CBD interacted with several different prescription medications. They reported that combining CBD with substances that can have sedative and anesthetic effects can result in both therapeutic as well as adverse effects.⁵

CBD has been studied for decades regarding its potential to reduce seizures in patients with epilepsy, both in clinical and less controlled settings.⁶ A study published in 1981 found that seven out of eight people using CBD to treat their epilepsy saw an improvement in the state of their condition.⁷

Many people with epilepsy also self-report treating their disease with CBD and often find success. While this is an excellent development, more controlled studies must be done to deeper understand how specifically CBD affects seizures and patients with epilepsy. It’s also vital to better understand how cannabinoids, like CBD, interact with the medications used to treat those conditions, like gabapentin. 

There is a potential concern that cannabinoids, like THC and CBD, may inhibit the metabolism of drugs through interactions with cytochrome P450 (CYP) enzymes. However, while most drugs metabolize via CYP enzymes, gabapentin does not. It isn’t metabolized to any degree in humans and is excreted intact in the urine. 

This may provide insight as to why gabapentin has shown few adverse effects when combined with cannabis in the limited published studies regarding the two.

Conclusion 

Gabapentin is a prescription medication that can treat a variety of conditions, like epilepsy or restless leg syndrome. How it interacts in the body simultaneously with cannabis depends on factors that are currently unknown. 

Research is limited, especially in controlled human studies, regarding how the two substances interact with the nervous system and how they affect pain.

Further research is needed, and current findings are conflicting. Self-reports claim that cannabis has helped reduce their intake of gabapentin, and gabapentin has been studied for its ability to alleviate withdrawal symptoms from cannabis dependence.

Gabapentin and cannabis have the potential to work better together but also to cause adverse effects.

The above information is not a substitution or replacement for professional legal advice. It is also not medical advice, a diagnosis, or a treatment plan. Consult a professional attorney or physician if you have questions or concerns regarding the laws, regulations, or your health.

Sources

¹ Atwal, Nicholas, et al. “THC and Gabapentin Interactions in a Mouse Neuropathic Pain Model.” Neuropharmacology, vol. 144, Jan. 2019, pp. 115–121, 10.1016/j.neuropharm.2018.10.006. Accessed 12 Apr. 2021.

² Hjorthøj, Carsten, et al. “Cannabis‐Based Medicines and Medical Cannabis for Patients with Neuropathic Pain and Other Pain Disorders: Nationwide Register‐Based Pharmacoepidemiologic Comparison with Propensity Score Matched Controls.” European Journal of Pain, 16 Oct. 2021, 10.1002/ejp.1874.

³ Mason, Barbara J, et al. “A Proof-of-Concept Randomized Controlled Study of Gabapentin: Effects on Cannabis Use, Withdrawal and Executive Function Deficits in Cannabis-Dependent Adults.” Neuropsychopharmacology, vol. 37, no. 7, 29 Feb. 2012, pp. 1689–1698, 10.1038/npp.2012.14.

⁴ “Taking Gabapentin with Other Medicines and Herbal Supplements.” Nhs.uk, 16 Sept. 2021, www.nhs.uk/medicines/gabapentin/taking-gabapentin-with-other-medicines-and-herbal-supplements/#:~:text=Gabapentin%20can%20intensify%20the%20highs. Accessed 30 Nov. 2022.

⁵ Wilson-Morkeh, Harold, et al. “Important Drug Interactions Exist between Cannabidiol Oil and Commonly Prescribed Drugs in Rheumatology Practice.” Rheumatology, vol. 59, no. 1, 29 July 2019, pp. 249–251, 10.1093/rheumatology/kez304. Accessed 12 July 2020.

⁶ Thomas, Rhys H, and Mark O Cunningham. “Cannabis and Epilepsy.” Practical Neurology, vol. 18, no. 6, 18 Oct. 2018, pp. 465–471, pn.bmj.com/content/18/6/465, 10.1136/practneurol-2018-002058. Accessed 1 Mar. 2019.

⁷ CARLINI, ELISALDO A., and JOMAR M. CUNHA. “Hypnotic and Antiepileptic Effects of Cannabidiol.” The Journal of Clinical Pharmacology, vol. 21, no. S1, 9 Aug. 1981, pp. 417S427S, accp1.onlinelibrary.wiley.com/doi/abs/10.1002/j.1552-4604.1981.tb02622.x, 10.1002/j.1552-4604.1981.tb02622.x.

The information in this article and any included images or charts are for educational purposes only. This information is neither a substitute for, nor does it replace, professional legal advice or medical advice, diagnosis, or treatment. If you have any concerns or questions about laws, regulations, or your health, you should always consult with an attorney, physician or other licensed professional.

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