diff --git a/src/game/server/ai_basenpc.cpp b/src/game/server/ai_basenpc.cpp
index f607c453436..4567f7e6d99 100644
--- a/src/game/server/ai_basenpc.cpp
+++ b/src/game/server/ai_basenpc.cpp
@@ -12156,6 +12156,19 @@ CBaseEntity *CAI_BaseNPC::DropItem ( const char *pszItemName, Vector vecPos, QAn
 		m_OnItemDrop.Set( pItem, pItem, this );
 #endif
 
+#ifdef MAPBASE_MP
+		// Fixes health vials, grenades, etc. respawning
+		if (pItem->IsCombatItem())
+		{
+			pItem->AddSpawnFlags( SF_NORESPAWN );
+		}
+		else if (pItem->IsBaseCombatWeapon())
+		{
+			// Adding SF_NORESPAWN directly to weapons causes them to be considered level-placed, which we don't want
+			pItem->MyCombatWeaponPointer()->Drop( vec3_origin );
+		}
+#endif
+
 		return pItem;
 	}
 	else
diff --git a/src/game/server/item_world.cpp b/src/game/server/item_world.cpp
index 3ef4e77e9a4..969d6d9bb45 100644
--- a/src/game/server/item_world.cpp
+++ b/src/game/server/item_world.cpp
@@ -248,8 +248,13 @@ void CItem::ActivateWhenAtRest( float flTime /* = 0.5f */ )
 {
 	RemoveSolidFlags( FSOLID_TRIGGER );
 	m_bActivateWhenAtRest = true;
+#if defined( HL2MP ) && defined( MAPBASE_MP )
+	// HL2 entities (e.g. item_item_crate) often use ActivateWhenAtRest() before spawn, which is overridden by FallThink() in MP
+	SetContextThink( &CItem::ComeToRest, gpGlobals->curtime + flTime, "ComeToRestThink" );
+#else
 	SetThink( &CItem::ComeToRest );
 	SetNextThink( gpGlobals->curtime + flTime );
+#endif
 }
 
 
@@ -266,8 +271,12 @@ void CItem::OnEntityEvent( EntityEvent_t event, void *pEventData )
 		{
 			// Delay rest for a sec, to avoid changing collision 
 			// properties inside a collision callback.
+#if defined( HL2MP ) && defined( MAPBASE_MP )
+			SetContextThink( &CItem::ComeToRest, gpGlobals->curtime + 0.1f, "ComeToRestThink" );
+#else
 			SetThink( &CItem::ComeToRest );
 			SetNextThink( gpGlobals->curtime + 0.1f );
+#endif
 		}
 		break;
 	}
@@ -283,7 +292,11 @@ void CItem::ComeToRest( void )
 	{
 		m_bActivateWhenAtRest = false;
 		AddSolidFlags( FSOLID_TRIGGER );
+#if defined( HL2MP ) && defined( MAPBASE_MP )
+		SetContextThink( NULL, TICK_NEVER_THINK, "ComeToRestThink" );
+#else
 		SetThink( NULL );
+#endif
 	}
 }