prescription drugs
Drug-related deaths linked to pregabalin and gabapentin have risen 2,675 per cent and 637 per cent respectively in just six years . Addaction believes the risk of addiction and overdose related to these two prescription drugs hasn ’ t been made clear enough , particularly where they are prescribed to people with a history of substance misuse . Death rates have risen even more rapidly than those related to new psychoactive substances ( NPS ), which in the same time period show an increase of 123 per cent .
The ACMD advised government that pregabalin and gabapentin prescribing in the UK has increased by 350 per cent and 150 per cent respectively in five years , and an increasing number are also being bought and sold on the streets . The government has just confirmed that they will become class C drugs , subject to consultation . The medicines can depress the central nervous system causing sedation and reduced breathing . So if someone is already taking substances that depress the central nervous system , including alcohol , opioids like heroin , or benzodiazepines like diazepam , they will be more prone to overdose .
Addaction pharmacists and doctors are asking for more guidance to be given to prescribers , including GPs , about how the drugs can be prescribed more safely , particularly for people with a history of
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Death rates have risen dramatically for prescription drugs pregabalin and gabapentin . Let ’ s be aware of the risks , says Clare Kingsbury-Bell
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Drug-related deaths linked to pregabalin and gabapentin
Pregabalin Gabapentin substance misuse . The drugs were first prescribed for the treatment of epilepsy . Their use was then extended to include general anxiety disorders and soon they were recognised as useful in the treatment of chronic and neuropathic pain .
‘ That ’ s when they took off in terms of prescriptions because a chronic pain with a neuropathic element is difficult to manage with medication ,’ says Addaction pharmacist , Rachel Britton . ‘ They were marketed as drugs that could reduce the need for strong opiates . GPs were encouraged to use pregabalin and gabapentin in guidance about how to manage chronic pain , where we were seeing the use of long-term , high-dose opiates .
‘ It was then , four or five years ago , that we started hearing that , particularly in prisons , these drugs had a street value and people were using them illicitly . Drug users recognised them as another way of altering their state of mind and started using them in a similar way to benzodiazepines .’
She advises that prescribing of pregabalin and gabapentin needs to be done with the same caution as for benzodiazepines . This should include careful medication review to ensure that patients are getting benefit in terms of their chronic pain , and ensuring that the medication is not being overused . ‘ I would strongly caution against the use of these drugs in patients with a history of substance misuse ,’ she adds .
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‘ I ’ ve had clients who say their GP started them on a prescribed dose , they then started buying them on the street ...’
Ben Sessa , consultant psychiatrist at Addaction , draws strong comparisons between pregabalin and gabapentin and benzos , including the addictive qualities .
‘ The original suggestion that they don ’ t have abuse potential is not correct ,’ he says . ‘ Similar to benzos they have a very clear dependence risk with formal symptoms if you stop taking them including anxiety , agitation and physical symptoms including tremors , sweating and insomnia .
‘ I ’ ve had clients who say their GP started them on a prescribed dose , they then started buying them on the street and now can ’ t stop without getting severe physical symptoms . A medical detox of these drugs is incredibly slow and can take up to nine months if the dose is high . Talking with colleagues , we ’ re all seeing the same thing .’
Those taking pregabalin or gabapentin in line with professional medical advice are cautioned not to make any changes without first speaking to a healthcare professional .
If you have any queries , please use our free web chat facility or get in touch with your nearest service via www . addaction . org . uk
Clare Kingsbury-Bell is interim head of communications at Addaction
12 | drinkanddrugsnews | October 2017 www . drinkanddrugsnews . com