The sharp increase in deaths associated with the commonly prescribed anxiety drug, pregabalin, is a cause for concern. In 2018, there were 187 reported deaths related to pregabalin in England and Wales. Shockingly, this number more than doubled by 2022, with 441 deaths linked to the drug. Recent media reports have drawn comparisons to a “US-style opioid epidemic,” painting a dire picture of a medicine that “destroys lives.” However, this may be an exaggeration, as the number of fatalities caused by opioids in the US is in the hundreds of thousands. Such sensationalized reports could lead to unnecessary panic among individuals who rely on pregabalin for medical reasons.
Pregabalin, known by the brand names Lyrica and Alzain, is commonly prescribed to treat various health conditions, including epilepsy, nerve pain, and anxiety. Approved for use in Europe and the US in 2004, pregabalin is known for its rewarding properties, producing sensations of euphoria, calm, and relaxation. These effects may attract individuals without prescriptions to seek out pregabalin for recreational use. While pregabalin on its own is generally safe, like all medications, it carries potential side effects such as confusion and headaches. Moreover, there is a risk of dependency, especially with long-term use. The real danger lies in the interactions pregabalin can have with other drugs, potentially leading to life-threatening consequences.
Pregabalin can become dangerous when combined with other substances, whether prescribed or not. It should not be used alongside opioids, certain sleep aids, benzodiazepines, muscle relaxants, or specific diabetes and epilepsy medications. Most deaths attributed to pregabalin involve interactions with other drugs, resulting in respiratory suppression. Analysis of pregabalin-related deaths in England from 2004 to 2020 revealed that over 90% of cases involved the presence of opioids like methadone or morphine, with a quarter of individuals not having prescriptions for these substances. This indicates that many people might be obtaining these drugs through illicit means, posing a significant risk to their health.
The recent surge in pregabalin-related deaths aligns with an increase in prescriptions for the drug. In 2022, the UK alone witnessed 8.4 million prescriptions for pregabalin, a significant rise from 5.5 million in 2016. To mitigate the risks associated with pregabalin use, both healthcare providers and patients must be educated about the potential dangers and interactions of the drug. Regular reviews of pregabalin prescriptions are crucial to ensure that patients still benefit from the medication, recommending alternative treatments if needed. However, simply relying on drug education is insufficient, as certain groups are particularly vulnerable to the harms of pregabalin.
Individuals with a history of substance use disorder and mental health issues are at a higher risk of experiencing harmful drug interactions with pregabalin. The lack of communication between mental health and drug treatment services can lead to unintended consequences when prescribing medications. Illicit use of pregabalin is also on the rise in both Europe and North America, increasing the likelihood of unaware users combining the drug with other substances like methadone. Additionally, individuals living in deprived areas face higher rates of pregabalin prescriptions, highlighting the need for enhanced support and awareness of drug risks.
Understanding the underlying reasons for the escalating death rates linked to pregabalin is essential in developing effective harm reduction strategies. Merely halting pregabalin prescriptions or imposing stricter regulations on illicit distribution may not be the most viable solutions. Instead, a comprehensive approach that focuses on educating both prescribers and patients, monitoring medication use, and fostering communication between healthcare services is imperative. By addressing the root causes of pregabalin-related deaths, meaningful progress can be made towards safeguarding individuals from the dangers of this medication.
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