[ad_1]
There has been a significant increase in deaths related to the commonly prescribed anxiety drug, pregabalin. While there were 187 pregabalin-related deaths in England and Wales in 2018, this figure was more than double in 2022, with 441 drug-related deaths.
Recent press reports have framed these deaths as a sign of “American-style opioid epidemic“caused by a medication that”destroy lives“. This is not a fair comparison, given hundreds of thousands of Americans have died from opioids. These reports may only serve to cause undue panic about the drug, especially among those for whom it has been prescribed.
Pregabalin (also known by the brands Lyrica and Alzain) is used to treat a variety of health conditions, including epilepsy, nerve pain, and anxiety. The drug was first approved for use in Europe and the United States in 2004.
Pregabalin has rewarding propertiesand can produce feelings of Euphoria, calm and relaxation.. These effects may explain why even people without a prescription seek pregabalin.
Pregabalin on its own is not usually dangerous, although as with all medications, there are possible side effects – including confusion and headaches. You can also carry the dependency riskespecially if taken long term.
But where pregabalin can become dangerous, either used as prescribed or notis if taken together other drugs with which it interacts negatively.
Pregabalin should ideally be avoided along with other opioids, certain sleeping pills, benzodiazepines (another class of pain relievers), muscle relaxants, and even certain medications for diabetes and epilepsy. Most deaths attributed to pregabalin are due to interactions with other drugs, which cause suppression of breathing.
An analysis of pregabalin deaths in England between 2004-2020 has shown that the presence of other opioids (including methadone or morphine) was detected in more than 90 percent of deaths. However, only in a quarter of cases were the person prescribed these opioids. This suggests that people were probably obtaining these medications through illicit means and not through their doctor. Likewise, it is not clear from the data whether pregabalin had been prescribed or whether the person obtained it without a prescription.
Although this data only goes through 2020, the picture is likely to be similar for recent pregablin-related deaths.
Deaths
The recent rise in deaths from pregablin coincides in part with an increase in the number of people being prescribed the drug. Only in the United Kingdom there was 8.4 million recipes for pregabalin in 2022. This represents an increase from 5.5 million in 2016.
This may suggest that more support is needed to reduce patients’ risk, particularly in relation to co-use of other medications. Both prescribers and patients needs to be educated about the potential risks of using pregabalin, including dependency potential. Patients and doctors should also be aware of the drugs that pregabalin interacts with and the effects such combinations may have.
Prescribers must also review periodically pregabalin to ensure that patients are still benefiting from it. Otherwise, recommend other treatments, such as psychological therapiesIf a person is taking medication for anxiety, it might be more suitable.
But in light of the profile of drugs involved in deaths previously linked to pregabalin, it is clear that drug education alone will not be enough.
Certain groups may be at higher risk of harm from pregabalin. For example, people with a history of substance use disorder have a high level of concurrent mental health problems and may be prescribed pregabalin as a short-term treatment for anxiety.
But because support for mental health and drug treatment is usually provided by different servicesLack of communication between these services can sometimes mean that one service is not always fully aware of what medicines the other is prescribing, which could lead to harmful drug interactions.
Evidence also suggests that illicit use of pregabalin is a Growing problem in both Europe and North America. Is availability as a street drug It may mean that users are not aware of the risks of taking pregabalin along with other drugs, such as the synthetic opioid methadone.
There is the added complication of fear of negative consequences. Someone who has been prescribed pregabalin and uses illicit drugs cannot tell their doctor. People who use illicit opioids less frequently (for example, recreationally or to self-treat pain or mental health problems) are also at higher risk. high risk.
The evidence also shows that more people living in the northern england are prescribed pregabalin compared to those living in the south. Other research has also shown a link between social deprivation and medication prescription – People living in more deprived areas of England are prescribed drugs such as pregabalin at higher rates. Those living in disadvantaged areas may not receive the support they need, including support to understand the risks of taking or combining certain drugs, putting them at greater risk of harm.
Understanding exactly why these deaths occur is important for developing strategies to reduce drug harms and deaths. Simply stopping pregabalin prescriptions does not seem practical or safe, as it is considered a useful and effective medicine from which many people benefit. Imposing stricter restrictions on illicit pregabalin would also be impractical and could even lead to greater harm, which is exactly what happened after it became a Class C drug in 2019.
Understanding why people combine pregabalin with other medications, prescription or over-the-counter, is crucial to achieving anything meaningful.
Ian HamiltonHonorary Member, Department of Health Sciences, York University and Harry SumnallSubstance Use Professor, Liverpool John Moores University
This article is republished from The conversation under a Creative Commons license. Read the Original article.