Mar 13,2024
By Harry Sumnall, Liverpool John Moores University and Ian HamiltonHonorary Fellow, Department of Health Sciences, University of York
New York: There has been a significant rise in deaths linked to the commonly prescribed anxiety drug, pregabalin. While in 2018 there were 187 deaths linked to pregabalin in England and Wales, this number was more than double in 2022 – with 441 deaths linked to the drug.
Recent press reports have framed these deaths as signalling a “US-style opioid epidemic” caused by a medicine that “destroys lives”. This is not an equitable comparison, given hundreds of thousands of Americans have died due to opioids. These reports may only serve to cause undue panic about the drug, especially among those who have been prescribed it.
Pregabalin (also known by the brand names 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 US in 2004.
Pregabalin has rewarding properties, and can produce feelings of euphoria, calmness and relaxation. These effects may explain why even people who don’t have a prescription seek out pregabalin.
Pregabalin on its own is typically not dangerous, although as with all medication there are potential side effects – including confusion and headaches. It can also carry the risk of dependence, especially if taken long term.
But where pregabalin can become dangerous, whether used as prescribed or not, is if it’s taken alongside other drugs that it interacts negatively with. Pregabalin should ideally be avoided alongside other opioids, certain sleep aids, benzodiazepines (another class of anxiety drug), muscle relaxants and even certain diabetes and epilepsy drugs.
Most fatalities attributed to pregabalin are due to interactions with other drugs, leading to a suppression of breathing.
An analysis of pregabalin deaths in England between 2004-2020 has shown that in over 90 per cent of deaths, the presence of other opioids (including methadone or morphine) was detected. However, in only a quarter of cases were these opioids actually prescribed to the person.
This suggests that people were probably sourcing these drugs through illicit means and not through their doctor. Likewise, it’s not clear from the data whether pregabalin had been prescribed, or if the person sourced it without a prescription.
Although this data only goes up to 2020, it’s likely that the picture is similar for the recent deaths linked to pregablin.
Source: Healthworld