Pregabalin abuse hazards seen in PWID

Pain

By Michael Woodhead

29 Jun 2020

The abuse potential for the analgesic pregabalin has again been highlighted by a report showing is frequently used by people who inject drugs (PWID), and is often sourced on prescription.

Responses from 905 PWID who participated in the 2018 Illicit Drug Reporting System, indicated that more than 40% had a lifetime history of using pregabalin and 25% had used it within the previous six months.

The survey also showed that 10% of the people reported using pregabalin that was prescribed to them, while 15% had used pregabalin that was obtained illicitly, according to researchers at the National Drug and Alcohol Research Centre (NDARC), UNSW Sydney.

Those using prescribed pregabalin reported daily use, while those using non-prescribed pregabalin reported infrequent use, less than once a month.

The researchers said it was concerning to see suggestions of concomitant use of pregabalin and opioids, a practice that has been shown to almost double the odds of opioid-related death.

Pregabalin use by PWID was also significantly associated with recent use of prescribed benzodiazepines.

“It is therefore important that consumers are made aware of the potential risks of combining opioids and pregabalin or other central nervous system depressants.”

Lead investigator Dr Rachel Sutherland noted pregabalin was licensed for use in neuropathic pain and had become the most widely prescribed analgesics in Australia.

However, the PWID who obtained it illicitly without a prescription did not have symptoms of pain or discomfort.

“It is possible that people reporting non-prescribed pregabalin use are engaging in riskier patterns of substance use, which may put them at greater overdose risk,” warned Dr Sutherland.

“It is important to note that these findings are from a sentinel sample of PWID, and do not represent all people who inject drugs. However, our findings suggest that education campaigns targeting both health professionals and consumers regarding the risks of harm associated with concomitant use of pregabalin and other central nervous system depressants are warranted,” she said.

The findings are published in Drug and Alcohol Review.

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