Pregabalin misuse, poisoning in the spotlight


hospital staff wheel away empty gurney

One in seven Australians prescribed pregabalin are at risk of misusing the substance, new research has shown

Conducted by researchers at the NSW Poisons Information Centre, the University of Sydney and other universities, the research revealed that poisonings increased from zero in 2005 to 376 in 2016.

Since pregabalin was listed on the PBS in 2013, dispensing of the drug jumped from 132,012 dispensings in 2013 to 352,945 in 2016.

“Our study shows a clear correlation between the rapid and continuous rise of pregabalin dispensing and an increase in intentional poisonings and deaths associated with pregabalin since it was listed on the PBS in 2013,” says lead author and Specialist in Poisons Information at the NSW Poisons Information Centre, Dr Rose Cairns.

Pregabalin is now ranked sixth in the top subsidised drugs in Australia.

Since the introduction of pregabalin into Australia in 2005, there have been 88 recorded deaths associated with the drug in NSW – 82 of which were recorded after the 2013 approval of PBS subsidy for pregabalin.

The majority of pregabalin-associated deaths occurred in young, unemployed males who had a history of prior substance abuse, particularly with opioids, benzodiazepines, alcohol and illicit drugs.

“We believe that Australian doctors may not be aware of the abuse potential of pregabalin,” Dr Cairns says.

“Most patients who are prescribed this medication are in the older population but the group who are at high risk of overdosing are much younger. These people are likely to have been prescribed pregabalin despite having a history of substance abuse.”

According to data analysed from toxicology unit databases, up to two-thirds of people who intentionally misused pregabalin had a prior documented substance abuse history.

“Prescribers need to consider this growing body of evidence that pregabalin has abuse potential before prescribing, especially to patients with substance abuse history,” Dr Cairns says.

The recommendation has been made for prescribers to consider completing a risk assessment for misuse of pregabalin and to use precautions when prescribing other pharmaceuticals with an abuse potential.

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