Deaths from a Popular Anxiety Medication Surge in the UK
There has been a significant surge in deaths linked to the widely prescribed anxiety medication, pregabalin. In 2018, there were 187 fatalities related to pregabalin in England and Wales. However, by 2022, this number had more than doubled to 441 deaths associated with the drug.
Recent media coverage has portrayed these deaths as indicating a “US-style opioid epidemic” caused by a medication that “ruins lives.” However, this comparison lacks fairness, considering the hundreds of thousands of deaths in the United States due to opioids. Such reports might unnecessarily stir panic about the medication, particularly among those prescribed it.
An Overview of Uses and Approval
Pregabalin, marketed under brand names such as Lyrica and Alzain, treats various medical conditions, including epilepsy, neuropathic pain, and anxiety. It received approval for use in Europe and the United States in 2004.
Pregabalin possesses rewarding effects, inducing sensations of euphoria, tranquility, and relaxation. These effects may clarify why individuals without prescriptions seek it out.
While pregabalin by itself is generally safe, like all medications, it carries potential side effects such as confusion and headaches. There’s also a risk of dependency, especially with long-term usage.
The danger of pregabalin, whether used as directed or not, arises when it’s combined with other drugs it interacts adversely with.
Precautions and Drug Interactions with Pregabalin
Ideally, pregabalin should not be taken alongside opioids, certain sleep aids, benzodiazepines (another type of anxiety medication), muscle relaxants, and even specific diabetes and epilepsy medications. Most fatalities linked to pregabalin stem from interactions with other drugs, leading to respiratory suppression.
An examination of pregabalin-related deaths in England spanning from 2004 to 2020 reveals that in more than 90 percent of cases, other opioids (such as methadone or morphine) were present. However, only a quarter of these cases involved prescribed opioids, indicating that individuals likely obtained these drugs through illicit channels rather than from medical sources. Similarly, the data does not clarify whether pregabalin was prescribed or obtained without a prescription.
While this analysis covers data up to 2020, it’s probable that the trend persists in recent deaths associated with pregabalin.
The recent increase in pregabalin-related fatalities somewhat coincides with a surge in the number of individuals prescribed the medication. In the UK alone, there were 8.4 million prescriptions for pregabalin in 2022, a notable increase from 5.5 million in 2016.
Addressing Risks and Educating Stakeholders on Pregabalin Use
This trend suggests a need for enhanced support to mitigate patient risks, particularly regarding concurrent use of other medications. Both prescribers and patients require education regarding the potential hazards associated with pregabalin use, including the risk of dependency. It’s also crucial for patients and prescribers to understand the medications that interact with pregabalin and the potential consequences of such combinations.
Prescribers should regularly review pregabalin prescriptions to ensure patient well-being, considering alternative treatments like psychological therapies for anxiety if necessary. However, solely relying on drug education might not suffice, given the medications involved in previous pregabalin-related deaths.
Certain groups, like those with a history of substance use disorder, face elevated risks. Coordination gaps between mental health and drug treatment services may lead to harmful interactions, especially for individuals prescribed pregabalin for short-term anxiety relief.
Illicit pregabalin use is on the rise, with users often unaware of the risks when combined with substances like methadone. Additionally, fear of repercussions might deter patients from disclosing illicit drug use to their healthcare providers, putting occasional illicit opioid users at increased risk.
Geographical Disparities in Pregabalin Prescription Rates and Socioeconomic Impact
Research indicates that a higher proportion of individuals residing in northern England receive pregabalin prescriptions compared to those in the south. Additionally, studies have linked drug prescribing patterns to social deprivation, with residents of more deprived areas in England receiving prescriptions for drugs like pregabalin at higher rates. Individuals in deprived areas may lack the necessary support to understand the risks associated with taking or combining certain medications, thus increasing their vulnerability to harm.
It’s essential to comprehend the underlying reasons for these deaths to develop effective strategies for reducing harm and fatalities associated with the drug. Simply discontinuing pregabalin prescriptions isn’t feasible or safe, given its recognized usefulness and effectiveness for many individuals. Implementing stricter regulations on illicit pregabalin also presents challenges and may exacerbate harm, as evidenced by the outcome following its classification as a Class C drug in 2019.
Understanding the motivations behind the concurrent use of pregabalin with other medications, whether prescribed or not, is vital for meaningful intervention.
Read the original article on: Science Alert
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