Pregabalin Addiction and Abuse

An increasing number of people are treated for addiction to Pregabalin – a drug that has a similar effect to Valium. Doctors in the UK have issued a warning, stating that the risk of addiction is higher with Pregabalin due to its sedative effects and affordability. In 2015, Pregabalin was prescribed more in Northern Ireland than in other parts of the UK. It was also linked to the death of Aaron Strong, a 19-year-old teenager, who died from a cocktail of drugs.

The British Medical Association recently called for Pregabalin to be scheduled as a Class C controlled substance (the same as GHB and Valium). According to Consultant Psychiatrist, Yasir Abbasi, Pregabalin use is widespread throughout the UK. It works like Diazepam by ‘taking the edge off’ and sedating you. It is a growing problem, mostly affecting hard drug users and individuals who received a prescription for chronic pain after a devastating accident.

Due to the novelty of the drug, there is not enough information about its long-term effects. This is especially dangerous when considering that the average recreational user takes up to 3,000mg a day, where the regular dose is around 600mg. That’s five times the regular amount and easily enough for an overdose. The health risk increases when mixed with opioids and powerful substances, such as cocaine.

What Is Pregabalin? An Overview

Pregabalin and Gabapentin belong to a class of drugs known as Gabapentinoids. Pregabalin is a prescription-only medication, used to treat generalised anxiety disorder, neuropathic pain and epilepsy. Researchers found that fatalities involving Gabapentinoids increased to 137 in 2015, from one a year prior to 2009. 79% of those fatalities involved opioids such as heroin. In the United States, the number of hospital visits involving Gabapentinoids increased to 90% in 2008.

A Pregabalin user in the UK explained that he had taken the substance for nine years. On average, he consumes 2,500 mg a day and has been ‘doctor shopping’ and lying to his GP and pharmacist to avoid severe withdrawal symptoms.

Prior to expiration, Pfizer had the patent and sold it under the brand name ‘Lyrica’. When the patent expired, a cheaper version (Pregabalin) became available. According to the BMA’s representative, Dr Mark Pickering, Pregabalin showed up on five death certificates in 2009 and 38 in 2014.

Pregabalin works in the central nervous system to relieve pain and control seizures. It differs from other painkillers by managing pain in patients with fibromyalgia and eases nerve damage from diabetic neuropathy and spinal injury pain.

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What is Pregabalin used for?

Research shows that getting hold of Gabapentin and Pregabalin in the UK is very easy. The drugs are most common amongst heroin users, who add them to their cocktail of drugs and amplify the sedative effects and euphoric ‘high’ of both substances.

Pregabalin is a prescription medication under the class of anticonvulsants for treating nerve damages, shingles, diabetes and fibromyalgia. It is also used to treat epilepsy and restless leg syndrome. Doctors are always careful when prescribing anticonvulsants, because of the risk of abuse and dependence. The increase in the use of Pregabalin has been credited to the dramatic rise in the number of people suffering from diabetes and fibromyalgia.

Nerve-related changes are believed to cause fibromyalgia pain, causing nerve cells to send too many signals, which results in physical pain. Researchers are not sure how Pregabalin improves symptoms, but research findings suggest it calms over-sensitive nerves by reducing the number of nerve signals to alleviate pain.

Chemical Components of Pregabalin

Pregabalin is a central nervous system depressant and GABAergic anticonvulsant. It is a close GABA analogue and binds with high affinity to voltage-gated calcium channels. It doesn’t bind directly to any of the GABA neurotransmitters, opioid receptors or benzodiazepine receptors. They are modifiers of the α2δ subunit that affect GABA.

Animal studies showed that it’s three to ten times more potent than Gabapentin and two to four times more powerful as an analgesic. On an empty stomach, it absorbs rapidly with peak plasma concentration, which occurs within an hour.

Is Pregabalin addictive?

Pregabalin can improve sleep, reduce pain and help people suffering from fibromyalgia regain functions of their daily routine. However, it is an addictive substance, albeit with low potential. Compared to highly addictive substances like heroin and oxycodone, the ‘high’ you get from Pregabalin is less potent, which explains why most heroin users use it to amplify the effect of opioids.

Patients and recreational users might develop tolerance and dependence (on the feelings of euphoria and escape from anxiety and pain the medication offers), but there has been no proof of physical addiction to the substance. However, individuals who have a past history of substance abuse could also develop a psychological dependence on Pregabalin.

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The Legality of Pregabalin

In the UK, Pregabalin abuse is on the rise, with prescriptions being handed out too easily. Fatalities rose to 111 in 2016 and data from the NHS reveals that prescriptions have increased over 11-fold from 476,102 in 2006 to over 5.5 million in 2016. In January 2016, the advisory council on the Misuse of Drugs wrote to the Home Office recommending that Pregabalin and Gabapentin should be reclassified as Class C controlled substances.

This means that there can be no prescription refills and patients can only use the medication for one month. The latter explained the risk of diversion, misuse and addiction. In September 2017, an article in The Guardian stated that Pregabalin would be classified as a Class C controlled substance.

In the United States, 4% of users exhibited euphoria after using Pregabalin during clinical trials. The DEA classified Pregabalin as a Schedule V controlled substance. The FDA has approved it for treating neuropathic pain, partial onset seizures and treatment of fibromyalgia.

How addiction develops

Like most addictions, Pregabalin abuse begins when you like the way the drug makes you feel and depend on that feeling to get you through the day. Pregabalin doesn’t produce a ‘high’ like Oxycodone, but you’ll feel a sense of relaxation and relief from pain. It is the temporary feeling of the absence of anxiety and pain that makes it addictive.

When you continue using Pregabalin or increase your dosage without informing your doctor, you’ll soon build tolerance. Subsequently, the original dosage won’t have any effect on you. At this stage, you should inform your doctor, but most users increase their dosage and continue taking Pregabalin until they develop a dependence on the drug. This means you’ll experience withdrawal symptoms when you stop taking Pregabalin. To prevent the onset of withdrawal symptoms, you’ll continue taking the drug until you become addicted.

Who is at risk of Abusing Pregabalin?

Patients with legal prescriptions: Many people get hooked on pain medication. You might have been in a terrible accident, suffering epilepsy, convulsions, anxiety or insomnia. At first, the side effects might be off-putting, but you grow to like the mild, euphoric ‘high’ and relaxing properties of Pregabalin.

Prisoners: According to the BMA, Pregabalin abuse is prevalent in prisons, where it is traded for cigarettes and other commodities. Prisoners use it to escape mental health issues they might be suffering or to forget about their surroundings for a brief period by feeling the relaxing effects of the drug.

Individuals with a history of substance abuse problems: Research has shown that those with a history of substance abuse have a high potential to become addicted to Pregabalin. Any substance – even with the slightest euphoric qualities – could lead to abuse and addiction.

Mental health issues: Pregabalin is prescribed to treat insomnia and anxiety. If you deal with these mental health conditions, you might self-medicate using Pregabalin. The long-term solution would be to schedule therapy, as the medication is only a short-term answer.

How Is Pregabalin Abused?

When studies were conducted to determine the abusive potential of Pregabalin, it was found to create a feeling similar to that of Valium. It doesn’t act in GABA, opioid or Benzodiazepine receptors, so scientists are curious as to how it produces addiction in humans. If you take this substance for longer than prescribed, you risk building tolerance.

Teenagers who are experimenting with drugs might find it attractive because of the mild addictive effects, but they are a vulnerable category. You abuse Pregabalin if you crush the pill to snort, smoke, chew or inject it directly into your bloodstream. Snorting Pregabalin is a dangerous habit that is not advised, as it damages thin membranes in your nose and destroys your sense of smell.

Signs and Symptoms of Pregabalin Abuse

The first sign of abuse is when you build tolerance for Pregabalin and take higher doses to feel the original effects. People abuse this drug for the euphoric feeling and relaxation they enjoy when taking it. Pregabalin abuse is common amongst young adults and heroin users; it is quickly growing in the UK as a prescription medication, with over five million prescriptions written in 2016 alone.

Signs of Pregabalin abuse include:

  • Visiting multiple doctors to receive several prescriptions (‘doctor shopping’)
  • Neglecting your physical appearance
  • Poor performance at work
  • Neglecting home and family responsibilities
  • Loss of interest in hobbies you enjoyed in the past
  • Using the money set aside for bills and food to buy drugs
  • Appearing relaxed and calm all the time
  • Experiencing short-term memory loss
  • Becoming irritable, hostile and violent when you can’t access Pregabalin
  • Exhibiting poor judgement under the influence of Pregabalin
  • Disrupted sleep patterns
  • Stealing from friends and colleagues at work to buy drugs
  • Inexplicable mood swings
  • Requesting refills from your pharmacist and doctor

If you notice any of these signs in yourself or a loved one, drug rehabilitation treatment is needed to help overcome addiction to Pregabalin. Recovery can help you get your life back and reverse any damage caused whilst under the influence of Pregabalin.

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The health risks of abusing Pregabalin

Pregabalin is a GABA analogue for treating neuropathic pain and partial-onset seizures. Similar to benzodiazepines, the anxiolytic effects occur rapidly, giving it an edge over other medications. In two recent studies, participants who had a history of substance abuse were administered Pregabalin.

In the first study, the patient (a 47-year-old male) was consuming alcohol and cannabis in addition to Pregabalin. When he tried to quit, he experienced vegetative withdrawal symptoms such as arterial hypertension, restlessness, cravings and tremors. Even after detox and treatment, he relapsed almost as soon as he was discharged.

In the second study, a 35-year-old female who had a history of neuropathic abdominal pain was given Pregabalin after she stopped taking opioids for pain relief. Her dosage was the maximum of 600mg. Within two months, she had built dependence on Pregabalin and asked her doctor to increase her regular dosage. When he refused, she went to three different hospitals to source new prescriptions. She was later advised to seek treatment at an inpatient detox centre, but she never went.

In both cases, Pregabalin worked on the reward centre of the patient’s brains to trigger the anticipation of relief, as a result of past experiences with narcotic painkillers and addictive substances. Taking Pregabalin in high doses leads to side effects such as fatigue, poor vision, impaired memories, nausea, vomiting and poor coordination.

Four things you should know about Pregabalin

Pregabalin is not just for treating seizures

When Pregabalin was approved in 2004, it was labelled an anticonvulsant. Today, it is used to treat spinal cord injury, shingles, fibromyalgia and nerve pain from diabetic neuropathy. It slows down brain impulses that cause seizures and affects neurotransmitters associated with sending pain signals throughout the nervous system.

Pregabalin triggers allergic reactions

It’s important you should know about the allergic reactions that can occur when using Pregabalin. Severe side effects include angioedema, swelling of the mouth, face, gums, lips, throat and neck. You might also notice hives, acne, breathing difficulty and rashes.

You might experience suicidal thoughts when taking Pregabalin

An uncommon side effect of taking Pregabalin (or any seizure medication) is suicidal actions and thoughts. This situation occurs in 1 in 500 people. Noticeable behavioural changes include dangerous impulses, worsened depression, panic attacks, restlessness, anxiety and aggression.

Do not use the ‘cold turkey’ method when quitting Pregabalin

You should not abruptly stop taking medications that work in the brain, because this triggers side effects of Pregabalin, which include increased sweating, anxiety, diarrhoea, stomach pain and increased occurrence of seizures.

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Side effects of abusing Pregabalin

More research is needed to determine the physical and psychological signs of abusing Pregabalin. For now, the available scientific results have found there are side effects that can occur when you abuse Pregabalin. This substance induces drowsiness, dizziness and confusion, which increases the risk of accidents and self-harm. Manufacturers advise that breastfeeding women should not abuse Pregabalin, except when the benefit outweighs the risk.

Common side effects of Pregabalin include:

  • Difficulty sleeping
  • Constipation
  • Nausea and vomiting
  • Poor muscle control
  • Flatulence
  • Weight gain

The effects of Pregabalin on the brain and body

A few years ago, scientists reported that Pregabalin was a death sentence for new brain synapses. New research on the long-term effects of abuse revealed a serious cost to health and advocates for the use of natural resources for managing chronic pain.

An editorial in the UK journal Addiction noted that prescription rates rose to 350% and that Pregabalin was ineffective in the majority of cases where it was prescribed. Meaningful pain relief was achieved in less than 20% of patients. Those who suffered from fibromyalgia fared worse than patients looking for pain relief.

A 2006 report in Neurology journal stated that pregnant women who used Pregabalin increased the risk of major birth defects. Pregabalin blocks limb development, normal growth and kill cells by disrupting nerve signals in the embryos.

A 2017 study on animals showed that after three weeks, there was pathological damage present, such as loss of muscle and high levels of inflammatory cells. Recent research findings revealed that Pregabalin treatment shrunk grey matter in the brains of fibromyalgia patients by blocking the production of excitatory neurotransmitter.

Co-occurring disorders

Anxiety: Anxiety disorder is a common co-occurring disorder treated alongside Pregabalin abuse. Research has shown that it is effective in treating Generalized Anxiety Disorder. Current treatments have some drawbacks such as high rate of sexual dysfunction.

Benzodiazepine and alcohol use disorder: Both conditions are severe substance dependence with severe psychological and physical effects. Current research shows that Pregabalin is an effective treatment for withdrawal symptoms in both disorders. However, clinicians have to be careful with a prescription because of the risk of abuse among former recreational users.

Other mental health issues include:

  • Bipolar disorder
  • PTSD
  • Personality disorders
  • Depression
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Pregabalin withdrawal

Pregabalin withdrawal symptoms are uncomfortable and similar to those that surface during withdrawal from benzodiazepines and alcohol. The severity of symptoms and duration of detox depends on the longevity and frequency of your Pregabalin use. If you consumed high doses, withdrawal symptoms might last up to two weeks, while for those who used lower doses, symptoms might fade out within a week.

Acute withdrawal symptoms manifest within 24 hours after your last drug intake and last up to two days. Residual symptoms might linger for several weeks. The onset of withdrawal symptoms has been blamed on tolerance, when the body and brain adjust to the presence of Pregabalin in the body.

As stated earlier, you should not apply the ‘cold turkey’ method to quit Pregabalin. Enrol at a detoxification centre, where you’ll receive professional treatment. Medically-supervised detox is the safest way to undergo withdrawal. Doctors use the tapering process to gradually reduce your regular dose, until all traces of Pregabalin have left your system. If you used other drugs such as heroin, you’ll also experience the related withdrawal symptoms for such substances.

Symptoms of Pregabalin withdrawal

If you were taking Pregabalin for seizures or anxiety, the seizures will likely return more frequently and you might experience rebound anxiety symptoms.

Common withdrawal symptoms include:

  • Seizures
  • Confusion
  • Anxiety
  • Cravings
  • Heart palpitations
  • Nausea and vomiting
  • Agitation
  • Headaches
  • Diarrhoea
  • Suicidal ideation
  • Extreme sweating
  • Mood changes
  • Depression
  • Difficulty sleeping

Medications for treating Pregabalin withdrawal

In addition to the tapering process, doctors might prescribe medication to treat specific withdrawal symptoms, such as:

Clonidine: A medication for treating blood pressure and managing Pregabalin withdrawal symptoms.

Dexmedetomidine: A prescription medication, used when Clonidine is ineffective, because it is expensive and has a potential for hypertension.

Sleeping aids: Insomnia is a common occurrence during Pregabalin withdrawal. Doctors might prescribe non-habit-forming medication, such as Trazodone.

Other medications include:

  • Antidepressants
  • Nausea medication, such as Zofran
  • Anti-convulsants for managing seizures

Treatment and Rehab for Pregabalin abuse

The goal of rehab is to help you maintain lifelong abstinence from Pregabalin. Doctors use information gathered at intake to create a specialised treatment plan for you. After intake, you’ll undergo medical detox to remove Pregabalin from your body. This also manages the onset of withdrawal symptoms.

To treat psychological withdrawal and understand why you abused Pregabalin, doctors at a rehab centre incorporate a range of behavioural therapies during treatment. This includes Dialectical Behavioural Therapy, Motivational Interviewing, Individual counselling and Group counselling.

Pregabalin overdose explained

While research shows that Pregabalin overdose isn’t always life-threatening, the number of related fatalities suggests otherwise. Symptoms of overdose include:

  • Muscle twitching
  • Excessive sleepiness
  • Speech disturbances
  • Confusion
  • Numbness
  • Blurred vision

The breakdown in muscle fibres (some of which are deposited in the kidney) can also lead to kidney damage.

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How to help a loved one who is abusing Pregabalin

The first step is to educate yourself about Pregabalin abuse. Go online and conduct your own research; find out all you can about the causes of addiction, as well as the side effects and signs of abuse. You’ll need the assistance of addiction experts to help your loved one get the best medical care. Call an addiction helpline and a drug counsellor will help you find some of the best rehab centres in the UK.

The important thing with addiction is that the desire and decision to receive treatment has to come from the addict. You can’t force someone to get better. Therefore, be patient, understanding and empathic. After all, no one chooses to be an addict. An interventionist can help you and your family members organise an intervention if all pleas go unanswered. However, be ready to face resistance, because the thought of withdrawal could be the scariest aspect for them.

Pregabalin abuse in the UK

A UK photographer from Brighton shared his Pregabalin addiction story: he received his first prescription six months ago to ease the pain of nerve damage in his hand and to treat anxiety. It made him dizzy and nauseous. Soon, he was taking Pregabalin as a sleeping aid and despite all the earlier side effects, he is currently battling an addiction to the substance.

Julia Buckley (who works at The Independent) was able to stop after six weeks, because she didn’t feel like herself whilst taking Pregabalin. She was constipated, ‘zoned out’ and experienced memory loss and difficult concentrating. The worst aspect was the suicidal thoughts she experienced. She felt like she wasn’t able to control her thoughts or behaviour when taking the drug.

According to Dr Pickering, a BMA representative, the situation is more alarming in prisons. Patients procure prescriptions in smaller towns (where the problem is less known) and smuggle them into prisons, where they are a ‘hot’ commodity. Even worse, prison drug dealers open the capsules and fill them with paracetamol. Inmates who have a legitimate prescription are also forced to sell theirs.


Why is the Pregabalin ‘high’ popular?

It’s hard to give an exact reason why recreational users chase the mild ‘high’ induced by Pregabalin, because it is different from that of other addictions. It mostly happens from overprescribing and is popular in poor areas, where people aren’t able to afford expensive opioids like heroin. Even in countries where prescription is strictly controlled, it seems fairly easy to get source Pregabalin.

How dangerous is Pregabalin Abuse?

Abusing Pregabalin means you’re taking higher doses or for longer periods than prescribed. This increases the risk of experiencing severe side effects, such as seizures, suicidal thoughts, change in blood pressure, and difficulty breathing. You also risk an overdose when you combine Pregabalin with substances like alcohol and heroin.

Can Pregabalin be used legally?

Pregabalin has legal applications. It is used to treat several medical conditions such as fibromyalgia, neuropathic pain, social anxiety disorders, alcohol withdrawal, restless leg syndrome, chronic post-surgical pain and prevention of migraines.

Is Pregabalin a controlled substance?

Pregabalin is a Class C controlled substance in the UK and a Schedule V controlled substance in the United States.

Can I mix Pregabalin with other substances?

Mixing Pregabalin with other drugs such as alcohol, opioids, barbiturates, benzodiazepines and illicit substances can lead to overdose. Most of these substances depress the central nervous system and enhance severe side effects of Pregabalin.

Who is most at risk of abuse?

People at risk of Pregabalin abuse are mostly those who receive a prescription; individuals with related mental health issues such as anxiety and panic disorders; and individuals with a previous history of substance abuse.

What is the difference between Pregabalin and Lyrica?

There might be some confusion between brand names and their generic counterparts. Lyrica and Pregabalin are actually the same. The only difference is the brand name on the box.

Can You Get ‘High’ on Pregabalin?

While Pregabalin doesn’t work on opioid receptors, benzo receptors or GABA receptors, it does induce mild euphoric effects that could lead to abuse.

Which drugs interact with Pregabalin?

Drug interactions include alcohol, benzodiazepines and opioids.

Does Pregabalin show up in urine tests?

In the past, urine tests only detected popular narcotics and stimulants, but newer models might be able to detect Pregabalin.

How can I safely quit Pregabalin?

Consult your family physician for help or enrol at a medical detox facility to receive treatment for physical and psychological symptoms of addiction.

What are the signs of Pregabalin abuse?

Signs of abuse include: neglecting family responsibilities, poor hygiene, mood swings, always looking happy, poor job performance, irritability and restlessness.

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