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Pregabalin and gabapentin become controlled drugs to cut deaths from misuse

BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k4364 (Published 16 October 2018) Cite this as: BMJ 2018;363:k4364
  1. Susan Mayor
  1. London

Pregabalin and gabapentin will be reclassified as class C controlled substances in the UK from next April to reduce the growing number of deaths associated with their misuse, the government has said.1

Victoria Atkins, parliamentary under secretary for crime, safeguarding, and vulnerability, said, “Any death related to the misuse of drugs is a tragedy. We accepted expert advice and will now change the law to help prevent misuse of pregabalin and gabapentin and addiction to them.”

Official figures showed that 190 drug related deaths involving pregabalin or gabapentin were registered in England and Wales in 2017.2 Previously, the number of deaths linked to pregabalin increased sharply from four in 2012 to 111 in 2016, and deaths associated with gabapentin rose from eight to 59 over the same period.3

Pregabalin and gabapentin are prescription-only antiepileptic drugs used for treating epilepsy, peripheral and neuropathic pain, and generalised anxiety disorder in adults.

Both drugs are structurally related to the neurotransmitter γ-aminobutyric acid (GABA) and can cause elevated mood, particularly when used in combination with other drugs such as opioids.

The Advisory Council on the Misuse of Drugs raised concerns in 2016 about medical misuse, illegal diversion, and addiction associated with pregabalin and gabapentin. It found that pregabalin prescribing had increased by 350% and gabapentin prescribing by 150% in the previous five years.

The council recommended that the two drugs should be reclassified as class C drugs under the Misuse of Drugs Act, and the government launched a public consultation on the issue.4 This found widespread support among doctors, pharmacists, and patients.

Regulations implementing the law to reclassify pregabalin and gabapentin are due to go before parliament on 17 October and will come into force from April 2019.

With pregabalin and gabapentin as class C drugs, doctors will have to physically sign prescriptions for them rather than issuing electronic prescriptions. And pharmacists will need to dispense the drugs within 28 days of a prescription being written.

The change will mean that it will be illegal for people to possess pregabalin or gabapentin without a prescription. It will also be illegal to supply or sell the drugs to others.

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