As announced in October 2018, amendments to the Misuse of Drugs Regulations 2001 and the Safe Custody Regulations 1973 means that Pregabalin and Gabapentin have now officially become class C controlled substances as of 1^st April 2019.

By controlling the usage of Pregabalin and Gabapentin, it’s hoped that the number of overdose-related deaths will decrease.

So what are these drugs used for, and why are people choosing to misuse them?

Pregabalin

Pregabalin is used to treat epilepsy, anxiety and nerve pain. It works in several different ways; it can prevent seizures by stopping the abnormal electrical activity in the brain, it was block pain by interfering with pain messages between the spine and brain, and it stops the brain from releasing chemicals that cause anxiety. It comes in capsule form, is taken 2/3 times a day with or without food, and takes at least a week to work. Side effects can include dizziness, feeling sleepy, and headaches, but these usually go away on their own.

Pregabalin can make users feel relaxed, calm and even euphoric. It can also enhance the euphoric effects of other drugs like opiates. It is recommended that users do not stop taking it abruptly as it may cause anxiety, insomnia, pain, nausea and sweating.

Substantial misuse of Pregabalin has been reported, making it possible that some users may develop dependence, and its use has been implicated in a number of deaths across Europe in recent years.

Gabapentin

Gabapentin is used to treat epilepsy, nerve pain, and migraine headaches. It comes in capsule or tablet form, is taken 3 times a day with or without food, and can take a few weeks to work. It works by changing the way nerves send messages to your brain; if the messages are reduced, the pain will be too. Side effects include drowsiness, fatigue, dizziness and muscle tremors, though most side effects are mild and should go away on their own.

Gabapentin can cause users to feel relaxed, calm and euphoric. Some users comment that taking Gabapentin is similar to taking a stimulant. It can also enhance the effects of other drugs, like opiates. It is also known to cause feelings of depression, anxiety, hostility, and in rare cases, suicidal thoughts and hallucinations.

Gabapentin is difficult to overdose on, but it is regularly misused due to its relaxing effects. It’s also regularly mixed with other drugs like heroin or fentanyl, and this combination is what makes Gabapentin risky and potentially even lethal.

The Law

Illegitimate use of both Pregabalin and Gabapentin has increased over the years and they have both continually been linked to overdose-related deaths.

Under the new law, pharmacists will not be able to repeat dispense the two drugs and will not be able to accept electronic prescriptions. They will also have to dispense the drug within 28 days of a prescription being written. Doctors will have to hand sign prescriptions. Treatments of Pregabalin or Gabapentin will also be limited to 30 days.

The change in the law is expected to prompt a decline in the use of the drugs as prescribing, dispensing and collecting them becomes more difficult for patients, doctors and pharmacists.

However, there are concerns that, despite the new changes lowering the prescription and usage of these drugs, it may push users onto another similar drug. A similar case happened when Tramadol became a controlled substance; it’s what pushed the use of Gabapentin and Pregabalin through the roof, with an increase of 350% over 5 years.