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Worrying rates of pregabalin use in heroin users

Research from Imperial College London suggests a concerning prevalence of pregabalin (PGL) use in heroin users in the UK.

This study determined the prevalence of gabapentin (GBP) and PGL use in a post-mortem population identified from coroners’ cases in London and South East England between 1 January 2016 and 31 December 2017.

A routine drug screen and a specific screen for GBP and PGL were carried out in the overall cohort and in the subcategories of heroin users and non-heroin users. The prevalence of both drugs was compared with tramadol (Class C drug).

Of 3750 samples analysed, 118 (3.1%) were positive for GBP, 229 (6.1%) for PGL and 120 (3.2%) were positive for tramadol. The most common drug group observed with GBP and PGL was non-heroin-related opioids at 60.2 per cent and 64.6 per cent, respectively.

Of 354 deceased (9.4%) who were heroin users, 6.5 per cent also tested positive for GBP and 19.5 per cent screened positive for PGL. The prevalence of PGL in heroin users was 4.1 times greater than in non-heroin users (P<.0001). GBP and PGL use are being significantly under-reported in fatalities. If routine analysis without additional screening of GBP and PGL had been performed in this cohort, GBP would have been under-reported by 57.6 per cent (P<.0001) and PGL by 53.7 per cent (P<.0001).

The findings support the UK government’s decision to reclassify GBP and PGL as Class C drugs.


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