Combining opiods and pregabalin potentially risky

The use of pregabalin (brand name Lyrica), a medicine for neuropathic pain, is relatively common among a sample of people who regularly inject drugs (PWID) in Australia, a new study by researchers at the National Drug and Alcohol Research Centre (NDARC), UNSW Sydney has found.

In a sample of 905 participants from the 2018 Illicit Drug Reporting System, it was identified that 25 per cent of PWID reported using pregabalin in the previous six months.

Lead author, Dr Rachel Sutherland said; “10 per cent of the sample reported using pregabalin that was prescribed to them, while 15 per cent reported using pregabalin that was not prescribed to them.”

“Those using prescribed pregabalin reported daily use, whilst those using non-prescribed pregabalin reported infrequent use (i.e. less than once a month),” said Dr Sutherland.

Recent use of prescribed benzodiazepines and non-prescribed pharmaceutical opioids was associated with both prescribed and non-prescribed pregabalin use.

This is concerning in light of a recent study in Canada that found concomitant use of pregabalin and opioids almost doubled the odds of opioid-related death.

“It is therefore important that consumers are made aware of the potential risks of combining opioids and pregabalin or other central nervous system depressants.”

In this study, recent use of non-prescribed benzodiazepines and illicit stimulants were significantly associated with non-prescribed pregabalin use, as was past-year non-fatal overdose for any substance.

“It is possible that people reporting non-prescribed pregabalin use are engaging in riskier patterns of substance use, which may put them at greater overdose risk,” said Dr Sutherland.

“It is important to note that these findings are from a sentinel sample of PWID, and do not represent all people who inject drugs. However, our findings suggest that education campaigns targeting both health professionals and consumers regarding the risks of harm associated with concomitant use of pregabalin and other central nervous system depressants are warranted,” said Dr Sutherland.

The study is published in Drug and Alcohol Review.

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