Popular pain medication linked to an increase in overdoses, suicides

Experts now say that there is increasing evidence that vulnerable people become addicted to it and that it is being abused by drug users and traded on the black market.

Since it was mentioned in 2013 on the PBS for nerve pain, subsidized recipes have gone from 322,078 in 2012-13 to 4.07 million scripts in 2017-18, for more than 633,000 patients. It is now one of the most expensive drugs for the Australian taxpayer.

"It was initially marketed with low potential for abuse," said Professor Nicholas Buckley, professor of clinical pharmacology at the University of Sydney.

"But the warning signs were almost there from the beginning and reportedly caused euphoria as a side effect."

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Packages containing 20 Lyrica capsules can now be found on dark-web markets advertised for about $ 120. The Therapeutic Goods Administration (TGA) is finalizing an investigation into the question of whether any regulations should be made about the pregabalin abuse.

The age can also reveal that pregabalin has also been linked to dozens of cases in which patients who use it have developed suicidal thoughts.

The TGA has registered six suicides since 2012, involving pregabalin as a factor, including the death of a 54-year-old man in 2014, in addition to another six suicide attempts, although the TGA noted that there may not be a link to these side effects and the medicine.

The reported side effects of Lyrica indicate that it doubles the risk of suicidal thoughts or behavior compared to a placebo. For each 530 treated patients an additional person can experience suicidal thinking or behavior.

Professor Chris Maher, director of the Institute for Musculoskeletal Health at the University of Sydney, was recently involved in a study investigating whether pregabalin could reduce the intensity of back and leg pain, sciatica.

He said he nearly canceled the trial after patients complained about developing sudden suicidal tendencies.

"Some people in the trial said to us:" I do not know what this drug is, but I am beginning to think about it and I have never had such thoughts, "said Professor Maher.

Professor Maher says the drug has been marketed to GPs as a safer and more effective alternative to opioids for patients with nerve pain.

Pregabalin has been used for years as a successful anti-epileptic. It is assumed to work by blocking certain nerve signals, although the exact method of operation is unknown.

In 2013, Pfizer was successful in applying for the drug to be included in the Pharmaceutical Benefits Scheme for the treatment of neuropathic pain (nerve pain).

"The safety of our medicines is of paramount importance to Pfizer," said a spokesperson for the company in a statement.

He said that the product information documents for physicians and consumers "clearly indicate that patients should be carefully assessed for a history of substance abuse and observed for signs of misuse and abuse".

"The conditions in which pregabalin is indicated can be chronic and incapacitating and have a significant impact on the lives of patients and their families," said the spokesman.

"It is important to note when properly prescribed and administered … pregabalin is a very important treatment option for many people living with chronic neuropathic pain and epilepsy."

However, the medicine, also called "bud", "gabby" or "slows", is increasingly being brought to the attention of paramedics and other health professionals for the wrong reasons.

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A new report published in the Medical Journal of Australia on Monday revealed that the number of ambulances with pregabalin since 2012 more than tenfold in Victoria, with more than 1200 callouts between January 2012 and December last year.

Many of those who had had an overdose had taken pregabalin with other sedatives, including alcohol, painkillers and benzodiazepine, such as valium.

The head of the Penington Institute, John Ryan, said that this combination of drugs was particularly dangerous.

"It makes a multiplier effect … slowing people's breathing and resulting in so-called inadequate oxygen that they can actually die," he said.

Ryan also warned that a sudden withdrawal of the drug can be risky and that people need medical advice to slow down their use.

One of the main concerns of investigators investigating abuse is evidence that it falls into the hands of people who may be particularly vulnerable to addiction or abuse – with a history of depression, self-harm, suicide or drug use, which means it had been inappropriate to write them in the first place pregabalin.

One study estimated that more than half of the government subsidies on pregabalin (which reached $ 154 million in 2016-2017) were spent on providing the drugs to these "high-risk users".

For help call Lifeline at 131 114.

Liam is the science reporter of Fairfax Media

Aisha Dow reports on health for The Age and is a former city reporter.