From Pulse, 26 January 2016. Story by Caroline Price.
The prescription drugs gabapentin and pregabalin could soon be more tightly regulated in the UK, after Government advisors called for them to be classed as controlled drugs.
The plan – which would see gabapentin and pregabalin categorised as ‘Class C’ drugs and placed under schedule 3 prescribing regulations – would mean the drugs cannot be repeat dispensed and prescriptions will only be valid for one month.
The move comes after increasing concerns over recreational use of the drugs, particularly amongst the opioid abusing population, and a rise in deaths related to their misuse.
In a letter to Home Office ministers, Professor Les Iverson, chair of the Advisory Council on the Misuse of Drugs, noted that Office for National Statistics data on deaths related to drug poisoning had recorded a ‘significant increase in deaths from 2012 onwards’.
This included 38 deaths where pregabalin was mentioned on the death certificate and 26 where gabapentin was mentioned.
The letter added that ‘pregabalin and gabapentin present a risk of addiction and a potential for illegal diversion and medicinal misuse’ and recommended that both drugs ‘are controlled under the Misuse of Drugs Act 1971 as Class C substances, and scheduled under the Misuse of Drugs Regulations 2001 (as amended) as Schedule 3’.
It comes after NHS England and Public Health England issued advice to GPs and other prescribers urging caution with the drugs, particularly where a patient may have a history of drug misuse.
RCGP prescribing advisor Dr Martin Duerden, a GP in North Wales, said the move would mainly affect users, as it will become an offence to carry either drug unless they are obtained through prescription, but that GPs ‘may need to be more circumspect in terms of carefully checking for appropriate use, and not writing prescriptions for large quantities’.
Dr Andrew Green, chair of the GPC’s clinical and prescribing subcommittee, said he ‘would support the move’.
Dr Green said: ‘All GPs will recognise the problems described in the submission, pregabalin in particular has huge potential for abuse and dependency.’
However, Pfizer, which markets both gabapentin and pregabalin, said it ‘strongly disagreed’ with the plans, which it said was based on ‘potentially misleading information’ that could impact negatively on patients.
In a statement, the company said: ‘We strongly disagree with this and are extremely concerned about the negative impact this recommendation, if adopted, could have on many patients living with chronic neuropathic pain, generalised anxiety disorder and epilepsy.’
The statement added: ‘We are concerned that the advice contains a number of inaccuracies and some potentially misleading information, and is contrary to the totality of the safety data available for pregabalin and gabapentin.
‘Controlling the supply of these products across the whole UK, would be a disproportionate measure that would impact on patients and their quality of life, and could also result in additional economic and operational burden on an already strained healthcare system.’
Correction: This story was changed on 27 January 2016 to indicate that under schedule 3 regulations drugs cannot be repeat dispensed (not prescribed)
In the last 2 months I mistakenly reduced my dose of Pregabalin, by 2 thirds and only 3 weeks ago, I felt so much better in myself e.g. clear head, better sleep etc. I was prescribed this drug by my pain consultant for neuropathic pain.
This week I will finish with them altogether on his advice. I have not suffered more with the pain even though it is still there and do feel better for doing the reduction.
It is early days for judging the long term effects of living with pain and without Pregabalin, but thought it worth mentioning, as having to do without has not been unbearable and the dizziness after reducing the dose was acceptable.
Of course we are all different and must assess ourselves on this issue. Mine is a positive story so far and thought it worth telling to help stop anxiety if people who suffer from neuropathic need to change their prescription in future.
Well, that’s me stuffed! I’ve been on gabapentin for neuropathy for some time now, it’s worked well but I’ve struggled with some of the side effects. My GP switched me to Pregabalin a month ago, but the side effects are even worse, so I’m going back to gabapentin. Without this drug, I won’t be able to walk more than a few steps, or use my left arm at all.
Sorry to hear this ShirleyP. Do we know what will replace these drugs to help people in pain please?
Ive joined this to comment, In 2010 i was diagnosed with a neurological issue and put on to pregabalin. I was on a mere 300mg a day to start and after year one i was put up to a massive 900mg a day. About a month ago i went to see my GP and he stopped the pregabalin and said they are trying to ban it. Im now on 1200mg of gabapentin. I was called to my GP this week to say they are now thinking of stopping this also as the other.
My reason for comment is ive been so lucky apart from the first few weeks when i was drugged up with both the above ive had no more issues. Ive been fine on both drugs lucky.
This has really upset me because ive been told by an official that these are the only two type of drugs that help with the neurological issues i have. Which means if its banned i will be screwed.
They are not actually looking to ban either drug. What it would mean is they become a controlled medications, with tighter prescription restrictions, such as; reducing the amount made available in any one prescription and not allowing them to be available on repeats. Meaning you would have to visit the doctor each time to renew.
What your GP seems to have informed you with regards to Pregablin is also false. They are not looking to outright ban Pregablin, again just add it to the controlled drugs list. From what I do know, Pregablin being a newer medication -costs around 8 times the amount to produce than Gabapentin. Because of this GP’s are being squeezed into getting as many patients off of Pregablin and on to Gabapentin in an effort to cut overall medication costs on the NHS budget.
I wouldn’t be to worried about them completely cutting you off, providing your a suitable case study. If your GP does however and you find yourself struggling to even function, my advice would be to find another GP practice in your area who is willing to prescribe you at least Gabapentin.