A recent multicentric study conducted across Punjab and Chandigarh has brought to light a significant issue of non-medical use and dependence on Pregabalin among individuals undergoing treatment for substance-use disorders. The findings have prompted urgent calls for clinical and policy interventions to address this growing concern.
Study Overview
Pregabalin is a prescription medication primarily used for neuropathic pain, epilepsy, fibromyalgia, and generalized anxiety disorder. The study, led by doctors from multiple medical colleges, analyzed 974 valid responses out of 1,002 from patients aged 18 to 70 with substance-use disorders. The research covered regions including Bathinda, Chandigarh, Amritsar, and Patiala, encompassing the Malwa, Majha, and Doaba areas.
Key Findings
The results revealed that 44.6% (435 patients) reported non-medical use of pregabalin, while 24.8% (242 patients) met the criteria for dependence syndrome. Additionally, 19.8% (193 patients) were identified as non-dependent users engaging in non-medical use. Notably, none of the participants reported use of Gabapentin, another prescription anticonvulsant used for neuropathic pain and seizures.
The study population was predominantly male (98.3%), with an average age of 34.5 years. A majority came from rural areas (62.7%), were married, self-employed, and had over 10 years of education. Opioid-use disorder was the most common condition, affecting 67.8% of participants, followed by alcohol-use disorder at 25.3%. Tobacco-use disorder was also prevalent, present in 49.8% of cases.
Reasons for Use
Participants cited various reasons for using pregabalin: relaxation (16.8%), pain relief (12.1%), euphoria (9.3%), enhancing other substances (3.3%), inducing sleep (3%), or relieving anxiety (1.6%). A combination of these reasons was reported by 46.8% of users. In some cases (6.9%), use was linked to the unavailability of heroin or lack of funds for primary substances.
Access and Consumption
Access to the drug remains a concern, with 73.5% of users procuring pregabalin from licensed chemists without a legible prescription. Friends introduced 61.4% of users to the drug. Most consumed it once or twice daily, with doses ranging from 300 mg to 2,400 mg, although 12% reported exceeding 2,400 mg per day.
Clinical Risks
The study highlighted clinical risks, including epileptic seizures linked to pregabalin use in 7.8% of participants. Higher frequency, larger doses, and seizure incidence were significantly associated with dependence. Younger individuals were more likely to use pregabalin, with increasing age linked to lower odds of use.
Expert Recommendations
The research team, including Dr. Jitender Aneja, Dr. Neeru Bala, Dr. Ajeet Sidana, and others, described the findings as an early indication of a growing problem. Published in Substance Abuse Treatment, Prevention, and Policy, the study calls for increased vigilance among healthcare providers and policymakers. Recommendations include systematic screening for non-medical use, development of treatment protocols, and policy measures to curb drug diversion. Further research and reliable detection methods through blood or urine testing are also needed.
Conclusion
The findings underscore a concerning trend, with nearly half of treatment-seeking substance-use disorder patients misusing pregabalin and nearly one in four showing signs of dependence. Urgent coordinated clinical and policy responses are required to address this issue effectively.
