By Emily Stearn, Health Reporter and Stephen Matthews Health Editor For Mailonline
17:52 04 Mar 2024, updated 18:21 04 Mar 2024
Mounting fears over opioids and benzodiazepines have seen doctors increasingly dole out a supposedly ‘safer’ painkiller to Brits battling anxiety, epilepsy and nerve pain.
Yet evidence now suggests pregabalin, widely thought to be less addictive than its alternatives, may be just as dangerous.
Tens of thousands of Brits take the prescription-only drug, nicknamed ‘Valium on steroids’ and the ‘new Xanax’ by doctors aware of its powerful effects.
NHS chiefs themselves acknowledge it can make users feel like a ‘zombie’.
Amid rising prescription rates, MailOnline analysis shows that one in 25 residents in parts of the country are now taking gabapentinoids — a family of pain medications that includes pregabalin.
This is despite campaigners calling for guidelines of ‘GABAs’ to be changed so their usage is restricted because of their addictive nature, just like with benzos.
Such warnings concern the drugs’ use for pyschiatric disorders, not for nerve pain and epilepsy. Critics claim there’s no good evidence to support the use of the drugs in the long-term to treat anxiety.
The drugs can cause unpleasant side effects, including weight gain and memory problems.
They are reported to cause significant withdrawal symptoms including nerve pain, anxiety, sleep problems, nausea and excessive sweating. Renowned psychiatrists claim valium is ‘easier to get off’.
Deaths linked to the drug have also soared 100-fold in a decade amid its increasing usage — a bigger rise than any other substance, including cocaine, heroin and even cannabis.
Pregabalin, sold under the brand names Lyrica, Alzain and Axalid, has been linked to nearly 3,400 deaths in Britain in the last five years.
This includes 779 fatalities in 2022 — up from just nine a decade earlier in 2012.
Users of the drug have told MailOnline it has led to erratic behaviour, blurred vision, mood swings and suicidal thoughts.
Many are now desperate to lower their dosage or come off the medication that has ‘robbed them of their lives’ altogether.
Health experts, however, urge users not to abruptly stop taking the medication over fears of withdrawal symptoms, including nausea, an increased heart rate and even seizures. It some cases it can prove deadly.
Last week, Peaky Blinders star Paul Anderson, 48, was fined after pleading guilty to possession of drugs, including pregabalin.
Paul, who played Arthur Shelby, pleaded guilty to drug possession after spending Boxing Day at a pub in Hampstead, north London, when officers found crack cocaine, a wrap of brown powder found to be amphetamines plus diazepam and pregabalin, prosecutor Kevin Kendridge said.
Following warnings from the Advisory Council on the Misuse of Drugs, pregabalin was made a class C drug in 2019.
The ruling made its sale and possession without a prescription illegal.
Officials feared ‘pregabs’ sold on the black market were being abused by heroin and other opioid addicts to enhance highs.
Data shows GPs now dish out more than £23million worth of pregabalin — which costs £2.70 per item — annually in England.
In total, there were 16million courses of GABAs dished out in England in 2022/23.
More than half of these are thought to have been pregabalin.
GABA rates have increased by 56 per cent since NHS Business Services Authority records began in 2015/16.
At the same time, figures for benzodiazepines and Z drugs have fallen.
Experts have previously said this is due to the worrying shift towards GABA drugs, which affect the brain chemical GABA. In effect, they calm down over-excited nerve cells.
Pregabalin was first licensed in 2004 as a medicine to stop epilepsy seizures, and then for neuropathic or nerve pain because it blocks pain signals in the brain.
Patients taking it also reported feeling calmer, sparking doctors to start offering it for anxiety.
Yet pregabalin and gabapentin, thought of as its milder sibling, can also be given ‘off-label’ (to treat a condition for which they’re not licensed) for things such as lower back pain — and for which there is little or no evidence that they work.
As well as the shift in prescribing, the increase coincides with soaring numbers of Brits being diagnosed with mental health issues.
Ian Hamilton, associate professor of addiction at the University of York, told MailOnline: ‘Part of the problem with pregabalin medication is that it is prescribed for long term conditions such as epilepsy and anxiety.
‘Given that these health problems can persist for years, taking pregabalin over this period increases the risk of physical and psychological dependency.
‘The dramatic rise in prescriptions for pregabalin have happened in part due to the increase in people with mental health problems such as anxiety.
‘Unfortunately many people are given these drugs without any psychological support such as counselling as there are long waiting lists for talking therapies.
‘Equally up to a third of people who are prescribed other medications for anxiety and depression will not experience any benefit from them, this means that doctors will prescribe pregabalin medication as an alternative.’
He added: ‘What is really concerning is that this appears to be happening in poorer areas where access to these therapies is difficult, leaving GPs with little choice but to prescribe pregabalin as a way of ensuring at least some treatment.
‘We have also seen a significant rise in non-medical use of pregabalin drugs where people source these drugs without seeing a doctor.
‘This is due to the effect pregabalin has physically and psychologically, it can create feelings of euphoria and relaxation.
‘As pregabalin is already regulated as a class C drug under the Misuse of Drugs Act it is unlikely that there would be any benefit from increasing penalties for misuse, as the current restrictions have had little impact.
‘What would clearly make a difference would be ensuring timely access to specialist mental health support but that requires investment and there is no sign that the government will reverse its squeeze on public services.’
Latest NHS statistics reveal almost 105,000 patients were prescribed GABAs in 22/23 across Cheshire and Merseyside.
This equated to around 3.9 per cent of residents being given gabapentinoids, population figures analysed by MailOnline suggest.
Similar rates were seen in the NHS districts of Lincolnshire (3.8 per cent), Lancashire and South Cumbria (3.7), and Staffordshire and Stoke-on-Trent (3.6).
Lee Fernandes, lead therapist for the UK Addiction Treatment Group told MailOnline: ‘Pregabalin is an incredibly strong and potentially dangerous prescribed drug because it can be extremely addictive when misused.
‘Unfortunately we know that GPs are in between a rock and a hard place – they have a very short window to tackle a potentially big problem for patients.
‘But whether they’re prescribing pregabalin for pain relief or to help with anxiety symptoms, we’d like to see them instead taking a more holistic approach and addressing the root cause of the pain or the anxiety, rather than tackling the problem with a pill.
‘This is a drug that can ruin lives and should not be prescribed lightly.’
Dr Iain Brew, who has spent decades working in community drug treatment service, said: ‘There’s a woeful lack of provision in psychology and it’s easier and cheaper to chuck drugs at a patient, but drugs aren’t the answer.’
He told the Sunday Times: ‘We don’t want these drugs to be banned, we just don’t want them being abused and killing patients.
‘When barbiturate drugs first came out, doctors thought “great, a way of helping people cope with life”. They got overprescribed and a lot of people died.
‘Then benzodiazepines came out, and everyone got prescribed them, and it became apparent there was addiction, then sleeping pills, and everyone got addicted again.
‘It’s happening again with pregabalin.’
With the rise in its use, both legal and illegal, have come social problems.
Court records show dozens of people being arrested for possession of pregabalin and charged with stealing the drug from pharmacies.
In one case, a 37-year-old from Kingston upon Hull pleaded guilty to theft of 15 boxes of pregabalin from a medical centre. He was sentenced to 16 weeks in jail.
Pregabalin users have also told MailOnline about the shocking impacts the drug has had on their lives.
Alex Silva, who was prescribed pregabalin after a slipped disc on his neck, said ‘after two months on it, all I could think about was to kill myself’.
He added: ‘No doctor ever informed about suicidal thoughts. Thank God, I read about it and stopped taking it straight away. Horrible drug but the worst of all, was that no one told me about the suicidal thoughts.’
Another user who was prescribed pregabalin for lower back pain, said: ‘I went completely crazy for two months and had to wean myself off due to erratic behaviour, blurred vision, mood swings and suicidal thoughts.’
They added: ‘The doctors don’t tell you this when prescribing and when you mention concerns that’s when it seems you are given the information. I was lucky but only because my partner questioned the tablets when I was losing the plot.’
In 2019, the now defunct Public Health England raised the alarm about the side effects and withdrawal symptoms and concluded more people were being prescribed pregabalin for longer.
It called for a national helpline, regular reviews of prescriptions and alternatives to medicines.
Two years later in 2021, drugs watchdog the National Institute for Health and Care Excellence called for doctors to improve the safety measures they took when prescribing painkillers and dependency-forming drugs such as pregabalin.
Researchers at University College London (UCL), the University of Bristol and Keele University are now investigating the effects of taking pregabalin alongside an antidepressant to treat anxiety symptoms.
Under the PETRA trial, which began last year and will involve up to 500 participants, scientists hope its results will let doctors give better advice to people with anxiety.
Experts, however, have long warned that when pregabalin is mixed with other drugs such as opiates or alcohol, it can also cause severe respiratory depression or in some cases even prove fatal.
Dr Franziska Denk, senior lecturer, King’s College London, said: ‘Most deaths related to pregabalin occur in combination with other drugs — usually opioids and usually when taken illegally.’
Brits who take drugs recreationally should be warned of its ‘potentially dangerous side effects, especially when combined with substances’, she added.
She added: ‘I do not think there is much evidence to suggest that it should be banned from being legally prescribed, or indeed that it is being over-prescribed to a dangerous degree.
‘Epilepsy is a very dangerous, life-threatening condition, for which none of the other existing medications, besides pregabalin, are without the risk of serious side-effects.’
In January, Sean Cummings, a coroner in Bedfordshire, issued a prevention of future death report after Joy Ebanks, 59, died from an overdose of pregabalin and oxycodone.
He quoted research that questioned the effectiveness of pregabalin and highlighted that dependence on it ‘was increasingly recognised as a problem’.
It followed a similar warning by a coroner in north London in October.
It comes as official data released by the ONS in December revealed there were 4,907 drug poisoning deaths in 2022 – a rate of 84.4 deaths per million people.
This is the tenth consecutive annual rise, up on the 4,859 recorded in 2021 and the most since records began in 1993.
Health experts, however, cautioned patients should not stop taking their prescribed pregabalin ‘abruptly’ over fears Brits could suffer withdrawal symptoms.
Thorrun Govind, TV pharmacist and former chair of the Royal Pharmaceutical Society, said: ‘What you should do is speak to your healthcare professional and check that it’s appropriate for you still and have a rounded discussion about your individual needs and make sure it’s suitable for you.
‘Pregabalin isn’t the first line treatment for anxiety. There are other options out there for people if they are concerned.
‘Even for epilepsy there are other options available. But obviously, with epilepsy you will be on a medication for a long time.
‘We need to make sure people are really comfortable and understand the drug that they’re taking and the benefits and risks.’
Glyn Lewis, a professor of epidemiological psychiatry at UCL, added: ‘There is a known problem of combining pregabalin with opiate medication.
‘Pregabalin could be effective and helpful for many people but patients should follow the advice of their doctor and report any side effects they experience.’
Sarah Carter is a health and wellness expert residing in the UK. With a background in healthcare, she offers evidence-based advice on fitness, nutrition, and mental well-being, promoting healthier living for readers.
