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Control measures for gabapentinoids under examination

By Catherine Reilly - 25th Nov 2022

Possible control measures in relation to pregabalin and gabapentin prescribing are being examined by a subcommittee chaired by the Department of Health.

The early warning and emerging trends (EWET) subcommittee, which is part of the national advisory committee on drugs and alcohol, is looking at potential control measures and how these may be introduced. 

Pregabalin and gabapentin are indicated for the treatment of epilepsy, peripheral and central neuropathic pain, and generalised anxiety disorder, in adults.

The Department released no substantive details about the current process. In January, the Department had stated that the EWET was considering a consultation on the matter. At the time, the spokesperson said that controlling substances under the Misuse of Drugs Acts 1977-2016 required a “clear evidence base” and an analysis of the benefits and risks. “If evidence exists to suggest that the scheduling of a substance would reduce its misuse or abuse, a multiple stakeholder approach is required, to include a referral to the European Commission.”

According to correspondence to GPs from the HSE Medicines Management Programme in 2020, there was a high level of pregabalin prescribing. The correspondence reiterated the “need for vigilance when prescribing pregabalin due to the risk of addiction, and potential for illegal diversion and medicinal misuse”.

Drug-related death figures compiled by the Health Research Board have shown an increase in deaths where pregabalin was implicated, from 14 in 2013 to 45 in 2017.

In 2019, the UK government reclassified pregabalin and gabapentin as class C controlled substances after experts highlighted rising fatalities linked to the drugs.

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