Pregabalin Abuse in Combination With Other Drugs: Monitoring Among Methadone Patients

Lancia, Massimo; Gambelunghe, Angela; Gili, Alessio; Bacci, Mauro; Aroni, Kyriaki; Gambelunghe, Cristiana

doi:10.3389/fpsyt.2019.01022

Cited by 26 publications

(31 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the last ten years, pregabalin has been extensively prescribed off-label for psychiatric conditions such as bipolar disorder, alcohol/narcotic withdrawal states, and ADHD, and it has entered the black market ( 25 , 26 ). The principal population at risk consists of patients with other current or past substance use disorders, mostly opioid and multi-drug users who consume pregabalin in high dosages to achieve euphoria and also to reduce withdrawal symptoms, or to potentiate the effects of methadone ( 27 ). Pregabalin use was detected for example in 10.7% ( 28 ) and 14% ( 27 ) of hair specimens from of opioid maintenance patients in Italy, and in 4 to 17.7% of urine samples from opioid maintenance patients in Switzerland ( 29 ), Ireland ( 30 ), Sweden ( 20 ), and Israel ( 31 ), while one other study found zero prevalence in hair samples ( 32 ).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Novel Psychoactive Substance (NPS) Use in Patients Admitted to Drug Detoxification Treatment

et al. 2020

View full text Add to dashboard Cite

Background About 15 years ago, a diverse group of new recreational psychotropic substances began to emerge, which were marketed for example as “legal highs,” “research chemicals,” or “designer drugs.” These substances were later subsumed under the label “Novel Psychoactive Substances” (NPS). Important NPS classes are cathinones, synthetic cannabimimetics, phenethylamines, and herbal drugs. The health care system for psychotropic substance use disorders (SUDs) traditionally focused on a few substances, such as alcohol, heroin, cocaine, amphetamines, or cannabis. Users of illicit substances often engage in polydrug use. However little is known about the prevalence of NPS use within the group of “classical” illicit substance users. Objective We investigated lifetime and recent use of NPS and other drugs in patients who underwent in-patient detoxification treatment from illicit drugs in Germany. Methods In a multicenter study with eight participating facilities, patients admitted to treatment underwent a standardized interview at admission, concerning their past and current substance use. The interview comprised classical substances of abuse, NPS, and rarely used substances such as LSD. In addition, participating sites had the opportunity to analyze their patients’ routine drug screenings by means of gas chromatography/mass spectrometry (GC/MS), which permitted detection of NPS. Results Interviews from 295 patients could be analyzed. Most patients were opiate dependent and multiple substance users. About 32% reported use of synthetic cannabimimetics during lifetime, but usually only a few times. An important reason for their use was that NPS were not detected by drug testing in prisons or drug treatment facilities. Cathinones, herbal drugs or other NPS had rarely been used during lifetime. NPS use during the last 30 days before admission was nearly zero. This was confirmed by urine analysis results. In contrast, lifetime and current use of opiates, alcohol, cocaine, benzodiazepines, and cannabis was high. In addition, 18% reported of regular unprescribed pregabalin use during lifetime, and 20% had recently used pregabalin. Conclusion Patients admitted to drug detoxification treatment showed multiple substance use, but this did not include NPS use. The diversion of legal medications such as pregabalin in this group is a serious concern.

show abstract

Section: Discussionmentioning

confidence: 99%

Prevalence of Novel Psychoactive Substance (NPS) Use in Patients Admitted to Drug Detoxification Treatment

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Hair was the selected modality of analysis, as it provides long-term information on drug use. It is a strong, stable tissue that is less affected by adulterants or short-term abstinence and thus has an advantage over traditional matrices (e.g., blood or urine) of being able to confirm long-term exposure to drugs over a period of weeks to months, depending on the length of the hair collected [ 20 ]. Considering that the average hair growth is 1 cm per month, a hair sample that was 3 cm in length allowed us to examine a retrospective time window of approximately 3 months [ 20 ].…”

Section: Resultsmentioning

confidence: 99%

Changes in Drug Use Patterns during the COVID-19 Pandemic in Italy: Monitoring a Vulnerable Group by Hair Analysis

Gili

Bacci

Aroni

et al. 2021

IJERPH

Self Cite

View full text Add to dashboard Cite

From 22 March until 18 May 2020, a complete lockdown in Italy was ordered as a countermeasure against the COVID-19 pandemic. Social isolation measures affect some populations more than others, and people with drug and/or alcohol disorders (SUDs) are more likely to be adversely affected. This study presents, for the first time, laboratory data on the use of alcohol and drugs in a high-risk population during Italy’s first wave of the COVID-19 pandemic. Thirty subjects with SUDs were monitored for the use of illicit drugs and alcohol every 3 months before, during and after the lockdown, by hair analysis. The number of samples positive for heroin, cocaine, MDMA and cannabis fell considerably during the lockdown and then resumed to pre-lockdown levels when the period of confinement was over. Interestingly, the consumption of benzodiazepines and alcohol followed the opposite trend; both the number of benzodiazepine-positive samples and the level of alcohol consumption increased and remained high, even at the end of the lockdown. The confinement measures produced significant changes in drug/alcohol use patterns, with a shift toward the use of substances that were more easily accessible, used as self-medication for negative feelings, and used to alleviate the effects of abstinence from drugs that were no longer readily available.

show abstract

“…This has also been demonstrated with mirogabalin ( 48 ). Published literature has shown that the risk of gabapentinoid abuse increased in subjects with a history of substance use disorder, particularly in those with opioid use disorder ( 8 , 9 , 49 – 54 ). The present data suggest that abuse could be observed in subjects without any opioid abuse history; within the 265 spontaneous reports of gabapentinoid abuse collected, 38.7% of subjects with a substance abuse disorder had no opioid use disorder.…”

Section: Discussionmentioning

confidence: 99%

Gabapentinoid Abuse in France: Evidence on Health Consequences and New Points of Vigilance

et al. 2021

View full text Add to dashboard Cite

Introduction: Gabapentinoid drugs (gabapentin and pregabalin) are widely used worldwide for epileptic and pain disorders. First signals of gabapentinoid abuse occurred in the last decade. This study aims to describe clinical characteristics of gabapentinoid use related disorders and health consequences in France.Materials and Methods: We designed a multisource investigation reviewing data reported to the French Addictovigilance Network (FAN) with pregabalin and gabapentin from 2010 to 2019. Information was obtained through the analysis of Spontaneous Reports (SRs) notified by health professionals and the pharmacoepidemiological surveys OSIAP (suspicious prescriptions forms indicators of potential abuse), OPPIDUM (observation of illicit drugs and misuse of psychotropic medications), DRAMES (death related to prescription drugs and other substances), and DTA (toxic deaths due to analgesics).Results: Over 2010–2019 period, were collected: (i) 265 SRs (258 pregabalin; 7 gabapentin); (ii) 816 forged prescription forms (805 pregabalin, 10 gabapentin, 1 involving both drugs); (iii) 145 cases of gabapentinoid use in people who use drugs (121 pregabalin; 24 gabapentin) and (iv) 31 cases of gabapentinoid-related deaths (25 pregabalin; 6 gabapentin). Risk factors of gabapentinoid abuse were opioid use disorders or psychiatric history, but cases of primary abuse in subjects without any substance abuse history were observed. Adverse outcomes concern almost exclusively pregabalin, with coma, dyspnea, convulsion, and conduction disorders. Treatment demands increased from 10.6% in 2018 to 23.1% in 2019, with pregabalin cited as the first substance leading to addictological care in the 2019 OPPIDUM survey. Gabapentinoid-related deaths increased over time. Pregabalin has become the first drug mentioned in forged prescriptions in 2019 (23.8% of OSIAP), while it ranked at the 15th position in 2017 (2.6%).Discussion: This study shows the importance of addictovigilance monitoring for gabapentinoids. Addictovigilance data helped to make visible the gabapentinoid-abuse related health harms (hospitalization for serious neurologic, psychiatric or cardiac effects, requests for addictological support and deaths) and to confirm the intrinsic abuse potential of pregabalin. These data highlight new points of vigilance considering observed primary abuse. At this point in France, the risk of abuse and related complications is very apparent with pregabalin. Still, it is identical to that observed elsewhere with gabapentin.

show abstract

Pregabalin Abuse in Combination With Other Drugs: Monitoring Among Methadone Patients

Cited by 26 publications

References 48 publications

Prevalence of Novel Psychoactive Substance (NPS) Use in Patients Admitted to Drug Detoxification Treatment

Prevalence of Novel Psychoactive Substance (NPS) Use in Patients Admitted to Drug Detoxification Treatment

Changes in Drug Use Patterns during the COVID-19 Pandemic in Italy: Monitoring a Vulnerable Group by Hair Analysis

Gabapentinoid Abuse in France: Evidence on Health Consequences and New Points of Vigilance

Contact Info

Product

Resources

About