Pregabalin misuse: the next wave of prescription medication problems

Bridin Murnion and Katherine M Conigrave
Med J Aust 2019; 210 (2): . || doi: 10.5694/mja2.12056
Published online: 4 February 2019

Overseas experience need not portend the future of prescription drug misuse in Australia

Dispensing data indicate that pregabalin prescribing in Australia is rising rapidly, and the numbers of self‐poisonings and deaths are also increasing.1 This mirrors the European and North American experience of escalating misuse and harms.2,3 Although Australian guidelines recommend it only as second line treatment for neuropathic pain,4 pregabalin is now the seventh most expensive drug in terms of Pharmaceutical Benefits Scheme (PBS) expenditure.5

  • 1 Drug and Alcohol Services, Wyong Hospital, Wyong, NSW
  • 2 University of Sydney, Sydney, NSW
  • 3 Drug Health Services, Royal Prince Alfred Hospital, Sydney, NSW

Competing interests:

No relevant disclosures.

  • 1. Cairns R, Schaffer AL, Ryan N, et al. Rising pregabalin use and misuse in Australia: trends in utilization and intentional poisonings. Addiction 2018;
  • 2. Lyndon A, Audrey S, Wells C, et al. Risk to heroin users of polydrug use of pregabalin or gabapentin. Addiction 2017; 112: 1580–1589.
  • 3. Gomes T, Greaves S, van den Brink W, et al. Pregabalin and the risk for opioid‐related death: a nested case‐control study. Ann Int Med 2018; 169: 732–734.
  • 4. Siddall P, Hall A. Neuropathic pain: diagnosis and treatment today. Medicinewise News [online]. Mar 2018. (viewed Oct 2018).
  • 5. Australian Government Department of Health. PBS Expenditure and prescriptions, twelve months to 30 June 2017. (viewed Oct 2018).
  • 6. Crossin R, Scott D, Arunogiri S, et al. Pregabalin misuse‐related ambulance attendances in Victoria, 2012–2017: characteristics of patients and attendances. Med J Aust 2019; 210: 000–000.
  • 7. Morrison EE, Sandilands EA, Webb DJ. Gabapentin and pregabalin: do the benefits outweigh the harms? J R Coll Physicians Edinb 2017; 47: 310–313.
  • 8. Australian Institute of Health and Welfare. Impacts of chronic back problems (AIHW Bulletin 137). Aug 2016. (viewed Oct 2018).
  • 9. Shanthanna H, Gilron I, Rajarathinam M, et al. Benefits and safety of gabapentinoids in chronic low back pain: a systematic review and meta‐analysis of randomized controlled trials. PLoS Med 2017; 14: e1002369.
  • 10. Mathieson S, Maher CG, McLachlan AJ, et al. Trial of pregabalin for acute and chronic sciatica. N Engl J Med 2017; 376: 1111–1120.
  • 11. Hayes C, West C, Egger G. Rethinking chronic pain in a lifestyle medicine context. In: Egger G, Binns A, Rössner S, Sagner M, editors. Lifestyle medicine. Lifestyle, the environment and preventive medicine in health and disease. Third edition. London: Academic Press, 2017; pp. 339–353.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.