Chandigarh: A multicentric study across Punjab and Chandigarh has flagged high levels of non-medical use and dependence on Pregabalin among patients undergoing treatment for substance-use disorders, prompting calls for urgent clinical and policy intervention.Pregabalin is a prescription medication commonly used to treat neuropathic pain, epilepsy, fibromyalgia and generalised anxiety disorder. The study, conducted by doctors from multiple medical colleges, analysed 974 valid responses (out of 1,002) from substance-use disorder patients aged 18-70 across Bathinda, Chandigarh, Amritsar and Patiala, covering the Malwa, Majha and Doaba regions. The findings indicate that 44.6% (435 patients) reported non-medical use of pregabalin, while 24.8% (242 patients) met the criteria for dependence syndrome. Another 19.8% (193 patients) were identified as non-dependent users engaging in non-medical use. None of the participants reported use of Gabapentin, a prescription anticonvulsant medication primarily used to treat neuropathic pain (nerve pain from shingles or diabetes) and partial-onset seizures in adults and children.The study population was 98.3% male, with an average age of 34.5 years. A majority of them were from rural areas (62.7%), and most were married, self-employed and had more than 10 years of education. Opioid-use disorder emerged as the predominant condition, affecting 67.8% of participants, followed by alcohol-use disorder at 25.3%. Tobacco-use disorder was also common, present in 49.8% of cases.Reasons for pregabalin use varied. Participants reported using the drug for relaxation (16.8%), pain relief (12.1%), to experience euphoria (9.3%), enhance the effect of other substances (3.3%), induce sleep (3%), or relieve anxiety (1.6%), while 46.8% cited a combination of these reasons. In some cases (6.9%), use was linked to the non-availability of heroin or lack of money to purchase primary substances.Access to the drug remains a concern. A majority of users (73.5%) reported procuring Pregabalin from licensed chemists without a legible prescription, while 61.4% said they were introduced to the drug by friends. Most participants consumed the drug once or twice daily, typically in doses ranging from 300 mg to 2,400 mg, though around 12% reported consuming doses exceeding 2,400 mg per day.The study highlighted clinical risks associated with its use. In all, 7.8% participants reported experiencing epileptic seizures linked to Pregabalin use. Higher frequency of consumption, larger doses and seizure incidence were significantly associated with dependence. Analysis showed younger individuals were more likely to use Pregabalin, with increasing age associated with lower odds of use.The study, conducted by a team of researchers including Dr Jitender Aneja, Dr Neeru Bala, Dr Ajeet Sidana, Dr Rohit Garg, Dr Sandeep Goyal, Dr Sharanjot Kaur, Dr Lokesh Goyal, Dr Ira Domun, Dr Rahul Bangar, Dr Madhur Verma, Dr Bharat Udey and Dr Jawahar Singh, describes the findings as an early indication of a growing problem of Pregabalin misuse among individuals with substance-use disorders. The findings have been published in the latest edition of Substance Abuse Treatment, Prevention, and Policy.Experts have called for increased vigilance among healthcare providers and policymakers, recommending systematic screening for non-medical use, development of treatment protocols and policy measures to curb diversion of the drug. The study also highlights the need for further research and the development of reliable methods to detect pregabalin use through blood or urine testing.The findings point to a concerning trend, with nearly half of patients seeking treatment for substance use disorders reporting non-medical use of pregabalin and nearly one in four showing signs of dependence, underlining the urgency of addressing the issue through coordinated clinical and policy responses.
