Rising deaths linked to pregabalin misuse sparks review

A Telegram user claiming to be a London-based pharmacist offered to sell pregabalin tablets to a BBC reporter for less than £1 per pill

A sharp rise in deaths linked to the misuse of a widely prescribed drug has prompted a government review, the BBC has learned.

Pregabalin, dispensed more than nine million times in England last year, has the fastest-rising mortality rate of any prescription medicine in the UK and is cited in a third of drug-related deaths, according to the Office for National Statistics (ONS).

A BBC North West investigation also found evidence of dealers using encrypted messaging apps to sell pregabalin pills for less than £1.

The Advisory Council on the Misuse of Drugs will "carry out an updated harms assessment", said a Home Office spokesperson, adding the government would "consider their findings carefully".

As a Class C controlled drug since 2019, it is illegal to either possess pregabalin without a valid prescription or supply it to others.

When used as prescribed, pregabalin is safe and effective in treating conditions including anxiety, nerve pain and epilepsy, said Professor Ian Hamilton, an expert on addiction at the University of York.

But he warned: "Not only can it be fatal in terms of overdose, but also people tend to use it with other drugs including heroin and alcohol."

The NHS website also states some pregabalin users can become addicted.

Alex Cottam died in September 2021 after taking three times the safe limit of pregabalin

A grieving mother who discovered her son lying dead on the floor of his flat, surrounded by boxes of pregabalin pills, told the BBC she believed he would "still be here" were it not for the drug.

Alex Cottam's inquest found the 27-year-old software testing engineer had died from "multiple drug toxicity", including three times the safe limit of pregabalin.

According to the ONS, the drug was cited on 1,625 death certificates in England and Wales in the five years to 2023 - nearly four times the number recorded in the previous five years.

The ONS also confirmed more than 90% of people who died from pregabalin poisoning had other substances such as opiates and alcohol in their system.

Speaking to the BBC on the third anniversary of Alex's death, Michelle Cottam described her son as "lovely, clever and popular".

Michelle said she was certain he had not intended to end his own life, a conclusion shared by the coroner who ruled his death was due to "misadventure" rather than suicide.

"He just wanted the anxiety to go away," explained Michelle. "And sometimes he didn’t see a future, but that’s because the drugs were making him feel like that.

"I can't help thinking every day that pregabalin killed my son and if it wasn't for that drug he'd still be here."

Michelle Cottam blames pregabalin for Alex's death

As a young teenager, Alex suffered the loss of his dad and went on to struggle with depression and anxiety.

"The doctor said he wouldn’t help him while he was drinking or smoking cannabis so he gave them all up," said Michelle.

"The doctor decided then to treat his anxiety with pregabalin."

Alex started taking the medication when he was 25 and it initially appeared to help.

But his mum said he "became addicted" and started boosting his supply by buying pregabalin from illicit websites.

Michelle said Alex was hospitalised 12 times in the two years before his death.

In early 2021, he moved out of his family home and into his own flat.

Breaking down in tears, Michelle said: "Myself and my other son Jaydon went round there one day. I could hear my phone ringing in his flat and I was worried.

"I rang the police and they came and burst through the door.

"They said not to come in but I had to. I walked into his bedroom and he was dead on the floor."

Michelle said she was still haunted by the memory of seeing "packets of pregabalin round him, something like 20 boxes. And they were all in the cupboards in his flat.

"We were too late to do anything."

'Illicit demand'

Pregabalin is also being increasingly used by homeless people.

In Manchester the BBC learned it was often being sold for as little as £1 per pill.

Michael Linnell, who runs Greater Manchester’s Drug Information System and advises nationally on new and emerging trends, said there had been a "concerning" rise in its use in the streets.

Mr Linnell said this "street market" was partly fuelled by online sellers.

Using the encrypted Telegram messaging service, one supplier - who claimed to be a London-based pharmacist - offered to sell a 150-tablet packet of 300mg pregabalin pills to the BBC for £120.

The BBC was offered 150 pills from a Telegam vendor saying they were based in London

Roz Gittins, chief pharmacy officer at the General Pharmaceutical Council, said: “We are aware of the ongoing illicit demand for pregabalin, and the concerning number of deaths linked to inappropriate pregabalin use.”

It urged people to only use online health services that are registered with UK regulators and warned that anyone using illicit websites was taking huge risks with their health.

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