What is it and why can it be dangerous?

By David Wilson & Mike McBrideBBC News NI

Getty Images Hand holding pillsGetty Images

The prescription drug pregabalin has been linked with a growing number of deaths in Northern Ireland.

But what is it and why can it be deadly?

Here we answer some common questions about the drug, which continues to make headlines.

What is pregabalin?

Pregabalin, also known by the brand name Lyrica or the street name bud, is an anti-epileptic drug also used to relieve chronic pain.

The drug comes in several forms, including capsules, oral solutions and long-acting tablets.

It is a prescription-only medicine that should only be taken under the care of a doctor.

What effects does pregabalin have on the body?

The drugs information service Talk to Frank says pregabalin can produce "feelings of euphoria, relaxation and calmness".

Side effects include dizziness, uncontrollable shaking, forgetfulness, difficulties with speech, blurred vision, shortness of breath and chest pain.

Pregabalin can be safe when prescribed and taken under medical supervision, but very dangerous when taken recreationally, Londonderry GP Joe McEvoy has said.

That is partly because people buying the drug on the street or the internet "do not know what they are getting", he added.

Getty Heroin and syringeGettyTaking pregabalin with opioids, such as heroin, can be particularly dangerous

"They may be getting some pregabalin in there or they may be getting a dose many times higher than anticipated.

"It is a very dangerous drug when used in the wrong doses, by the wrong person, or when it is mixed with other medication in a way that we cannot really predict what the outcome will be."

Some recreational users take pregabalin and opioids - for instance heroin - together, but health professionals warn the combination can cause breathing difficulties and serious malfunction of the heart, in some cases leading to death.

How many deaths are there each year?

Drug-related deaths involving pregabalin have risen over the years, according to the Northern Ireland Statistics and Research Agency (Nisra).

In the agency's latest published data from 24 November 2022, of the 213 drug-related deaths recorded last year, 71 deaths mentioned pregabalin in the death certificate.

The annual number of deaths involving this controlled substance rose from 1 in 2013, 9 in 2016, to a peak of 77 in 2019, and then was recorded to be 71 in 2021.

One addiction counsellor warned that there was "no quality control" and said users were playing "Russian roulette".

Can you get addicted to pregabalin?

A significant danger of pregabalin abuse, as with most medication, is addiction.

Pregabalin's calming effect has the potential to become a crutch for users.

The drug can produce what is known as a "gentle high" and, as a result, it can be easy for users to underestimate the drug's addictive nature over time.

Dependence on pregabalin is especially of concern for those with a prior history of drug abuse or addiction.

Where are the drugs coming from?

There is an illicit market for the drug in Northern Ireland, with many people purchasing it online from unregulated websites.

It is understood that pregabalin has been coming into Northern Ireland in fairly constant levels for a number of years, along with other prescription drugs.

Is pregabalin a controlled drug?

The Misuse of Drugs Act 1971 divides drugs into three categories, Class A, B and C, according to the harmfulness they cause to the user or to society when they are misused.

In 2019, pregabalin was made a Class C drug, making it illegal to possess it without a valid prescription or to supply it to others.

PSNIThe Police Service of Northern Ireland said officers seized pregabalin 804 times between July 2021 and June 2022

Police Service of Northern Ireland (PSNI) statistics show pregabalin is the fourth most commonly seized drug behind cannabis, cocaine and benzodiazepines.

Official figures from the police show that between July 2021 and June 2022 pregabalin was seized by officers on 804 occasions.

In the twelve months between July 2022 and June of this year, that figure rose to 1,081 - a rise of more than 34%.

What support is out there?

If you have been affected by addiction, help and support is available at BBC Action Line.

If you live in Northern Ireland, you can also call Lifeline, a 24 hour helpline on 0808 808 8000.

Tommy Canning, who is the head of the Northlands Addiction Treatment Centre in Derry, has said it can be challenging for families of users.

"Families can feel helpless because no matter what they seem to do if their son or daughter don't realise or accept the problem they have then very often the support out there can't meet their needs.

"People come into us all the time and say: 'We just want our old daughter or our old dad back.' Because, fundamentally, they have changed in the process of their addiction."

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