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Gabapentinoids to be kept in a safe under Government proposals



Gabapentinoids will have to be kept in a safe and prescriptions written to specific legal requirements, the Home Office has said in its consultation on reclassifying the drugs.

The consultation document proposes three options for reclassification, all of which recommend categorising the two drugs as class C controlled substances under the Misuse of Drugs Act.

This comes after official figures revealed in September that there were 111 deaths related to pregabalin in 2016 and 59 related to gabapentin, compared with four and eight respectively in 2012.

As a result, the Government announced that it had accepted recommendations from advisers to make them a class C drug, subject to a consultation.

The consultation document proposes three options, including one recommended by the Advisory Council on the Misuse of Drugs (ACMD) that requires gabapentinoids to be stored in a safe as well as categorising them as class C drugs.

Under this option, prescriptions for pregabalin and gabapentin will have to meet specific requirements, including signing and dating the prescription in ink.

Certain healthcare professionals, including GPs, would also have to fill out a ‘requisition form’ each time they receive a stock of the drugs to supply to patients if this option were taken.

Other options outlined in the consultation suggest reclassifying the drugs but not requiring them to be kept in a safe or subject to the specific prescription requirements.

In June, BMA leaders called for pregabalin to be reclassified as a controlled drug following evidence it is increasingly used recreationally and in prison populations.

Following the Government’s announcement, Dr Andrew Green, clinical and prescribing policy lead for the BMA’s GP Committee, welcomed the change in legislation, saying the drugs ‘have a significant potential for dependence’.

Dr Green this week told Pulse that the GPC will be formally looking at the consultation before forming an opinion on the options set out.

According to a statement from the deputy chief economist from the Home Office, Tim Laken, the preferred option is the one recommended by the ACMD.

He said the drugs have ‘have become significantly misused among the opioid-using and prison populations’ and placing them under the Misuse of Drugs Act ‘offers stricter offences for illicit production and distribution of the drugs’.

The case against prescribing gabapentinoids

A Cochrane Review from June this year found that gabapentin ‘can provide good levels of pain relief to some people with postherpetic neuralgia and peripheral diabetic neuropathy’, but added that its effectiveness for other types of neuropathic pain ‘is very limited’.

Meanwhile, another study published in Addiction last year, that found that misuse of gabapentin was at a staggering ‘40-65% among individuals with prescriptions’.

GPs have previously been told by NHS England to prescribe Lyrica, and not pregabalin, for neuropathic pain – a decision which was later overturned by a High Court decision.

However, Scottish-based health charity Pain Concern has said reclassifying gabapentinoids is creating ‘fear and anxiety’ among the patients who use them responsibly.