The Irish Times view on the reclassification of Pregabalin: a case to move ahead

Making it a controlled drug would inconvenience the responsible patients who account for the bulk of the prescriptions, but that is not sufficient justification for ignoring the warnings from coroners

Last March the Coroners Society of Ireland called for the reclassification of the prescription medication Pregabalin as a controlled drug. Marketed under the name Lyrica, it is used to treat epilepsy, nerve pain and general anxiety disorders. It has also been linked to poisoning deaths, say the coroners.

Prescriptions for controlled drugs must be renewed monthly. This would lead to closer monitoring of the use of the drug, which can end up on the street and accessed there by people with addiction problems. It is known as the “coffin tablet”, reflecting its sedative properties.

The appeal fell on deaf ears, with the Department of Health referring the matter to the Health Products Regulatory Authority (HPRA) who in turn said controlling substances under the Misuse of Drugs Act 1977 was the Department’s responsibility.

This week the coroners renewed their call, saying the drug was detected in one out of every 16 postmortem toxicology tests. When heroin or methadone was also found postmortem, the incidence of Pregabalin rose to 27.8 per cent.

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It is an open question as to how many deaths in the intervening 12 months might have been prevented if Pregabalin had been reclassified instead of the issue being batted backwards and forwards by the HPRA and the department. The reluctance of the Department to move on the issue is hard to fathom. It claims that an evidential basis is needed for reclassification. How much more evidence does it need?

The coroners’ view is based on its members’ inquests, as well as research by the Royal College of Surgeons, the National Drug-Related Deaths Index and Safety Net, a medical charity providing services to homeless and other marginalised people.

More than 615,000 prescriptions for the drug were written at a cost of €5.83 million in 2021. Making it a controlled drug would inconvenience the responsible patients who account for the bulk of the prescriptions but that is not sufficient justification for ignoring the warnings.