Download a copy of Extern's pregabalin user guide here

1 April 2019

A new guide which aims to reduce the risk of death and harm for people who are problem users of the drug pregabalin is being launched today by leading social justice charity Extern (Monday, 1st April). The guide is aimed at people who are using pregabalin when it hasn’t been prescribed for them, and people who have a prescription, but who are overusing the drug.

Funded by the Public Health Agency, the publication, entitled ‘Pregabalin User Guide: How to Reduce the Risks’, is aimed at people who are problem users of the drug.

Pregabalin, also known as Lyrica, or ‘Buds’, has been linked to dozens of deaths in Northern Ireland. Figures released by the Northern Ireland Statistics and Research Agency (NISRA), have revealed a fourfold increase in deaths where pregabalin was listed on the death certificate, with eight deaths in 2016, rising to 33 in 2017.

Legislation change

Publication of the guide comes on the day (1st April, 2019) when new legislation comes into force classifying Pregabalin as a class C controlled drug under the Misuse of Drugs Act (1971). This means it is now illegal to possess Pregabalin without a prescription, with the maximum penalty for unlawful possession of the drug being two years in prison. Selling or supplying Pregabalin can now carry a prison sentence of 14 years


Prescribed to treat health problems, including nerve pain, epilepsy and anxiety, pregabalin is increasingly being used in harmful ways. This is despite the drug having a number of associated risks and side-effects, including dependency, overdose, and death - particularly when mixed with other substances, including opioids and alcohol.

Northern Ireland currently has the highest prescription rate for pregabalin within the UK. There is also a growing illicit market here for the drug, with many people purchasing it online from unregulated websites.

Speaking about the new guide, author Chris Rintoul, from Extern’s Drugs & Alcohol Consultancy Service, said: “Just because pregabalin is a prescription drug, does not mean that it is not dangerous. In an ideal world, pregabalin would only be used as, and how, it is prescribed. Unfortunately, however, and even with the introduction of today’s new legislation, the reality is that there are thousands of people in Northern Ireland, and many more globally, who will continue to use this drug who have not been prescribed it, or who will find themselves using it outside of their prescription limits.

“It is vital therefore, that as a society, we do as much as we can to enable those people to reduce the risk of harm to themselves. That is why Extern, with the valuable support of the Public Health Agency, have created this frank and open guide. It offers informed and non-judgemental advice, and I would urge anyone who is misusing pregabalin to visit and download a copy of the guide, or get hold of a copy from their GP. It could save their life.”

Advice in the booklet ranges from information on how people can reduce their risk when swallowing, snorting or injecting the drug, to highlighting how easy it is to overdose when combining pregabalin with alcohol or other drugs.

Speaking about its publication, Extern CEO, Charlie Mack, added: “Every day in Extern, along with our colleagues in the health service, we are seeing more and more families being impacted by the misuse of pregabalin, including, tragically, an increasing number of deaths. For some people, simply stopping their use of a substance outright is not always straightforward, as well as being dangerous in itself, and this booklet recognises this important fact. I would like to commend the Public Health Agency for their support in creating this vital and forthright guide, as I have no doubt its publication will help save lives and reduce harm.”

Michael Owen, the PHA’s Drug and Alcohol lead, said: “The most important thing to remember is that all drugs, whether illegal drugs or prescription medication, carry risks. The PHA strongly recommends that you do not take anything unless it has been prescribed to you by a medical professional and in accordance with your prescription.

“Unfortunately we do see people misusing drugs, like pregabalin, and that’s why this resource will provide valuable information to help people reduce the harm that can be caused when misusing this drug.

“One of the biggest risks of drug misuse comes when drugs, including alcohol, are mixed. Mixing can increase the toxicity of already potentially harmful substances and increases the risk of serious harm and death.

“If you have taken drugs or have misused a medication and are feeling unwell, please seek medical help urgently.

“If you think you might have a problem with alcohol and/or drugs and would like to get help, please visit  for information on support services near you.”

Joe Brogan, Head of Pharmacy and Medicines Management at the Health and Social Care Board, described the growing numbers of deaths associated with pregabalin and other prescription drugs as a “scourge”.

He added: “In many cases of pregabalin misuse, it has not been prescribed – it has been sourced through family or friends or bought on the street or via the Internet. Many such drugs that are bought from illicit sources do not actually contain medicines that they purport to be.

“Any medicine or any drug can be a poison – it all depends on three things: Where you get it from – was it prescribed and supplied from a regulated source; how much you take – was it taken within accepted dosages; What you take it with – mixing drugs together and with alcohol can create a toxic mix that is lethal.

“As a healthcare professional that has highlighted the risks of pregabalin misuse for many years, I cannot emphasise enough the need to only take medicines as prescribed by a prescriber. However, I recognise that people are dying as a result of pregablin misuse. This new booklet will give those problem users of the drug useful information on how to reduce their risk of harm or death.”

Pregabalin User Guide: How to Reduce the Risks’, is being distributed to relevant services across Northern Ireland, including homelessness services, addiction services, GP surgeries and community pharmacies. It can also be downloaded directly from

Extern has also previously produced a user guide for people who are supporting users of pregabalin.

It too can be downloaded here:

User Guide

Anyone seeking help with their pregabalin use can contact Extern on +44(0)28 90 840555 or via email at [email protected]

Further information on Extern’s full range drug and alcohol support services is also available at