"Bursting the Lyrica bubble”: Experiences of pregabalin use in individuals accessing opioid agonist treatment in Dublin, Ireland

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Brennan, Rebekah
Van Hout, Marie Claire
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Associazione per l’Utilizzo delle Conoscenze Neuroscientifiche a fini Sociali
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Terms and Conditions for Use of Self-Archived Versions.Aim: The World Health Organization (WHO) declared the COVID-19 pandemic a global health emergency. Many countries of the world, including Ireland, closed their borders and imposed nationwide lockdown. During this period, all major anthropogenic transport activities, which contribute to atmospheric pollution, were restricted. The current study examines the impact of the transport restrictions on ambient nitrogen dioxide (NO2) concentrations and hospital admissions for asthma across Ireland. Methods: This is a retrospective population-based cohort study. National ambient air quality monitoring network data were analysed to investigation variations in NO2 concentrations. Asthma hospital admissions data were collected from the HSE Hospital In-patient Enquiry (HIPE) for Cork, Dublin, and Meath.Results: During the period of transport restrictions, there were reductions in the annual mean NO2 for Cork, Dublin and Meath (i.e. 12µg/m3 to 11µg/m3 (p = 1); 25µg/m3 to 17µg/m3 (p < 0.001); and 23µg/m3 to 21µg/m3 (p = 1)). Reductions in asthma hospital admissions were also observed. Among the 8,471 patient episodes included in this study, the mean [SD] age at admission was 47.2[22.9] years; 61% were female (n=5,134); mean [SD] length of stay was 4.9[10.9] days. Conclusion: The findings of this study provide an opportunity to explore the impact of NO2 emissions for Cork, Dublin and Meath on asthma hospital admissions, in order to improve air quality modelling and policy development of management of asThis is a pre-copyedited, author-produced version of an article accepted for publication in FEMS Microbiology Ecology following peer review. The version of record [O'Sullivan, J. N., Rea, M. C., Hill, C. and Ross, R. P. (2020) 'Protecting the outside: biological tools to manipulate the skin microbiota', FEMS Microbiology Ecology, 96(6), fiaa085 (14pp). doi: 10.1093/femsec/fiaa085] is available online at: https://doi.org/10.1093/femsethe Authors. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited© 2020, The Institution of Engineering and Technology. This paper is a postprint of a paper submitted to and accepted for publication in IET Optoelectronics, and is subject to Institution of Engineering and Technology Copyright. The copy of record is available at IET Digital Library: https://digital-library.theiet.org/content/journals/10.1049/ietFlanagan, Michael; Ryan, Jessica M.; Connelly, Tara; Cooke, Fiachra; McCullough, Peter; Neary, P Background: Pregabalin, also known by a brand name of Lyrica, is a prescription only gamma-aminobutyric acid (GABA) analogue and licensed for a range of medical conditions, e.g. chronic pain, generalised anxiety and epilepsy. In recent years, pregabalin has attracted clinical and research attention due to an increase in its association with overdose fatalities. Individuals with opiate use and those in opioid agonist treatment are an identified at-risk group for problematic pregabalin use and overdose. As such, research focusing on pregabalin use in individuals accessing opioid agonist treatment is highly relevant. Aim: This study aims to add to the evidence based on diverted pregabalin use in the OAT cohort in Ireland. Methods: Fifteen semi structured interviews were conducted and analytically coded using thematic analysis with software programme NVivo12. Results: Individuals on OAT may use Lyrica to self-regulate negative emotions; Lyrica use in this population is embedded in a polydrug use culture of “tablet taking”; participants illustrated concerning reports of inappropriate prescribing and described psychiatric symptoms occurring during withdrawal. Conclusions: We report here on the first study in Ireland investigating the experiences of individuals who access opioid agonist treatment (OAT) and reported current or recent pregabalin use. Increased pharmaco-vigilance amongst medical practitioners is warranted when prescribing Lyrica to individuals with vulnerabilities such as a history of problematic drug use. Trauma informed interventions in addition to pragmatic harm reduction information for polydrug users to prevent cross tolerance, dependence and overdose deaths should be part of the healthcare and policy response.
Pregabalin , Gabapentinoid , Lyrica
Brennan, R. and Van Hout, M. C. (2020) 'Bursting the Lyrica bubble”: Experiences of pregabalin use in individuals accessing opioid substitution treatment in Dublin', Heroin Addiction and Related Clinical Problems, 22(6), pp. 5-13.
© 2020, the Authors.