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Controlled drugs

Pregabalin and gabapentin to be reclassified as Class C controlled substances

Following a public consultation and advice from the Advisory Council on the Misuse of Drugs, gabapentinoids are to be reclassified following concerns over misuse.

Pregabalin blister pack of pills

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Pregabalin and gabapentin have been associated with a growing number of drug-related deaths

Pregabalin and gabapentin are to be reclassified as Class C controlled substances from April 2019, the government has announced.

The switch will come more than two years after the Advisory Council on the Misuse of Drugs recommended that the two medicines become controlled drugs and be placed under Schedule 3 of the Misuse of Drugs Regulations 2001 and Class C of the Misuse of Drugs Act 1971. 

The medicines are used for treating neuropathic pain, seizures and anxiety, but illicit use of the drugs has increased in recent years. In June 2018, NHS Scotland figures revealed that gabapentinoids had been prescribed prior to a fifth of drug-related deaths in Scotland in 2016.

Following a consultation on the status of gabapentinoids, which closed in January 2018, the UK government has decided to reclassify the medicines but not to apply the requirements for safe custody.

It is illegal to possess controlled substances without a prescription or to sell or otherwise supply them to others. Under the new classification, pharmacists will not be able to accept electronic prescriptions for pregabalin and gabapentin, although an impact assessment from the government says that this “may be mitigated in the future if the Electronic Prescribing System (EPS) can be used to prescribe controlled drugs electronically instead”.

A pilot scheme prescribing Schedule 2 and 3 drugs using the EPS began in October 2018.

Prescriptions of pregabalin and gabapentin will also be limited to 30 days’ treatment, and repeat prescriptions will not be issued. Any prescription received must be dispensed within 28 days.

Ash Soni, president of the Royal Pharmaceutical Society (RPS), said in response to the reclassification that “these restrictions are designed to improve safety, and from that perspective will be recognised as a positive step by pharmacists”. But he emphasised that patients must be made aware of the changes so that they understand the new requirements for prescriptions, particularly regarding the time limits for dispensing and restrictions in prescribed quantity.

“It is likely that there will be some reduction in the prescribing of these drugs and pharmacies will need support in managing their stock holding to ensure they meet patient demand, without ending up with significant stocks that go out of date,” Soni added.

“Misuse of the gabapentinoids, often in combination with opioids, is becoming more prevalent and recognised in specialist drug and alcohol services”, said Graham Parsons, RPS spokesperson on misuse of drugs and chief pharmacist of the charity Turning Point. 

“It is always a fine balance when drugs are reclassified. Prescribers must always be cautious that the pendulum does not swing too much in the other direction leading to patients with a genuine clinical need being denied evidenced-based pharmacotherapies.”

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2018.20205611

Readers' comments (3)

  • My concern, in relation to this reclassification, is for patients being able to be prescribed sufficient medication when they go on holiday. If they travel for 5 weeks or more outside the UK, how will they obtain enough medication to cover their needs? I understand that only one months supply can be ordered at any one time. Is this direct?

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  • So because there May be a link between some people in Scotland using opioids whilst being prescribed these medications, (I note it does not say if they actually were found to have them in their system and also at what volume), the majority of end users who only get a months supply at a time anyway....have to jump through more hoops just to get the treatment they need! 😡

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  • The Pharmaceutical Industry is what's hazards to our health because of their ass backward laws that have allowed hundreds of thousands of patients yes patents under a doctors care to prescribe drugs that were additive and many the companies rich off of other peoples pain and misery leading to overdoses addition and deaths, Now something that has no relation with opioids called gabapentin that is helping people like me and countless others with their symptoms has got you guys so nervous that your going to call it a Schedule Class C narcotic Well now your being overly caution causing a big headache for people who have absolutely nothing to do with the opioid crisis that was entirely committed by your industry. What the hell. Why is it always those who are innocent of their crimes but are treated like criminals for the sake of face. Your face at that . Your Industry has shame written all over it and now you want to try and look all caring and respectable and professional and all that to make up for your irresponsible actions and crimes committed against innocent people who were used by the Pharmaceutical Industries to make billions and billions and billions and destroying families and people lives and killing them. You should be ashamed and all put in jail for the humanity crises you have caused our country and now you want to look at other countries and see how they prescribe drugs and go by what they presume to be safe or not. Well you didn't have to ask them about opioids did you because you knew what was happening right under your noses and did nothing. Now you want to act all big and decent in trying to make everyone think that Big Phama has a heart after all by enacting measures of concern that only makes you look stupid because gabapentin is not additive and was never found in large sums of people who overdosed on opioids but it just happen to be in their system enough to say it was part of the cause of the overdose because people just happen to be taking it at the same time they overdosed. You have no proof no any real evidence or studies that say it dangerous even in large quantities. you would have to take the whole bottle for it to even kill you. Stop being stupid and stop trying to call it what it's not. Don't classify this helpful and beneficial drug that is helping those who are not abusing it but will be labeled as narcotic users .when asked by employers do you take any scheduled drugs and how many times and how many MGs do you take. And don't think it's not coming when employers will be asking that kind of question about the drugs people take. Your drug companies will make it harder on everyday working class people who are trying their best to get along in this country but as always it's those people who get struck because the rest of the world don't know how to act.

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