Pregabalin and Gabapentin, drugs frequently used to treat chronic neuropathic (nerve-type) pain are to be reclassified as controlled class C drugs in April 2019 under the Misuse of Drugs Act. This means that they will be under tighter control from doctors and reclassification of drugs to Class C, like Tramadol in recent times, tends to lead to less frequent prescription and use overall. The new classification will mean that doctors will have to physically sign individual prescriptions rather than sending them electronically or by fax, and pharmacists will have 28 days to dispense the prescription from the time it is written. It will be illegal to be in possession of these drugs or to sell these drugs to others – a practice that has been happening more commonly now, as was the case with Tramadol before it was reclassified as a Class C substance.
Pregabalin and Gabapentin were originally designed to be used for Epilepsy, and can be used for mood-stabilisation, but mostly is now used for analgesia for cases of chronic pain. Unfortunately, their use has been associated with elevated mood, especially in combination with other drugs resulting in known fatalities, hence the move by the Government to reclassify the drugs.
Why is this important for health care providers?
Chronic pain is one of the most frequent complaints seen by health care providers including doctors and complementary therapists. Most recent guidelines worldwide do ask techniques previously thought to be complementary and alternative like Acupuncture, Chiropracty, and other manual therapies, as well as behavioural and psychological techniques be considered as part of a Pain Management Programme. These include the Blueprint for Health Care Providers Involved in the Management or Support of Patients with Pain (US FDA 2017), the British Pain Society, and SIGN to name a few. NICE is due to release its guidance on Chronic Pain in 2020 and with the emerging evidence-base of risks versus benefits, it is likely that the Complementary and Alternative Therapies mentioned above will be given an equal mention.
Restriction of Opiate medication as well as now Pregabalin and Gabapentin for Chronic Pain may mean that doctors need to give further consideration of complementary and alternative therapies as part of the individual patient management programme. Certainy, in the US FDA Guidance mentioned above, it was suggested that Health Care Providers become familiar with these modalities.
It may be that the Integrative Health Convention taking place this year at the Park Plaza Victoria in London on Sat 5th & Sun 6th of October 2019 will be a place where these techniques can be learnt about in a safe environment with members of both the medical profession and complementary therapists.
Reference Article:
https://www.gov.uk/government/news/pregabalin-and-gabapentin-to-be-controlled-as-class-c-drugs
