{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T18:11:32Z","timestamp":1791483092072,"version":"4.3.4"},"reference-count":29,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,5,15]],"date-time":"2017-05-15T00:00:00Z","timestamp":1494806400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2017,5,15]],"date-time":"2017-05-15T00:00:00Z","timestamp":1494806400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["RO1036975\u201001"],"award-info":[{"award-number":["RO1036975\u201001"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004801","name":"Shota Rustaveli National Science Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004801","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To examine the risk to heroin users of also using gabapentin or pregabalin (gabapentoids).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Multi\u2010disciplinary study: we (a) examined trends in drug\u2010related deaths and gabapentoid prescription data in England and Wales to test for evidence that any increase in deaths mentioning gabapentin or pregabalin is associated with trends in gabapentoid prescribing and is concomitant with opioid use; (b) interviewed people with a history of heroin use about their polydrug use involving gabapentin and pregabalin; and (c) studied the respiratory depressant effects of pregabalin in the absence and presence of morphine in mice to determine whether concomitant exposure increased the degree of respiratory depression observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>England and Wales.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Interviews were conducted with 30 participants (19 males, 11 female).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>(a) Office of National Statistics drug\u2010related deaths from 1 January 2004 to 31 December 2015 that mention both an opioid and pregabalin or gabapentin; (b) subjective views on the availability, use, interactions and effects of polydrug use involving pregabalin and gabapentin; and (c) rate and depth of respiration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Pregabalin and gabapentin prescriptions increased approximately 24% per year from 1 million in 2004 to 10.5 million in 2015. The number of deaths involving gabapentoids increased from fewer than one per year prior to 2009 to 137 in 2015; 79% of these deaths also involved opioids. The increase in deaths was correlated highly with the increase in prescribing (correlation coefficient 0.94; 5% increase in deaths per 100\u2009000 increase in prescriptions). Heroin users described pregabalin as easy to obtain. They suggested that the combination of heroin and pregabalin reinforced the effects of heroin but were concerned it induced \u2018blackouts' and increased the risk of overdose. In mice, a low dose of S\u2010pregabalin (20\u00a0mg\/kg) that did not itself depress respiration reversed tolerance to morphine depression of respiration (resulting in 35% depression of respiration,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.05), whereas a high dose of S\u2010pregabalin (200\u00a0mg\/kg) alone depressed respiration and this effect summated with that of morphine.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>For heroin users, the combination of opioids with gabapentin or pregabalin potentially increases the risk of acute overdose death through either reversal of tolerance or an additive effect of the drugs to depress respiration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.13843","type":"journal-article","created":{"date-parts":[[2017,5,10]],"date-time":"2017-05-10T19:04:17Z","timestamp":1494443057000},"page":"1580-1589","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":147,"title":["Risk to heroin users of polydrug use of pregabalin or gabapentin"],"prefix":"10.1111","volume":"112","author":[{"given":"Abigail","family":"Lyndon","sequence":"first","affiliation":[{"name":"School of Physiology, Pharmacology and Neuroscience University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Audrey","sequence":"additional","affiliation":[{"name":"School of Social and Community Medicine University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Wells","sequence":"additional","affiliation":[{"name":"Mortality Analysis, Office for National Statistics  Newport UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica S.","family":"Burnell","sequence":"additional","affiliation":[{"name":"School of Physiology, Pharmacology and Neuroscience University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Ingle","sequence":"additional","affiliation":[{"name":"School of Social and Community Medicine University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob","family":"Hill","sequence":"additional","affiliation":[{"name":"School of Physiology, Pharmacology and Neuroscience University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Hickman","sequence":"additional","affiliation":[{"name":"School of Social and Community Medicine University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graeme","family":"Henderson","sequence":"additional","affiliation":[{"name":"School of Physiology, Pharmacology and Neuroscience University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,5,15]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1060028015620800"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.5414\/CP202118"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40263-015-0303-6"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.13324"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-013-1578-5"},{"key":"e_1_2_7_7_1","first-page":"309","article-title":"Pregabalin abuse amongst opioid substitution treatment patients","volume":"108","author":"McNamara S.","year":"2015","journal-title":"Ir Med J"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2014.14101272"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11126-016-9421-7"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-017-0700-x"},{"key":"e_1_2_7_11_1","unstructured":"PHE\/NHS guidelines.2014Advice for prescribers on the risk of the misuse of pregabalin and gabapentin. 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