Marketed under the name Lyrica for 20 years in France, an anti-epileptic drug, pregabalin, has in recent years been diverted into a street or recreational drug, prompting increased surveillance by health authorities and customs.
French customs announced a major seizure in Paris in mid-April: 30,000 doses of pregabalin, along with hundreds of kilos of tobacco and thousands of counterfeit items.
"We saw an upsurge in seizures in 2023, and since then, this phenomenon has continued," Corinne Cléostrate, deputy director of legal affairs and anti-fraud at the General Directorate of Customs, told AFP.
Pregabalin, nicknamed "the poor man's drug," is mainly sold illegally on the streets of working-class neighborhoods in Paris and Marseille, and has become an affordable alternative to more expensive drugs, such as cocaine.
"It's really a street phenomenon that has grown in recent months," summarizes Corinne Cléostrate.
With fake prescriptions, the black market, and online orders, "Lyrica has become the most accessible drug on the street market, selling for between €1 and €3 per capsule," compared to around €66 per gram for cocaine, says addiction specialist Dr. Dorian Rollet.
– “To forget” –
Initially prescribed for epilepsy or generalized anxiety disorder, the use of this medication is diverted for its anxiolytic and analgesic effects, "but also for euphoria, high and psychostimulation," continues Dr. Rollet.
As for the users, "many young adolescents in a migratory situation or young adults use it. 'It's to forget,' they tell us, their migratory journey, the difficulties," Dr. Laurène Dufayet, a forensic doctor and toxicologist at the medical-legal unit of the Hôtel-Dieu in Paris, told AFP.
According to the French National Agency for the Safety of Medicines (ANSM), cases of abuse and/or dependence are reported "mainly in men (82%) with a significant proportion of minors (25%)".
This substance can also be combined with drugs such as MDMA or cocaine to increase their effects, explains the toxicologist.
"The risk of overdose with pregabalin alone is low. However, there is a risk of overdose (...) and respiratory arrest when other drugs, or alcohol, are consumed at the same time," warns Dr. Dufayet.
"Moreover, it is a drug that acts on the central nervous system, so there is a risk of becoming dependent on the drug," she adds, emphasizing the importance of prevention in this area.
To combat the increasing misuse of pregabalin and the falsification of prescriptions, the ANSM decided in 2021 to tighten prescription requirements. It is now limited to six months and requires a secure prescription, which is more difficult to falsify.
But despite the change in prescription conditions, the increase in the number of reported cases of abuse, dependence or clinical complications linked to misuse continues, the ANSM reported to AFP.
For Corinne Cléostrate, "the trafficking therefore comes from elsewhere," traveling via express and postal freight. "Pregabalin capsules are found in packages ordered online on the darknet" as well as on the roads, "particularly from northern Europe."
At the end of January, at Beauvais airport (Oise), customs discovered more than 13,000 pregabalin tablets in the possession of a traveler from Greece.
A year earlier, the National Anti-Fraud Office (ONAF) had dismantled a trafficking ring following another seizure on a passenger also from Greece. The investigation uncovered a network transporting 300,000 pills to Marseille, generating €600,000 in revenue.
However, this does not mean that the drug is made in Greece: it could be manufactured in China, Bulgaria, Poland or even Germany, explains Corinne Cléostrate.
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