Pregabalin misuse: About seven cases of death in the region of Marseille

Pregabalin is a prescribed medication licensed in France for the treatment of epilepsy, neuropathic pain and generalized anxiety disorder. Although of recent use, the diverted use of this molecule, generally in combination with other psychoactive compounds, is growing significantly (increase in prescription requests in detention, existence of street markets) due to its euphoric effects at high doses. The authors report seven cases of pregabalin-related death that occurred at the Marseille Medicolegal Institute between July 2019 and February 2021. For each of them, peripheral blood analyses allowed the identification and quantification of pregabalin as well as other recreational or therapeutic substances. Pregabalin concentrations range from 7.6 to 102 mg/L and are consistent with lethal concentrations described in the literature. The profile of the users is also comparable to those found in the literature. The frequency of poly-drug use, and in particular the association with benzodiazepines and opioids, should be emphasized. These results illustrate the increasing misuse of pregabalin and should alert to the frequency and dangerousness of the association with opioids as well as to the need to systematically look for pregabalin in autopsy specimens. (C) 2021 Societe Francaise de Toxicologie Analytique. Published by Elsevier Masson SAS. All rights reserved.