Figures from the National Drug Related Deaths Index, showing that more than two people died each day in the Republic in 2016 as a result of drug use, are of concern. A total of 736 people died in 2016 compared to 431 in 2004 – an increase of 71 per cent – according to the data from the Health Research Board.
Alcohol, either alone or with other drugs, continues to be the principal substance implicated in deaths. However, the identification of prescription drugs as the leading cause of poisoning deaths must ring alarm bells.
Prescription drugs were implicated in seven of every 10 poisoning deaths in 2016. While the opiate methadone and the tranquiliser diazepam are the most common prescription drugs implicated, some new prescription drugs are emerging as a cause of death. Pregabalin, licensed for use in Ireland in the treatment of epilepsy, neuropathic pain and generalised anxiety disorder, was implicated in 14 deaths in 2013, but the drug contributed to 65 deaths in 2016.
Although deaths from heroin continue to decrease, methadone, a liquid drug prescribed by doctors here as part of a management programme for heroin addicts, was implicated in almost one third of poisoning deaths in 2016. And benzodiazepines, in the form of sleeping tablets and anti-anxiety pills, continue to be the most common prescription drug found in those who died. While a small number of prescription drugs are misused on the back of forged prescriptions, most will have been given to patients by doctors. This raises an important issue: are doctors in Ireland prescribing drugs, with the potential for abuse, appropriately?
The prescribing of pregabalin has increased, especially as a painkiller. It can be prescribed by all doctors, including non-consultants and GPs.
With a four-fold increase in deaths from pregabalin, the time has come to restrict its prescribing to certain specialists. And the Department of Health must consider including all prescription drugs with the potential for misuse on a revamped controlled drugs list.