New "poor man's drug," the anti-epileptic pregabalin under customs surveillance

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 accessible 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.

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 "mostly among men (82%) with a significant proportion of minors (25%)."

This substance can also be combined with drugs like MDMA or cocaine to enhance 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, reports the ANSM.

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.