Pregabalin Misuse: Motives, Pattern, and Knowledge about Its Risks among Patients in Methadone Maintenance Treatment

We examined motives for pregabalin misuse and the relation with knowledge on its risks among patients receiving MMT. A questionnaire was used to assess patients' knowledge before and after an explanatory session. Responses were either "never-use" or "ever-use" (past, occasional, chronic). Pregabalin in urine was tested during 1 month, 4 months before, and 24 months after the explanatory session. Of 231 participants, 72 (31.2%) responded "ever-use" while 46 (19.9%) tested positive for pregabalin (42 (58.3%) of the "ever-use" and 4 (2.5%) of the "never-use" group). The 'occasional' subgroup had the highest proportion of non-prescribed pregabalin (75%), used it for recreational purpose (16.7%) and non-orally (41.7%). A faster dropout (shorter retention in MMT) was observed among patients who used pregabalin not orally (1.4 years, 95%CI 1.2-1.7) vs. (1.7 years, CI 1.6-1.8, p = .02), and those who used it not for pain (p = .024). Knowledge scores were higher among those tested positive for pregabalin (3.5 ± 1.7 vs. 2.9 ± 2.0, p = .04). Pregabalin is highly misused among MMT patients. Those who use it not for its indications, or not orally had a shorter retention in MMT, most likely not as a sole cause. "Ever users" knew more about pregabalin indications and risks. Monitoring and education on pregabalin are recommended.