Profile of migrant people with non-medically supervised use of pregabalin: a scoping review

Pregabalin is a gabapentinoid drug used to treat neuropathic pain, epilepsy and anxiety. Over recent years, prescriptions and non-medically supervised use of pregabalin have increased in several European countries, especially within the French-speaking regions. These increases have been reported in young migrants, particularly those from Maghreb. However, the available peer-reviewed literature is poor with respect to the main characteristics of migrant people with non-medically supervised use of pregabalin and their trajectory of use. This scoping review explored both indexed scientific databases and grey literature to better identify the profile of pregabalin users, including their geographical origin, context and motivations of use, sociodemographic and psychiatric features.

A search of relevant articles was conducted in several scientific databases of peer-reviewed journals, complemented by grey literature retrieved from reference lists of peer-reviewed publications and interviews with professionals involved in migrant support and healthcare.

Two main populations of migrants using non-medically supervised pregabalin were identified. The first and main group consists of people coming from Maghreb, primarily from Algeria. They are commonly young socially marginalized men, who use pregabalin to experience euphoria or to cope with psychological trauma. These individuals usually migrate for economic reasons, and they frequently seek to specifically migrate to French-speaking countries for linguistic or family reasons. Pregabalin initiation is generally reported in the country of origin, and continues post-migration, in the context of precarious living situations or enrollment in criminal networks that provide an easier access to the drug, in exchange for engaging in different illicit activities. The second identified population with non-medically supervised use of pregabalin comes from Eastern Europe, and consists of older male individuals, who usually report using pregabalin to enhance or replace opioid drugs. In this second group, migration is motivated by economic or political reasons, and/or for getting access to healthcare services for chronic viral infections, such as Human Immunodeficiency Virus or Hepatitis B or C virus. They do not specifically aim to migrate into a French-speaking country.

The increase in non-medically supervised use of pregabalin observed among migrant people in many Western European countries seems to be mainly related to two distinct migrant populations, i.e., Maghreb, and Eastern European respectively. Between the two categories of migrant people, motivations for pregabalin use, as well as migration trajectories, seem to be different, suggesting that prevention, harm-reduction and treatment strategies should be tailored to each group.