Pregabalin was described “very easy to get, really dangerous, and addictive”
Pregabalin on the streets of Liverpool.(Image: Marianna Longo/Jonathan Blackburn/Liverpool ECHO)
People experiencing homelessness in Liverpool city centre have described a pill trading hands for as little as 47p as being “worse than heroin”. One drug user told the ECHO pregabalin, a prescription drug with legitimate uses as an anti-anxiety and epilepsy drug, is “very easy to get, really dangerous, and addictive”, adding: “The withdrawal is worse than heroin”.
Earlier this week, the ECHO reported on a “wave” of pregabalin use in Birkenhead as homeless charities fear deaths will follow. The ECHO has found use of pregabalin, known as pregab, is endemic in the city‘s homeless population, with users reaching into their pockets and pulling out the pills when asked about the drug.
‘The withdrawal is worse than heroin’
Claire Mason, 41, has been on the street for “too long”. She said: “I know quite a few people who’ve died on them. Pregabs make everything ten times stronger, and people use it to make their stuff last longer.
“You can get them easily on Facebook and Gumtree. It’s very easy to get, really dangerous, and addictive. The withdrawal is worse than heroin.”
Mark Clinton, 50, has been on the streets for 18 months. He said: “You just go on the internet and buy them. It’s the same as ordering a can of Coke.”
People on the streets of Liverpool showed the Echo pregabalin pills when asked about the drug. (Image: Marianna Longo/Jonathan Blackburn/Liverpool ECHO)
‘I warn other people about pregabalin’
Eddie Riley, 53, has been homeless for 10 years. He told the ECHO he has known eight people, including two close friends, who have died after taking pregabalin along with other substances.
He said: “They were widely prescribed at one point. People don’t realise that mixing them with other drugs is dangerous. Uppers and downers together are going to make you skip a beat.
“I warn other people about pregabs. I’ve lost two close mates to it. You can get anything you want on the street. I’ve been on them myself. It kills the pain off, and it makes you tired.”
‘You just go up and ask people’
Another person experiencing street homelessness told the ECHO: “You can get pregabalin quite easily. You just go up and ask people.”
England and Wales saw 5,565 drug poisoning deaths in 2024 according to the Office for National Statistics. Pregabalin was mentioned on 617 of those death certificates, representing a presence in 11% of drug poisoning deaths nationally.
People on the streets of Liverpool showed the Echo pregabalin pills when asked about the drug. (Image: Marianna Longo/Jonathan Blackburn/Liverpool ECHO)
The ECHO was told by users that pregabalin can be picked up from street dealers for as little as £1.50 per pill in Liverpool. It is understood that pregabalin can be bought in bulk online for as little as 47p per pill.
‘A rational response to trauma’
Dr Harry Sumnall is a professor of substance use and member of the Government’s Advisory Council on the Misuse of Drugs, which is currently compiling a report on gabapentinoids, a class of drugs that includes pregabalin. He was not speaking on behalf of the Council.
Prof. Sumnall said: “Merseyside isn’t unique. Any area of any big city that does have issues with rough sleeping and street homelessness, those areas will be affected by substance abuse and alcohol.
“It’s important not to generalise, but within that community there will be higher levels of mental ill health, higher levels of people who have had adverse childhood experiences, untreated or undertreated mental health issues, a lack of social connection, really high levels of sexual assault, particularly in women.
“We’re talking about a population with a high level of complex or unmet needs. If you add drugs like pregabalin and gabapentin into that mix, it is perhaps understandable that there will be higher levels of use.
“Not to condone drug use, but you could almost see this as a rational response to some of those issues and the traumas of being on the streets. I think it’s really important that as a community in Liverpool we don’t judge and we reach out with support and compassion.”
Pregabalin became a Class C controlled substance in 2019. Prof Sumnall said levels of prescribing were “high” before the move and “rising quite rapidly”. He added: “That has plateaued, but the harms have increased despite reduced prescriptions.
“One of the issues in illicit use is that there is an interaction with other street drugs like heroin and benzodiazepines, and that can increase the risk of deaths and harm. Very rarely do you see pregabalin mentioned on a death certificate on its own. Polysubstance use is the norm on the street.”
“Often, despite really good work and good efforts, mainstream services that we all take for granted aren’t set up to meet the needs of street-homeless people.”
Police target criminals ‘higher up’ supply chain
Liverpool city centre Neighbourhood Policing Inspector Jack Woodward said: “We are aware of some use of Pregabalin alongside other controlled drugs within our street community, by people who have additional substance use disorders.
“Pregabalin is a prescription only medication and a Class C controlled drug. It is potentially harmful when sold illegally, and we work alongside our partners in health and social care in order to raise any such emerging issues, and tackle the harm caused, through regular multi-agency meetings and liaison.
“We work closely with drug and alcohol support services in Liverpool, to ensure that drug users, who are often vulnerable to exploitation by organised criminals, are safeguarded and helped to a better place.
“The risk to users from Pregabalin and other controlled drugs causes great harm within our communities. We will always look to target and disrupt criminals involved higher up the supply of controlled drugs, including those who unlawfully supply prescription drugs or other drugs with the appearance of prescription drugs. We will assess all information and take whatever positive action we can to make our communities safer.
“If you are concerned about your own use of Pregabalin or other drugs or alcohol, or you are concerned about somebody else, there are support services available.”
A Home Office spokesperson said: “Every drug-related death is a tragedy for those who have lost their lives, their families and for their wider communities.
“Our independent advisors are carrying out an updated harms assessment for gabapentinoids, which includes pregabalin. This will review their control as Class C Drugs and we will consider their findings carefully.”
The ECHO approached the Liverpool YMCA and Liverpool City Council for comment.