By Shahista Namale
The misuse of prescription medicines, particularly pregabalin, is raising concern as young people increasingly experiment with drugs for recreational and non-medical purposes.
Pregabalin is prescribed to treat conditions including epilepsy and nerve pain and is also used for some anxiety-related conditions. But when taken in doses higher than prescribed or without medical supervision, it can produce unwanted effects and may lead to dependence.
The drug is also frequently used alongside other substances, including opioids, a combination that can increase the risk of serious harm and potentially fatal overdose.
Dr Hakim Sendagire, a Ugandan physician, biochemist, academic and researcher at Makerere University School of Public Health, says the growing misuse is being driven by several factors, including easy access to medicines, weak enforcement of drug regulations and widespread experimentation among young people.
“The problem is that social media does not appear to be merely introducing young people to these substances—it can also help them get hold of them,” Dr Hakim said.
He said some individuals use social media platforms to market and sell medicines, making potentially dangerous drugs accessible to people without prescriptions or medical supervision.
“This is something the ministry needs to intervene in and do something about before the situation worsens,” he said.
Dr Hakim said the risks become particularly concerning when pregabalin is taken in large quantities for its intoxicating effects.
“Pregabalin, especially in higher than prescribed doses, can make users relaxed and happy—a similar feeling to being drunk,” he said. “If one is using it as a sort of intoxicant to get drunk, then they are at risk of dependence. It’s not a free lunch in that sense.”
He also warned about the inappropriate use of propranolol, another prescription medicine that some young people may turn to in an attempt to manage anxiety in social situations.
While propranolol can be safely used when prescribed and taken as directed, inappropriate or excessive use can cause dizziness, fainting and a dangerously slow heart rate.
The risks are potentially greater when medicines are obtained from unregulated sources, Dr Hakim said.
“There’s always a danger of getting medicines that aren’t made to medical standards,” he said.
He urged young people not to use prescription medicines for recreational purposes or without medical guidance, warning that high doses can be dangerous and, in some circumstances, life-threatening.
The misuse of medicines can also create a cycle in which users come to rely on drugs to cope with particular situations, including social interactions, he said.
NDA CALLS FOR A MULTI-AGENCY RESPONSE
The National Drug Authority says addressing prescription medicine misuse cannot be left to the drug regulator alone.
NDA spokesperson Abiaz Rwamwiri said controlling drug and substance abuse requires coordinated action involving several institutions, including the police, Ministry of Health and education sector.
“Drug and substance abuse control can’t be achieved by a drug regulator alone. It must be done together with police, Ministry of Health, education system, among others,” Rwamwiri said.
He said the NDA has a unit dedicated to drug and substance abuse that, among other activities, conducts awareness campaigns targeting young people.
The authority also works with schools, religious institutions, hospitals and non-governmental organisations to raise awareness about the dangers of drug and substance misuse.
The concerns in Uganda form part of a wider international debate over the non-medical use of prescription medicines.
In England, pregabalin was reclassified as a Class C controlled drug in 2019 following concerns over its misuse. The drug remains widely prescribed for conditions including epilepsy and nerve pain.
Researchers have also reported concerns about pregabalin misuse in countries including Jordan, Ukraine and India, while China has introduced tighter controls on the drug.
For Uganda, health and drug-control authorities face the challenge of preventing prescription medicines from becoming readily available for recreational use while ensuring that patients who genuinely need them can continue to access them.
Dr Hakim said greater public awareness, stronger regulation of medicine sales and closer monitoring of online platforms could help limit the emerging problem, particularly among young people.
