2024-07-23 22:51:08
“When you’re craving Lyrica it’s horrible. You don’t eat, you don’t sleep, you think poorly, you want nothing.” Yassine (1) is 25 years old. He looks ten years older. With a faded haircut, a scar on his head, his face is marked, but his small, always sparkling eyes are sunken. The tall guy is sitting nervously in the office of his psychologist from the Oppelia Charonne association, in the 13th arrondissement of Paris. It’s been a year since he has been monitored in an attempt to completely wean off the medication. Before, he used to take dozens of red and white capsules a day, often mixed with other substances. Now, he takes only five. Four are prescribed by his psychiatrist, and the fifth, the last of the day and the “most powerful” according to him, he buys from street dealers.
Nicknamed “taxi” or “saroukh” (rocket in Arabic) for its euphoric effects, pregabalin – the generic name for Lyrica – is a prescription medication for generalized anxiety disorders, epilepsy, and even neuropathic pain. In 2020, it topped the list of medications mentioned in suspicious prescriptions, according to data collected by the French addictovigilance network. The following year, pregabalin was classified as a narcotic by the Ministry of Health. In the media, it is now dubbed “the drug of the poor.” But it concerns many young exiles and is readily available on the black market. “Here, patients addicted to Lyrica are flocking. It’s an emerging phenomenon,” begins Dr. Dorian Rollet, a Lyrica specialist in France and director of two ongoing studies on the subject. He has been working at Widal Hospital in the 10th arrondissement since 2018, just a stone’s throw from the Goutte d’or neighborhood. “The patients we follow are all in exile. Most are from the Maghreb and young, with a small portion originating from the Balkans,” he continues. According to the addictologist:
“A large part of unaccompanied minors from the Maghreb is concerned.”
On the street, young exiles, often minors, take Lyrica. A way to forget their daily life of wandering. /
Credits: Hervé Lequeux
300,000 pills seized
Last November, 8,344 capsules were seized in Metz. At the beginning of 2024, the French customs seized during the “first dismantling of an international network importing pregabalin,” after discovering 6,130 pills on a passenger from Greece. The investigation revealed the existence of a market for 300,000 pills in Marseille (13). The pills are sold for between one and three euros each, at dosages ranging from 150mg to 300mg. They sell for less in Marseille than in Paris, because they sometimes come from parallel trafficking of counterfeit medications or pills obtained from abroad that transit through the port of the city since the Netherlands or India. Or even by the migrants themselves, who have arrived from Italy. “A pill costs 2.50 euros, sometimes only 2 euros when you know the seller well,” Yassine states with a smirk. The Moroccan finds them in Barbès, at La Villette or in Saint-Denis and, recently, in the Place d’Italie in the 13th arrondissement. “In 2020, it cost even less, one euro per pill,” explains the tall brown-eyed man. The sellers? “Often Algerians,” he scoffs:
“Moroccans have the hash, and they have the pregabalin.”
The pill costs between 2 euros and 2.50 euros. /
Credits: Hervé Lequeux
The implementation of secure prescriptions in May 2021 only temporarily increased black market prices. Behind this parallel trafficking, built on falsified prescriptions and smuggled medications, many associations recognize regular resellers of Rivotril, nicknamed “Madame Courage.” This highly addictive benzodiazepine medication has been diverted for its “high” effect for over ten years. In the Goutte d’or neighborhood, consumers often mix Rivotril with Lyrica, hard alcohol, and laughing gas balloons. Sometimes even with cocaine or crack when tolerance has set in. This method of consumption is called “polypharming.” Dr. Dorian Rollet adds:
“The medication is consumed for its anxiolytic and ‘downer’ effect. Consumers have multi-traumatic backgrounds with affective deficiencies and complex traumas, like witnessing domestic violence or crime scenes, for example.”
In the Goutte d’or neighborhood, consumers often mix Rivotril with Lyrica, hard alcohol, and laughing gas balloons. /
Credits: Hervé Lequeux
Traumatic backgrounds
This is the case for Yassine. He grew up in Hay Hassani, a working-class neighborhood in Casablanca, Morocco. His father can no longer earn a living after a work accident, and his mother struggles to raise the five siblings. Yassine was 11 years old when his older brother killed their neighbor and friend right before his eyes during a fight. It is to escape this violence that he arrives in France from Italy in 2018. First spending a year in Brittany with an uncle, juggling odd jobs, before arriving in Paris in 2019. For two years, Yassine slept on the street, sometimes squatting. It is at Gare de l’Est that he finds refuge. “On the street, there are kind people and others who are crazy. I’ve seen very serious things and a lot of fights.” He reveals a large scar on his arm:
“Someone who was taking crack wanted to steal my bag and attacked me with a knife.”
“On the street, there are kind people and others who are crazy. I’ve seen very serious things and a lot of fights,” Yassine recalls. /
Credits: Hervé Lequeux
“I was with the minors; I saw a lot of people taking it. But I’m not into that,” Imad, 18, claims, locked up for two months when StreetPress meets him at the administrative detention center (Cra) in Vincennes last January. Like other foreign minors, he discovered Lyrica upon arriving in France, with friends who grew up in Algeria like him. He’s small, but he already knows how to impose himself in a group. He continues:
“On the street, everyone takes stuff, and Lyrica is something you start very young.”
Like other foreign minors, Imad discovered Lyrica upon arriving in France. /
Credits: Hervé Lequeux
Lyrica allows its users to experience a euphoric state, disinhibition, hallucinations, but also what some of them describe as “a feeling of omnipotence.” “Others consume it also because it protects against the cold, because you feel less lonely when you’re on the street. It’s self-medication,” specifies Fabrice Olivet, an expert at the National Agency for the Safety of Medicines and Health Products (ANSM) for twelve years and also vice-president of the association Self-support and Harm Reduction among Drug Users and Ex-Users (Asud). For Yassine, like many others, the first time he took Lyrica, the medication was prescribed by a doctor in Morocco for pain. Today, he explains that pregabalin helped him cope with freezing nights and the difficulty of sleeping on the cold ground in the street:
“People use it to stop thinking about their problems.”
Yassine recounts how pregabalin helped him withstand the freezing nights and the difficulty of sleeping on the street. /
Credits: Hervé Lequeux
However, excessive use, as with Yassine, can lead to physical dependence and disorders such as increased aggression and suicidal thoughts. Most importantly, it heightens the risk of respiratory depression and heart rhythm disturbances, two major manifestations of a fatal overdose.
Excessive use of Lyrica can lead to physical dependence and disorders such as increased aggression and suicidal thoughts. /
Credits: Hervé Lequeux
READ ALSO: The broken dreams of Mustapha, a Moroccan minor found hanged in prison
“The addiction dimension is not taken into account for these patients”
One day in early 2020, just before Covid, Yassine learns that he’s targeted by an Obligation to Leave French Territory (OQTF) while he is unsuccessfully trying to renew his residence permit. He is sent to the Cra in Vincennes for three months. “This left some not-so-good things in me. The violence was every day. They even fought with toothbrushes.” In the Cras, Lyrica is one of the most used medications. Most arrive already addicted, and depending on the facility’s policy they start forced withdrawal or are prescribed medication.
“It’s crazy here!” chimes in Nora (1), a nurse at this same detention center for ten years. She is responsible for distributing medication to detainees, undocumented individuals awaiting expulsion. When asked if she has ever heard of Lyrica, the fifty-something sighs heavily. She decided to stop distributing it at the Cra in May 2022. “I’m a nurse, not a dealer,” she asserts in light of the extent of the phenomenon. Here, “everyone has addiction problems.” But since 2018, it’s pregabalin they demand.
READ ALSO: The plight of exiles locked up at the Vincennes detention center
In her small gray office, full of paperwork, the nurse at the Cra in Vincennes adds:
“With heroin or cocaine, it’s easy! We give methadone or subutex and patients can manage their addiction. For Lyrica, there’s no substitute.”
So the various Cras create health protocols, without national directives, just makeshift solutions… Like in Vincennes, where they “mainly dispense Dafalgan-codeine or Acupan to relieve pain,” she clarifies. Other professionals still dare to prescribe it, despite the almost universal disapproval and the taboo surrounding Lyrica. “This type of protocol remains an outlier, unregulated, initiated by courageous doctors,” claims Fabrice Olivet, the Asud activist.
Currently, there is no substitute for Lyrica. /
Credits: Hervé Lequeux
For Dr. Samir, a general practitioner in the Cra and an associative health center in Toulouse, addiction to these medications “is not taken into account for these patients at all” by public authorities. He summarizes with irony:
“Consumers are a marginalized and racialized population: we’re not going to bother to create protocols to treat those people.”
For Dr. Samir, addiction to these medications “is not taken into account for these patients at all” by public authorities. /
Credits: Hervé Lequeux
Overdoses
Yet Lyrica kills even within detention centers. In 2023, two people have lost their lives there. A man in Vincennes in May and another in Marseille in June. Despite the secret of the ongoing investigation, in both deaths, leads point towards a pregabalin overdose. According to the latest data from the ANSM’s Drames (Deaths related to medication and substance abuse) investigation, pregabalin has been linked to the deaths of at least 25 individuals since 2018. In the majority of cases, the molecule is associated with opioids. Dr. Samir assures:
“That’s an underreported figure. When a person arrives at the hospital due to an overdose, this molecule is not always detected.”
Pregabalin has been linked to the deaths of at least 25 individuals since 2018. /
Credits: Hervé Lequeux
When Yassine leaves the Cra in the summer of 2020, he makes a radical decision: “I needed to stop the medication.” At 21, he decides to seek support. “I realized that the problem came from me, that others like me had traumatic backgrounds.” With the help of Oppelia Charonne, he hopes to find a job, get regularized, and “no longer be in violence.” He, who took a hairdressing course in Morocco volunteers to cut the hair of addicted patients, who, like him, once walked through the association’s doors hoping to regain their sobriety.
READ ALSO: Suspicious deaths and suicide attempts: a dark series at the Cra in Marseille
(1) Names have been changed.
Emerging Trends in Lyrica Abuse Among Young Exiles
Recent reports have highlighted a disturbing trend: the rising misuse of Lyrica (pregabalin) among young exiles, particularly from North Africa and the Balkans, in urban areas of France. As more young people face dire conditions of homelessness and trauma, the search for relief has pushed many towards this prescription medication, now dubbed “the poor man’s drug.” As instances of addiction grow, so do the challenges in addressing the issue within a medical and social support framework.
Increased Accessibility and Black Market Growth
The ease of obtaining Lyrica from street vendors in cities like Paris and Marseille exacerbates the crisis. Reports indicate that the drug, available at low prices, has become easily accessible, especially in impoverished neighborhoods. As authorities crack down on this illicit market, there is a concern that black market prices may fluctuate, but demand will likely persist due to the drug’s euphoric effects and ability to numb the harsh realities of street life.
Challenging Addictive Patterns
Data from medical professionals indicates that the majority of those abusing Lyrica come from backgrounds marked by trauma and instability. The dependency these users develop is often compounded by poly-drug use, mixing Lyrica with other substances such as opioids and alcohol, which creates a greater risk for acute health crises, including potentially lethal overdoses. This increasing complexity suggests a pressing need for tailored addiction treatment programs that acknowledge and address co-occurring disorders among marginalized populations.
Healthcare System’s Response
Within institutional settings like centers for undocumented migrants, the response to Lyrica addiction remains inconsistent and often lacking in medical oversight. The absence of formal protocols for treating Lyrica dependency creates a gap in care. As the problem evolves, healthcare professionals are calling for more comprehensive strategies, including the training of staff to better understand and treat addiction, particularly among vulnerable patient populations.
Long-term Rehabilitation Needs
The future of addressing Lyrica abuse will likely lean towards developing integrated support systems that encompass mental health, trauma recovery, and addiction treatment. Organizations that work closely with exiled populations are already laying the groundwork by offering psychological support and community resources, suggesting a promising direction for effective intervention strategies that prioritize recovery in a compassionate manner.
As drug policies evolve and public awareness increases, there is hope that long-term solutions focused on harm reduction and rehabilitation will minimize the impact of substances like Lyrica on vulnerable youth navigating the challenges of life in exile.