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Inside Health

Pregabalin and gabapentin misuse, Natural birth after caesarean, Adrenaline auto-injectors

Inside Health

BBC

Health & Fitness, Science

4.4575 Ratings

🗓️ 6 October 2015

⏱️ 28 minutes

🧾️ Download transcript

Summary

Prescriptions for nerve drugs pregabalin and gabapentin have risen dramatically in recent years and at the same time, concerns about abuse. Former prisoner and addict "Patrick" tells Dr Mark Porter that "gabbies" or "pregabs" are drugs of choice in jail and Dr Iain Brew, a GP who works in prisons, says misuse is a growing problem and there are examples of doctors being pressurised into prescribing them. Dr Cathy Stannard, consultant in pain medicine at Southmead Hospital in Bristol, chaired an expert group that drew up new prescribing guidelines for pregabalin and gabapentin and she tells Mark that more attention needs to be paid to emerging evidence of misuse.

Many women say that if they've had one caesarean section, they feel pressurised to have another one and Sara describes how her medical team planted "a seed of doubt" about the potential risks to her baby which she says for her meant another C-Section was inevitable. But new guidelines from the Royal College of Obstetricians and Gynaecologists spell out that vaginal birth after a previous caesarean is a clinically safe choice, with a 75% success rate, the same as for first-time mothers. Inside Health's Dr Margaret McCartney discusses the history of changing attitudes to natural birth after caesarean and says why the new guidelines should give future mothers the confidence to discuss, well in advance of their birth, the best option for them.

How do you fill in health check forms that ask for family history if you don't know who your family was? Inside Health listener Jessica is adopted and her heart health check suggested a very low risk of a stroke or heart attack when she couldn't answer the family history question. Mark and Margaret discuss how common this is, and what difference family knowledge would make to Jessica's risk (not much).

Adrenaline auto injectors were first used in the 1960s when they were developed for soldiers to use during nerve gas attacks allowing them to self administer the antidote. But is a device designed to be used by fit, trained soldiers just as suitable for use in children and adults of widely varying size and weight? These concerns were raised by a coroner conducting the inquest into the death of a 19 year old student who died of anaphylactic shock caused by a nut allergy, despite her using her auto injector. The Medicine and Healthcare Products Regulatory Authority and also the European Medicines Agency have been looking into issue and Dr Robert Boyle, allergy specialist at St Mary's Hospital, Paddington and Director of the Paediatric Research Unit at Imperial College, London provided expert advice. He talks to Mark about the limitations of auto injector design and urges everybody who might use the devices to ensure they are confident about exactly how to use them.

Transcript

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0:00.0

Hello, I'm Greg Jenna and good news, Your Dead to Me is back for a new series. Here we go. Yes, we'll explore Emperor Nero's notorious reign with Professor Marybeard and Patton Oswald. I would not want my daughter having the remote control, not alone an empire. We'll dissect the decadent life of Philippe Duke-Dor-Leon with Tom Allen. I've often tried to pretend I'm an aristocrat and being very quickly knocked down. And there'll be so much more with comedians like Olga Koch, Mike Mosniak and Rihalina. I'm excited. You're dead to me, the comedy podcast that takes history seriously. Listen first on BBC Sounds. Hello, thank you for listening to this edition of Inside Health. I hope you enjoy it. Coming up today, Caesarian Sections, a new guidelines for women having another baby

0:42.6

that should allay concerns that they'll probably need to go under the knife again.

0:47.4

And auto-injectors. Over 200,000 people in the UK are thought to carry

0:52.0

adrenaline injections for treating life-threatening allergy

0:55.3

to things like wasst things and peanuts. But how effective are they? Some of us press harder than

1:01.2

others when we're pressing the needle into our thigh. Some of us have more fat under our skin than others.

1:06.3

And the devices available have varying needle lengths. And studies have shown that in some people that's

1:12.0

not long enough to get it into the muscle. So if you inject adrenaline just under the skin or into the

1:16.1

fat, it's absorbed very slowly. It's probably not a good treatment for a severe allergic reaction.

1:21.3

More on auto injectors later in the program, but first we take a closer look at the latest

1:27.0

arrivals to the murky world of drug abuse.

1:30.9

Pre-Gabalin and gabapentin are prescription-only medicines designed to help with a number of problems,

1:36.5

but it's their pain-killing properties, in particular in nerve-related pain,

1:40.6

that's resulted in an explosion in their use.

1:43.4

The number of prescriptions for the drugs in the UK has risen dramatically in recent years

1:48.2

and an increasing number of pills are finding their way onto the black market.

1:53.2

Patrick, that's not his real name, abused pre-gabalin while in prison,

1:57.4

but his habits started well before that, along with many others. Do you want to buy any gabbies? Do you want some pre-gabs? Basically, you can be walking through town and someone will stop you asking if you want to buy him, so they've become that popular. You know, I was taking them outside, but when I went to prison, they've become top of the list for people to take. Because you've got nothing to do but thinking there

2:17.9

and when you take them,

2:19.1

they seem to take away all your problems

2:20.4

and the day seems to go really quick,

2:23.5

you know?

...

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