Prelude

Try to take it from a pharmacist and a fairly experienced 20-something year-old Egyptian; there are few things out there that are more overwhelmingly depressing than seeing somebody succumb to substance abuse.

I’m going to wager that you yourself have known, or at least come into contact with, an addict. Perhaps you’ve been one yourself? Maybe you still are? Regardless, you’ve no doubt seen examples of what it can do; whether it’s unassuming alcohol, relatively “harmless” hashish, widely abused Tramadol or violently possessive Heroin, in the grand scheme of things, addiction is mind-numbingly miserable, and any substance that brings you to your knees is not something you want to get involved with.

In the past few years, however, a relatively new drug has seen a marked level of abuse among all classes and backgrounds of Egypt, one that started off as a decent means to a useful end, but much like it’s other chemical counterparts, has fallen into the uncanny valley; Pregabalin. You might know by its more popular names, Pregabalin or Lyrica, and even if you sequester yourself to a safer social circle, you’ve no doubt heard of it; your brother probably used it for his ugly case of shingles, your mother might use it for her fibromyalgia and you might have seen your friends popping it at a party. So, a question presents itself; what is Pregabalin? Why do people abuse it? Is it really something to worry about?

Learning about Lyro

For the purpose of this article, I’m going to occasionally refer to Pregabalin as “Lyro”, purely for the fact that it’s the term most often used to refer to the substance on the streets and among relevant circles.

Pregabalin is a relatively new drug that is primarily used as an anti-epileptic or an anticonvulsant (it prevents seizures basically), although I can go into details about how it does what it does, suffice it to say that it just slows down your brain’s seizure impulses, and at the same time, inhibits brain chemicals responsible for pain signals throughout the nervous system. It is also more widely used for neuropathic pain management; whether it’s due to diabetes, a spinal cord injury, multiple sclerosis or fibromyalgia to name a few.

However, Pregabalin also happens to have a calming effect on those struggling with anxiety and/or depression, so much so that it isn’t outlandish to see it prescribed for those who can’t cope with generalized anxiety disorder, different grades of depression and mood stabilization. 

What’s The Deal?

Though experimentation and recreational drug use are generally part of the human experience, not all of us know when enough is enough. Some folks are just predetermined to have more addictive personalities. Others just happen to be victims of mental circumstance and just chase the proverbial rabbit, trying to find happiness. And even though it’s relatively rare, casual users can find themselves slipping down that slope much faster than they had anticipated.

Ultimately, people partake in narcotics of any sort to get high. However, it’s important to understand that a “High” isn’t the same concept for everybody; though it’s true that a high usually refers to euphoria or a sense of elation, a high can be any state of mind that is desirable to the user; it’s more a matter of perspective and preference than it is a one-size-fits-all term. But what does any of this have to do with Lyro?

It doesn’t give you a massive boost of weird energy like cocaine or methamphetamine, nor does it impart hallucinatory, otherworldly experiences like psilocybin or lysergic acid, and it definitely doesn’t give you a sense of euphoric idiocy like cannabinoids or opioids. The “high” that Lyro imparts is more about how it abolishes stress, anxiety, feelings of dread or inadequacy, and just puts you in a state where you can wade through life in a foggy, faux-confident state of mind. This is without mentioning its pain relieving attributes, and the exaggerated side effects it exhibits at higher doses. Though I and many others here at CairoScene worry about the effect an article such as this may have on the reader (i.e: encouraging abuse), I feel it necessary to describe what trying it looks like; from a bystander's perspective, users can either be more calm and in a state of listless wandering, or they can be catatonic zombies with a habit of stumbling around aimlessly, severely sedated and out of touch with reality. From a user's perspective? Well...

Enlightening Insights

“My friends and I were particularly bored at one point, and we didn’t have the funds or the will to go through the process of scoring anything, so we decided to try it out. We’d heard about it from other people and at parties, so we decided to give it a go.” An anonynmous former Lyro addict told me. “We got a box delivered to us and googled how to get a kick out of it, we each took a few pills and waited, and the feeling wasn’t what we expected, but we were too relaxed and at ease to care about anything.”

“I was trying to wean myself off of opiates for a bit,” an anonymous active addict told me, “you can’t just quit suddenly like it’s Ibuprofen, you either have to stay on them for a while and slowly taper off, or find a substitute to fill in the gaps, and Lyro was what did it for me. I still use it when I need to take the edge off without using the heavier stuff, but you grow such a high tolerance to it.”

Like I said before; Lyro is both a decent pain killer, and it abolishes anxiety for as long as it’s in effect, and as it currently stands, it is readily and inexpensively available in the grand majority of pharmacies, without the need for a prescription. Pair all that with the fact that a dauntingly large portion of the populace lives with depression and anxiety in variable degrees, in addition to the fact that doctors don’t necessarily check whether or not they’re prescribing it to somebody with a history of substance abuse. Can you put two and two together?

I managed to get in contact with Doctor Mustafa Omar, an experienced psychiatrist with an emphasis on addiction therapy at the Behman Hospital, who had some interesting insights on Pregabalin as well as addiction in general, “Through my observations and experience, Pregabalin is more often associated with individuals who are already established addicts more often than recreational users, with only 5% of people using the drug being able to achieve true euphoria. I have, however, seen people try to quit heroin by substituting it with Lyrica, which isn’t something we recommend at all. Though it’s on the lower end of the addiction spectrum, it is still a cause for concern, and its withdrawal symptoms can be very serious; leading to violent seizures, severe depression and ruined sleep patterns."

Though the good doctor’s words may allude to how Pregabalin might not be as dangerous as you think it is, that can’t be farther than the truth; it would do you and others a world of good to realize that any substance with the potential to be abused isn’t something you want to take lightly. It’s also important to note that, more often than not, narcotics in general aren’t truly the root of addiction; a drug is a vehicle for an already ingrained, hazardous disorder. “Drugs are essentially tools, the addiction lies within the mind and spirit of the individual abusing them.” Dr. Mustafa told me.

What’s the Worst that could happen?

The process of Lyro addiction is pretty bog-standard; you take a few pills at first to get to where you need to go, and that works for the first few times, but then you start to notice how that same amount just doesn’t cut it anymore, so you keep ramping it up. Eventually, you’ll reach a point where you’re taking entire strips or boxes of the stuff to keep chasing the mood, ignoring the fact that overdose is a thing that can happen at outrageous doses (which aren’t out of reach for an addict).

Pregabalin withdrawal is pretty pronounced; in most cases, withdrawal causes the opposite of what it’s intended to treat, with the simplest symptom being convulsions or seizures, some violent enough to cause some serious damage, other common side effects include disturbed sleeping patterns (long-term), marked fatigue, foggy confusion, frequent short term memory loss, difficulty concentrating, disrupted libido, twitching, uncontrollable shaking and shivering, notable weight gain, generalized pain and most unsettling of all, recurrent thoughts of suicide.

It’s also worth noting the potential Pregabalin may have as a “gateway drug.” Think of it this way; you’re starting to realize that it’s not going to cut it for long, and you either have to quit altogether, or keep going, and for those who decide to keep chasing their own version of happiness, jumping from chemical to chemical is a natural part of the process.

On the more practical side of things, there’s the issue of its availability in pharmacies and its usage for people that actually need it; seeing as how it’s being abused at a steadily increasing rate, it’ll soon manage to be a prescription only medication, which is great for curbing addiction, but bad for people that legitimately need it. There’s a stigma associated with having to use a prescription to get medication as it is, but having to get one for a pain killer? Rough. “A lot of the time, you’ll find pharmacies refusing to sell you a drug, even if you have a valid prescription. They’d have to know the doctor who issued it, and this can cause a lot of undue stress to individuals who are already dealing with illness.” Doctor Mustafa added on the matter. And if the prescription debacle wasn’t enough, the rate at which it’s being bought out is high enough that people who actually need it for medical purposes often find it difficult to obtain Pregabalin, whether it be for pain management or epilepsy, and that’s just not right.

So What’s the Takeaway?

Please understand that I wrote this article with the intent to spread awareness and not romanticize an addictive substance. I am not in the business of telling people what they should and shouldn’t do, I’d like to think you’re all adults and that you’ll have some measure of personal responsibility for your own actions. This is something that I as well as many others have noticed over the past few years, among friends, coworkers and even family, and the only message I’ll admit to preaching here is that addiction is truly one of the most saddening human experiences in our paltry existence.

You have all the info, and you can do your own research into the matter if you feel like it. All I ask of people is to know what they’re dealing with, and what they’re getting into, before stepping into proverbially darker hallways without a lick of preparation.

For those of you who happen to know a Lyro addict, or really any addict of any sort, for those of you who happen to be addicts yourselves and for those of you who need somebody to reach out to, I’ve compiled a few (hopefully) helpful references for those that need them:

The Egyptian Drug Addiction Hotline; 16024 (excellent round the clock service)

Alcoholics Anonymous in Egypt

Narcotics Anonymous in Egypt

Clinics

Revive Medical Group

Maadi Psychology Center

Heal Counseling Centre

Exist Counseling

Hospitals

The Behman Hospital

Psychological Medicine Hospital

Al Mashfa Hospital & Resort