Abstract
Objective: This study aimed to investigate the prevalence, patterns, and health consequences of pregabalin misuse among substance users in Karachi, Pakistan.
Methods: A cross-sectional analytical study was conducted from July to December 2025 at selected de-addiction centers and community settings in Karachi. A total of 420 substance users aged 18 to 65 years were recruited using purposive and snowball sampling. Data were collected through an interviewer-administered questionnaire measuring sociodemographic characteristics, substance use history, pregabalin misuse patterns, and health consequences. Multiple linear regression analysis was employed to examine the association between three independent variables (peer influence, perceived accessibility, and awareness of risks) and the dependent variable (health consequences severity score).
Results: The prevalence of pregabalin as the primary substance of use was 15.0%, while 45.0% of participants were polysubstance users. The majority were young adult males (26-35 years, 37.1%; male, 90.0%) from low socioeconomic backgrounds. Peer influence (β = 0.432, p < 0.001) and perceived accessibility (β = 0.278, p < 0.001) emerged as significant positive predictors of health consequences severity, while awareness of risks (β = -0.215, p < 0.001) demonstrated a significant protective effect. The model explained 46.0% of the variance in health outcomes.
Conclusion: Pregabalin misuse represents a significant public health concern in Karachi, with peer influence and pharmaceutical accessibility driving adverse health outcomes. Health awareness serves as a protective factor. Strengthening pharmaceutical regulations and implementing targeted health education interventions are urgently needed to address this emerging threat.