Health authorities in the UK have ordered tougher addiction warnings to be added to millions of prescriptions for widely used medicines that treat pain, anxiety, epilepsy, and insomnia, following a major drug safety review.
The move affects a broad group of medications taken daily by millions of people, including treatments often viewed by patients as routine or low-risk. Regulators say the new labels are designed to make it clearer that dependence, addiction, and difficult withdrawal reactions can occur even when the drugs are taken exactly as prescribed.
Why the warnings are changing
The Medicines and Healthcare products Regulatory Agency (MHRA) said the decision followed a detailed review by the Commission on Human Medicines, which examined growing evidence that certain prescription drugs are leading to long-term dependency in a significant number of patients.
Under the new rules, patient information leaflets will now carry the statement: “May cause addiction, dependence, and withdrawal reactions.”
The leaflets will also:
-
Clearly explain the difference between dependence and addiction.
-
Provide improved advice on how to taper off safely.
-
Encourage patients to discuss risks regularly with their doctors or pharmacists.
-
Include stronger warnings against mixing these medicines with alcohol or opioids.
-
Emphasize that prescriptions should never be shared with others.
Health officials said many patients underestimate how hard it can be to stop taking these medicines after prolonged use.
Millions affected across England
NHS data shows that around 4.5 million people in England were prescribed drugs in the gabapentinoid group during 2022 and 2023 alone. These medicines are commonly used for nerve pain and epilepsy, and are also prescribed off-label for anxiety, migraines, and other chronic conditions.
Experts estimate that roughly 800,000 people take pregabalin every day in the UK, with a significant number reporting fear that they may never be able to stop because of physical dependence.
Some patients trying to come off the medication describe severe withdrawal symptoms including anxiety, insomnia, tremors, sweating, nausea, confusion, and intense rebound pain.
In some cases, users who no longer receive prescriptions have turned to online sellers or street sources in an effort to maintain their dosage.
How these drugs affect the brain
Gabapentin and pregabalin belong to a class called gabapentinoids. They act on GABA-related pathways in the brain, producing pain relief, sedation, and a calming effect.
While highly effective for certain conditions, long-term use can alter how the nervous system functions, making the body increasingly reliant on the medication to feel normal.
Doctors say this is not a moral failure or lack of willpower, but a biological response.
“When patients try to stop suddenly, the nervous system can rebound aggressively,” one consultant neurologist explained. “That’s what creates the frightening withdrawal symptoms.”
Other drugs included in the warning expansion
The strengthened warnings also apply to two other major drug groups:
Benzodiazepines – often called “benzos” – including:
-
Diazepam
-
Lorazepam
-
Temazepam
-
Chlordiazepoxide
-
Clobazam
-
Clonazepam
These are usually prescribed for short-term anxiety, severe insomnia, seizures, or alcohol withdrawal. Although intended for brief use, many patients remain on them for months or years.
Z-drugs, used for insomnia, including:
-
Zopiclone
-
Zolpidem
Despite being marketed as safer alternatives to benzodiazepines, they can cause similar dependence and withdrawal issues.
Another Z-drug, zaleplon, was removed from UK prescribing years ago due to safety concerns.
The human cost of dependence
Patients affected by long-term use often describe their situation as a cycle they cannot escape. Many report waking in the night needing another dose, planning daily activities around medication access, and experiencing panic at the thought of running out.
Some develop loss of smell, memory problems, emotional blunting, or worsening anxiety over time. Others say they feel trapped between unbearable symptoms and fear of withdrawal.
For many, the most difficult part is the lack of awareness when treatment first begins.
“I was never told this could happen,” one long-term user told ITV recently. “If I’d known, I would have been much more careful.”
What the MHRA says
Dr Alison Cave, the MHRA’s Chief Safety Officer, said the new warnings are meant to protect patients, not frighten them.
“Addiction and dependency can happen to anyone taking these medicines, even when used as directed,” she said.
“That’s why we are strengthening warnings so patients and healthcare professionals can better understand the risks.”
She added that the drugs still have an important role in medicine, but only when patients are fully informed.
“These medicines remain valuable treatments for many patients and it’s important they have the information they need to be able to use them safely.”
Dr Cave also urged patients not to stop suddenly without medical guidance.
“Do not stop taking your medicine without advice, as this could cause withdrawal symptoms,” she said.
Can most people come off safely?
Experts stress that many patients can successfully taper off these drugs with medical support and experience no permanent harm. However, the process often takes months or even years for long-term users.
Some people require temporary use of alternative medications, psychological support, or structured withdrawal programs.
The key, doctors say, is gradual reduction and close monitoring.
“Cold turkey is one of the worst things you can do with these medicines,” said one GP. “That’s when patients get into trouble.”
Why awareness matters now
The new warnings come as prescription-drug dependence is increasingly seen as a silent public health issue. Unlike illegal drugs, prescription medicines carry an assumption of safety that can mask long-term risks.
Health leaders believe clearer labels will help patients make informed choices, ask better questions, and recognize early warning signs of dependence.
They also hope it will encourage doctors to review prescriptions more frequently and avoid automatic renewals without discussion.
What patients should do
If you are taking any of the medicines covered by the new warnings, experts advise:
-
Do not stop suddenly.
-
Speak to your GP or pharmacist before making any changes.
-
Ask about tapering plans if you’ve been using them long-term.
-
Avoid mixing with alcohol or opioids.
-
Never share prescriptions with others.
For patients already struggling, the MHRA says help is available through primary care, specialist pain clinics, and mental health services.
A shift toward honesty
Ultimately, health officials say the new labels represent a shift toward transparency.
For years, many patients believed these medicines were safer than they actually are when used long-term. The updated warnings aim to ensure that no one starts treatment without understanding both the benefits and the risks.
As Dr Cave put it: “People deserve the full picture. Only then can they make the right decisions for their own health.”
Emily Johnson is a critically acclaimed essayist and novelist known for her thought-provoking works centered on feminism, women’s rights, and modern relationships. Born and raised in Portland, Oregon, Emily grew up with a deep love of books, often spending her afternoons at her local library. She went on to study literature and gender studies at UCLA, where she became deeply involved in activism and began publishing essays in campus journals. Her debut essay collection, Voices Unbound, struck a chord with readers nationwide for its fearless exploration of gender dynamics, identity, and the challenges faced by women in contemporary society. Emily later transitioned into fiction, writing novels that balance compelling storytelling with social commentary. Her protagonists are often strong, multidimensional women navigating love, ambition, and the struggles of everyday life, making her a favorite among readers who crave authentic, relatable narratives. Critics praise her ability to merge personal intimacy with universal themes. Off the page, Emily is an advocate for women in publishing, leading workshops that encourage young female writers to embrace their voices. She lives in Seattle with her partner and two rescue cats, where she continues to write, teach, and inspire a new generation of storytellers.
