March 19, 2013
Propofol Abuse Among Healthcare Providers On The Rise
Jason Pierce, MSN, MBA, RN for redOrbit.com — Your Universe Online
A new study in the April edition of the Journal of Addiction Medicine suggests that propofol abuse by health care professionals is increasing. This appears to be especially true among physicians and nurses with easy access to the drug, such as those who provide anesthesia. The study also points out a number of characteristics common among health care professionals known to abuse propofol. The study´s authors, Dr Paul Earley and Dr Torin Finver of the Georgia Health Professionals Program, hope their findings can be used to develop tools to identify and treat providers suffering from propofol addiction.
The study reviewed data collected from patients admitted to one addiction center specializing in substance abuse among health care providers between 1990 and 2010. During the period of the study 22 patients were treated for propofol abuse. The patients included thirteen physicians, eight nurses, and one dentist. Most of the physicians and all of the nurses were anesthesia providers, who had ready access to propofol.
Propofol is a sedative-hypnotic drug designed to be injected intravenously (IV) for use as a general anesthetic. The hypnotic effect generally occurs within one minute of injection. Accidental overdose causes cessation of breathing and dangerously low blood pressure. The drug is designed to be administered only by highly trained clinicians in a controlled environment such as a surgical suite or intensive care unit.
Propofol causes rapid loss of consciousness following injection, which can lead to injuries from falls or other accidents. Half of those studied entered treatment following injuries sustained after losing consciousness. Five of the participants were admitted for treatment after being found unconscious.
Most of the propofol abusers had a history of depression, childhood abuse, and a family history of substance abuse. They were more commonly women, and had a higher than expected number of family members with schizophrenia. The health care providers most often began using propofol as a sleep aid even though the FDA has not approved its use as a treatment for insomnia or sleep disturbances.
The authors describe propofol addiction as, "a rapidly progressive form of substance dependence,” and point out that users quickly develop characteristics of addiction. The majority of the patients studied had only been using propofol for a few months, and five of the patients only had a single binge prior to treatment. "Propofol addiction is a virulent and debilitating form of substance dependence" with a "rapid downhill course," according to Dr Earley and Dr Finver.