J Korean Med Assoc.  2013 Sep;56(9):771-777. 10.5124/jkma.2013.56.9.771.

Propofol abuse among healthcare professionals

• Hong SH

• KMID: 2015673
• DOI: http://doi.org/10.5124/jkma.2013.56.9.771

Abstract

The number of healthcare professionals (HCPs) abusing propofol has been steadily growing, while recreational use of propofol among the general public has become a social concern. Propofol was once believed to be unsuited for the purpose of abuse because it wears off too quickly and induces unconsciousness more frequently than euphoria. However, studies have demonstrated the abuse potential of propofol. Animal studies have shown that propofol increases dopamine levels in the mesolimbic dopamine system, which is a putative mechanism of addiction for most addictive drugs. Behavior studies, not only with animals but also with human beings, have demonstrated that administration of propofol induces conditioned rewards and reinforcement. Although the incidence of propofol abuse among HCPs seems to be lower than that of abuse of common addictive substances, multiple articles and case reports have documented cases. Easy access to the drug is closely associated with its abuse among HCPs. In addition, the pharmacologic properties of propofol, specifically its short onset and offset, is one of reasons HCPs start to abuse this drug without any serious consideration and makes propofol abuse difficult to detect. To reduce propofol abuse among HCPs, we should develop a strict pharmacy control system for limiting access to propofol. Adopting radio-frequency identification system for controlled drugs could be an effective option. However, substance dependent HCPs are quite resourceful even in obtaining controlled drugs. Therefore, a multilateral approach to stem the rising tide of propofol abuse among HCPs is needed: a combination of preventative education, early identification and intervention, aggressive treatment, and consistent rehabilitation.

Keyword

Substance-related disorders; Healthcare professional; Propofol

MeSH Terms

Animals
Delivery of Health Care
Dopamine
Euphoria
Humans
Incidence
Pharmacy
Propofol
Reinforcement (Psychology)
Reward
Substance-Related Disorders
Unconsciousness
Dopamine
Propofol

Figure

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  Figure 1 Chemical structure of propofol (2,6-diisopropylphenol). From Wikimedia Commons. File:Propofol.svg [Internet]. [place unknown]: MediaWiki.org, according to the Creative Commons license [5].

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