Propofol Abuse Growing Problem for Anesthesiologists

Propofol?
I dont' get it! I mean, it wears off in like, 36 seconds. How could it be used for insomnia?

And yep, we just toss it in the trash when we're done...I never thought of people abusing it. I mean, propofol?

Bizarre.

Back in my PICU days before the Pyxis was around, Propofol was just fully stocked in a cabinet in the med room. One PICU RN was an abuser of Propofol and was actually found passed out in the employee bathroom (by one of our attendings) with a heplock in her foot.

It's a bit more controlled now in the Pyxis, but there is still the override function. I have never even thought to NOT dispose it in the garbage. Yikes, it's amazing what some people will do for their "fix."

We don't give propofol unless the pt is on a vent. That's dangerous stuff.

Our's isn't even in its own compartment. Meaning, I can go in and pull out tylenol or heparin flushes, and the propofol is just sitting next to it. So, it's about as controlled as tylenol!

I wonder if pharmacy will change it's mind with all this MJ media coverage.

I too have always wondered why the heck is this stuff not wasted??? We just pull out a bottle and throw it in the trash when we're done too. Apparently, I could have been making a whole lot of "extra income" over the years by sticking it in my pocket!~kidding!!

I was shocked when I heard Propofol could be abused. We had an anesthesiologist who "passed out" during a case, turned out he had a butterfly in his foot and was giving himself Propofol. He ended up losing his license. It was a shame because he was a great guy.

Two points here:

If MJ wanted a refreshing sleep, he's choosing the WRONG drug. Anesthesia induces NON-Rem sleep, and that's not refreshing in the least!

Dexmedetomidine is a much better alternative, or even Clonidine, for cryin' out loud...and Clonidine doesn't have to be ICU-monitored! I've seen it used MANY times as an adjuvant for insomnia medications.

Anesthesia does have access to drugs. We make up a good deal of the substance abuse, but a small percentage of healthcare providers.

I can't speak to why this is, but for someone to imply we "hit the Pyxis like a Saturday Sale" (I forget the exact words) is downright offensive!

If IT hits the fan during surgery, we can't just leave our patient to go to the Pyxis. We MUST have everything we even think we could concievably need right at our fingertips.

We are taught to prepare for every eventuality, because WE ARE RESPONSIBLE FOR THAT PATIENT'S LIFE ON THAT TABLE.

And until you know what all those eventualities are, do not be talking trash about our efforts to make sure we are prepared to meet every last one of those challenges head on.

Quoted from Anxious Patient's post (in regards to MDs discussing the MJ-propofol connection):

I think the goal here was not to remain sedated for the entire sleep period, but rather to have a brief period to use the drug to feel refreshed afterward. Apparently, there are some studies that suggest that propofol has the ability to erase one’s overall feeling of cumalative sleep deprivation. If that is truly what his goal in using it was, in fact, he may not have had more than a couple of hours of sleep daily in many years, due to the artificial feeling of refreshment.

Anyone else disturbed by how calm this discussion is? (And as a side note - yikes - a couple of hours' sleep daily in YEARS? Should that be the case, the guy literally wore himself out.)

I have no idea how large of a container propofol comes in, but I know that personally I don't throw any drug container in the trash - I toss it all in the sharps bin.

That said, it IS amazing how (almost) blase we find ourselves getting about stuff because we're around it all the time.

In my (long ago) experience working in an OR, many anaesthesiologists eschued wearing a mask. Others working in the rooms, did wear them appropriately. I also saw that more recently, as a patient.

I went to the article sited, and made the suggestion that in further planned studies about addiction to propofol, those who wear masks habitually in the OR have the blood and hair tests pre and post surgery, as would the anaesthesiologists. That would rule in or out harmful effects of not wearing a mask. Of course the surgeons and surgical nurses in the room are further away from aerosolized agents. The circulating nurse would be a fairly good "control" subject, as he/she leaves the room during surgery.

OSHA would need to be made aware of the numerical results of the studies.