Propofol Abuse Growing Problem for Anesthesiologists - page 3

by Anxious Patient

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  1. 6
    I'm a CRNA and I cannot BELIEVE that anyone with the LEAST bit of medical knowledge would give someone an anesthetic agent at his HOME. Yes, it's true that Propofol is not a scheduled drug...which I was somewhat surprised by when I was in anesthesia school. I haven't actually THOUGHT about that for years as it just lays in the cart and we get used to things being the way they are. However, every hospital I've worked in has some way of locking up all drugs, even the nonscheduled drugs. Either a locking anesthesia cart or a tackle box of some sort that locks. But to think that someone would abuse diprivan is just amazing. You're not even conscious after 20 seconds so how good could it be?? On another note, Michael did have access to all kinds of things......and I once worked at a hospital where a scrub tech decided to commit suicide and got ahold of an amp of sux (succinylcholine), depolarizing muscle relaxant...and injected it and chose to commit suicide...I don't think that was Michael's intent but he must have really wanted the propofol...and where there's a will, there's a way...
    Altra, NC29mom, Andrew, RN, and 3 others like this.
  2. 0
    Quote from carolinapooh

    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.

    100ml bottles. They don't fit in most sharps containers, only the ones with large openings.
  3. 0
    Quote from KimQCRNA
    I'm a CRNA and I cannot BELIEVE that anyone with the LEAST bit of medical knowledge would give someone an anesthetic agent at his HOME. Yes, it's true that Propofol is not a scheduled drug...which I was somewhat surprised by when I was in anesthesia school. I haven't actually THOUGHT about that for years as it just lays in the cart and we get used to things being the way they are. However, every hospital I've worked in has some way of locking up all drugs, even the nonscheduled drugs. Either a locking anesthesia cart or a tackle box of some sort that locks. But to think that someone would abuse diprivan is just amazing. You're not even conscious after 20 seconds so how good could it be?? On another note, Michael did have access to all kinds of things......and I once worked at a hospital where a scrub tech decided to commit suicide and got ahold of an amp of sux (succinylcholine), depolarizing muscle relaxant...and injected it and chose to commit suicide...I don't think that was Michael's intent but he must have really wanted the propofol...and where there's a will, there's a way...
    Kim - all we can think of is that SOMEONE had to be helping him without the proper monitoring equipment in place. How hard would it be to pop an LMA down, and assist with a BVM, with an infusion running? Add a little Demerol or one of the Fentanyl brothers, and you have a perfect TIVA.

    Interested in your reponse - I'm still in CRNA training, but my classmates and I picked this one apart the other day while waiting for our turn to renew our PALS cards.
  4. 1
    Quote from cardiacRN2006
    100ml bottles. They don't fit in most sharps containers, only the ones with large openings.
    Indeed. And we waste quite a few in the trash cans what with changing the bottle and tubing completely after 12 hours due to infection risk.
    cardiacRN2006 likes this.
  5. 1
    We Had a stretch of time when to anes docs would order propofol for hiccups, chills after surgery, etc. the pharmacy apparently had no problem sending a 250 cc glass bottle for iv.



    I refused to give it; with the charge nurse -me- having between 10 and 15 patients it was not an appropriate order. Plus the fact my OR stint was over 30 years ago. It took administration on call to convince them not to make (order) us to do it and they said if the patient needs it, then they have to go to a unit or PACU or OR holding with an anesthest or doc around.


    That stopped them in their tracks.
    lamazeteacher likes this.
  6. 1
    http://www.anesthesiologynews.com/in...rticle_id=7579

    Such a frightening article. Especially after all the media blitz about Michael Jackson possibly abusing propofol. I suppose I was naive but I never considered this was a med anyone would abuse. Does anyone have any stats related to this? I was curious about the item in the article that states that there may be correlation between inhaling exhaled propofol from patients in the OR.
    lamazeteacher likes this.
  7. 0
    We had an anaesthesiologist who committed suicide a couple years ago, using a propofol infusion. (His addiction was apparently fentanyl).

    It's pretty scary how easily these guys can access drugs. They sometimes walk into the ICU with labelled syringes in their pockets of midaz, roc, etc. so they can get the pt sedated prior to entering the OR.
  8. 2
    Quote from pebbles
    We had an anaesthesiologist who committed suicide a couple years ago, using a propofol infusion. (His addiction was apparently fentanyl).

    It's pretty scary how easily these guys can access drugs. They sometimes walk into the ICU with labelled syringes in their pockets of midaz, roc, etc. so they can get the pt sedated prior to entering the OR.
    They need the access, though.

    Just like we have a couple of RSI kits in our pyxis fridge which is easily overrideable that has all that and more.
    Altra and azhiker96 like this.
  9. 0
    Quote from nolabarkeep
    "Anesthesiologists may be unwittingly driven to substance abuse through chronic exposure to aerosolized fentanyl and propofol exhaled by patients in the OR."
    Why is this exclusive to anesthesiologists? Shouldn't this also affect everyone else in the OR? Also, I would assume that a large percentage of Pt's in the OR are intubated. This would lessen direct contact with exhalation. I would like to see other studies on abused drugs by anesthesiologists. I would bet that propofol is on the lower end of the abuse scale.
    I think like fire we have three elements that lead to this. With fire you need fuel, heat, and a source of O2. With substance abuse we need exposure, risky behavior, access to the drug. Many in the OR are exposed. The anesthesiologist has the greatest exposure by his/location near the patien'ts head. Some in the OR have the tendency to be willing to engage in risky behaviors- trying new drugs, stealing. But, few in the OR have access to the drug. Drugs are controlled by location and access. The anesthesiologist has that access. Therefore, the anesthesiologist who has the sum of all the Xs (or risk factors) equals Y (potential for substance abuse).

    I have to wonder why anyone would abuse a drug that might stop your respiratory drive while you are using it? That to me is a sign of almost suicidal behavior- the equivalent of Russian Roulette.
  10. 0
    Quote from KimQCRNA
    ......and I once worked at a hospital where a scrub tech decided to commit suicide and got ahold of an amp of sux (succinylcholine), depolarizing muscle relaxant...and injected it and chose to commit suicide...
    OUCH! That would not be a good way to go - suffocation. Nasty, nasty, nasty.


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