Abuse of propofol is a "rapidly progressive form of substance dependence" that is being more commonly seen among healthcare professionals, according to a study to be published in the April 2013 Journal of Addiction Medicine.
Data from an addiction center specializing in substance abuse problems among healthcare professionals identified 22 patients treated for propofol abuse from 1990 to 2010.
The number of healthcare professionals treated for propofol abuse increased steadily during the period studied, although increased recognition by addiction center staff may have played a role, noted study authors Paul Earley, MD and Torin Finver, MD, of the Georgia Health Professionals Program.
The patients were 13 physicians, eight nurses, and one dentist. Most of the physicians and all the nurses were anesthesia providers who had ready access to propofol.
Patients using propofol were more likely to be women, compared with healthcare professionals abusing alcohol or other drugs, the researchers found. Most had depression along with a history of childhood sexual or physical abuse. In addition, most reported a family history of substance abuse, and a higher than expected number had family members with schizophrenia.
The patients reported that they generally started using propofol to help them sleep. However, they quickly developed characteristics of addiction, with propofol becoming a preferred drug of abuse. Most sought addiction treatment within a few months after starting to use propofol. Five patients sought treatment after a single propofol binge. Five patients were admitted into treatment when they were discovered unconscious.
These characteristics reflect the "narrow window between desired effect and unconsciousness" and the rapid loss of control over propofol use, according to the authors.
"Propofol dependence is a rapidly progressive form of substance dependence seen in 1.6% of all healthcare addiction cases reporting to treatment," they wrote.
Within the limitations of the data, the study findings suggest that propofol abuse by healthcare professionals is increasing, particularly among physician and nurse anesthesia providers with ready access to anesthetics, the researchers concluded.
