posted on 6:12 AM, June 23, 2014
Click here for a .pdf of this press release.
Like many other drugs, propofol can make you high but also has important therapeutic indications
and is an indispensable medication. Tighter control as well as education is critically important to
ensure appropriate and safe use of this drug.
Phoenix, AZ July 28 2009. Propofol is not a typical drug of abuse. It doesn’t come as a pill or a powder;
it is only available for intravenous administration. It is not scheduled by the DEA, suggesting its abuse
potential is very low. It is primarily used by trained physicians and nurse anesthetists to induce a coma‐
like state in a patient so he/she is not awake and not aware of discomfort. Its use is normally confined to
the operating room, intensive care unit, or emergency department.
Unfortunately, like many psychoactive agents, propofol can be abused. In the last few years a number
of medical publications have attested to this growing problem. (See references). At a low dose, before
the patient is fully unconscious, propofol may induce a sense of euphoria similar to that which is
experienced with other sedative agents (such as benzodiazepines and opioids). Sexual hallucinations
and disinhibition have also been described. This “high” may be an experience that the user finds
pleasurable and seeks again. Repetitive use of propofol may result in intense drug cravings and drug
dependence similar to other drug addictions. Deaths have occurred from self‐administered use.
The major danger with many drugs, including propofol, is that people vary in their response to a given
dose, and this sensitivity is unpredictable. A dose that causes a “high” in one person may be the same
dose that causes respiratory depression leading to death in another person. (See references). And with
propofol in particular, the window between safe and potentially deadly in an unmonitored patient is
very small. In one survey study of anesthesiology residents, 25 cases of individuals abusing propofol
were reported including 7 who died from propofol abuse.
Propofol, even when used properly, can cause respiratory depression. Used by trained personnel in
monitored settings, propofol is very safe and highly effective. However, It is dangerous to use in an
unmonitored setting. For someone who is already on a mechanical ventilator (such as in the operating
room or intensive care unit) propofol‐induced respiratory depression is not a concern, and even at times
desirable, because the ventilator will continue to breath for the patient.
As medical toxicologists, members of the American College of Medical Toxicology (ACMT)
[www.acmt.net] routinely administer propofol to treat severely agitated patients suffering from the
effects of certain drug overdose or withdrawal. We are also called to consult on, and treat, patients who
have received excesses doses of medications and consequently suffer from their toxic effects, including
respiratory depression. Because of the potential life‐threatening toxicity of propofol its use outside a
monitored setting is strictly contraindicated. Because of its potential for abuse and toxicity, ACMT
strongly encourages tighter control of its distribution. Ongoing education about the lethal risks of
propofol is necessary to hopefully prevent senseless deaths from propofol in the future.
Bonnet U, Harkener J, Scherbaum N. A case report of propofol dependence in a physician. J Psychoactive Drugs.
Iwersen-Bergmann S, Rösner P, Kühnau HC, Junge M, Schmoldt A. Death after excessive propofol abuse. Int J
Legal Med 2001; 114:248–251.
Kirby RR, Colaw JM, Douglas MM. Death from propofol: accident, suicide, or murder? Anesth Analg. 2009
Klausz G, Róna K, Kristóf I, Töro K. Evaluation of a fatal propofol intoxication due to self administration. J
Forensic Leg Med. 2009 Jul;16(5):287-9. Epub 2009 Jan 23.
Riezzo I, Centini F, Neri M, Rossi G, Spanoudaki E, Turillazzi E, Fineschi V. Brugada-like EKG pattern and
myocardial effects in a chronic propofol abuser. Clin Toxicol (Phila). 2009 Apr;47(4):358-63.
Roussin A, Montastruc JL, Lapeyre-Mestre M. Pharmacological and clinical evidences on the potential for abuse
and dependence of propofol: a review of the literature. Fundam Clin Pharmacol 2007; 21:459–466.
Wischmeyer PE, Johnson BR, Wilson JE, Dingmann C, Bachman HM, Roller E, Tran ZV, Henthorn TK. A survey
of propofol abuse in academic anesthesia programs. Anesth Analg. 2007 Oct;105(4):1066-71,