Sunday, September 19, 2010

"Doctors speak out about 'pronapping' addiction to propofol/divprivan on the job and at home" --MY TAKE

I have tried multiple times to post my comment to this article written here without success so I will just post it on my blog:

Please understand this article is NOT credible (even though it claims to be at the bottom of the page).

Many medical professionals especially nurses would be livid to hear they are supposedly "napping on the job" when most nurses I know are not even allowed restroom breaks or to take a lunch. Meditation breaks? Seriously? Do you really think medical professionals have time to do that when they must tend to patients many times for more than 12 hours a day? Would that not constitute patient abandonment for a nurse to be meditating on the job?

To insinuate everyone who takes this medication receives a "high" is a gross mistake. Euphoria is not even listed as an adverse effect on LexiComp, nor is this medication scheduled (as all addictive/drugs of abuse are except anabolic steroids which are scheduled strictly to divert illegal use though not addictive). I do not even know if I believe the people who claim sexual inhibitions due to the drug (which can that not be a natural part of awakening after sleep, right?) because thousands of patient have received this drug and do not report such and even if someone has claimed it um, maybe it is not propofol? Unauthorized users do NOT have access to this drug. Have you ever worked in a hospital? It is not a pill you pop!

I do not have stats off the top of my head to point this out but the number of people who have died from propofol abuse or that abuse the drug is a tiny, tiny amount compared to the number who abuse pain killers, ALCOHOL, meth, etc. That point is actually clouded in your article as you mention a doctor here, a nurse there--that is not reflective of thousand of people with a problem, nor even hundreds. It is RARE.

You also failed to mention there is a severe shortage of the drug in hospitals nationwide.

It is not available like candy bars.

People do NOT die from over-injecting 20 mg! People do not die from injecting 200 mg! One standard dosing regimen is 2-2.5 mg/kg. A patient weighs 50 kg. That means they could be given 100-125 mg. Whoops that is 25 mg too much? Hardly. The FEW that have died from propofol have died from injecting it too fast in which is causes cardiovascular collapse by lowering their blood pressure and stopping their breathing. This usually happens while they are alone and thus no one is there to render them sufficient aid. It has nothing to do with the dosage. I have seen a doctor debate on giving a patient 100-200 mg of propofol for a short-term procedure. He requested a bag-valve mask and oxygen on hand in case of a problem.

The elimination half-life is NOT 5 minutes. You are confusing half-life with duration of action. The half-life of propofol, from Lexicomp is:

Half-life elimination: Biphasic: Initial: 40 minutes; Terminal: 4-7 hours (after 10-day infusion, may be up to 1-3 days)

The above information is hard to explain but the drug works in different compartments of the body where it hangs out for different amounts of time. Main thing to notice is the first half-life is 40 minutes, not 5 minutes. This is not a difficult concept to understand for a medical professional. Half life does not correlate with duration of action.

I am embarrassed to say this but the number of residents abusing drugs being only 1-2% is not correct. It is higher than that (when considering all drugs). About 10% of the basic population abuses some substance. It is higher for medical professionals because they have easier access to the substances.

To discuss an article talking about opioid addiction is pathetic. Propofol is not in any way, shape or form related to opioids.

It's "YouTube" not uTube.

The only reason propofol is referred to as "milk of amnesia" is because it is white. A majority of people know this--it is no secret.

I do not believe it has ever been used regularly for the treatment of seizures. It is used safely for colonoscopies and dental procedures as well as numerous other short-term procedures like cardioversions, fluid withdrawal from the body like from the abdominal cavity or lung area, etc. When used in an appropriate setting propofol is very safe.

The information contained here has been grossly twisted as is not a reflection of the information at hand.

Just to make it clear, Michael Jackson if he did indeed ask for propofol, did not want it for euphoria or sexual hallucinations. He wanted it to go to sleep so he could try to pull off his comeback tour and provide for his children since so many had shoved him into a financial hole via horrifying defamation of his character and swindling. He died trying to live.


  1. OMG! I just noticed "Diprivan" is misspelled in the heading! Sigh...

  2. Ooooh, nice response - who was it directed at? ROFLMHO at the typo, it happens to everybody at some point!


  3. It is directed to the "expert" who wrote it. If someone is getting PAID and being touted as credible then they need to get that shit right! Nothing ticks me off more than to see stuff like this that misleads the innocent! Goes to show that ANYONE and ANYTHING can twist the truth!

  4. Awesome of you to expose the inaccuracies in this article. I am a nursing student right now and I've done a few clinical rotations at the hospital. I didn't get to be with my nurse preceptors much because they were so busy. Your right most of them didn't take breaks and barely took lunch. The patient loads that they had were dangerouly high and it's even worse during the overnight shift according to some nursing assistants that I know.

    I've been researching propofol indepentantly to find articles on anesthesiologist's that are addicted to propofol. I don't know if there is any credibilty to that notion though, or if it's just another rumor that circulates among medical professionals.

  5. Hi Anon!

    Thanks for commenting about how nursing is in the real world. I am still just floored by this article. It was such a slap to so many hard working nurses!

    I have gotten many articles on propofol, both dealing with addiction and death, and I could recommend to you certain titles to read. I personally have focused more on death from propofol and not so much (yet) on addiction though the subject is touched on in the articles that review death. Without using stats, I will say on behalf of many nurses and doctor I know that have used it, that plain and simple it is not addictive. Honestly, those who say they are addicted, it reminds me of those people who have an "addiction" to food. Food itself is not an addictive substance but can be a problem for some people. It has nothing to do with the substance.

  6. Hi Nikki

    Thanks for your reply about the articles. I just read your recent article about propofol. Bravo! Your right from a few articles I have found as well it seems Propofol doesn't really have addicting characteristics. Do you know if it's possible for people to become dependent on it? Anyway, I think what is more the point is that it has been used recklessly by some (like Murray for his patient) for an off label use, and because of those reckless actions people (like Michael) have died. Thanks again for your blog!

  7. Hi again Anon,
    "Do you know if it's possible for people to become dependent on it?"
    In my opinion, no. Could that be argued? Yes. There are certainly no physical addiction properties for this drug. That is critical for the development of addiction. No tolerance, no withdrawals, no addiction. People are placed on this drug for weeks sometimes with no addiction development. However, psychological addiction is something that could be debated, but I believe only subtherapeutic levels have been debated. I do not buy into psychological addiction, certainly not pertaining to Michael. Anything can be psychologically addictive. I read an article where the "experts" deemed that propofol must be addictive because their test subjects, which were previous drug abusers, said they "liked it". This analysis was argued by other experts but still, it isn't like Murray could call up one of these doctors as a witness. Hopefully the prosecution would know that this study was not carried out well at all and proves nothing. Addiction should not be on trial--Murray's actions should be placed on trial. I used to think that this would be called "off-label' use but I think the more accurate term is "non-therapeutic use". Off-label usually implies the drug does work for the indication, it is just not in print because it costs millions of dollars to get a drug approved for a use. But, in this case, propofol has no use for insomnia, or sleep. I would think that could constitute misbranding. I am not sure, though. It should. Thanks again for your comments!