Two New Case Reports of Propofol Abuse and a Pattern Analysis of the Literature

Propofol has become the most widely used sedation and anesthetic drug worldwide. Previously it was thought to lack abuse and dependence potential.  Increased awareness of actual propofol abuse cases, however, is providing greater understanding of the associated (or perceived) motivations and rewards of propofol abuse.  We report the details of two new propofol abuse cases including the motivations for choosing this drug, abuse practices, subjective experiences, and outcomes.  An exploration of reported objective and subjective patterns in propofol abuse case reports was conducted using a modified  process of thematic (pattern) analysis. These patterns include: healthcare providers are the most frequent propofol abusers, hospital drug diversion is a primary access, abuse regimens consist of frequent injections, there often exists underlying psychological unrest, typically there is a history of prior drug and alcohol abuse, abusers are seeking relief from anxiety and stress along with restful sleep, abusers report a craving desire, death is frequently an outcome, and rehabilitation programs can be effective treatments. We conclude restrictive control of propofol is necessary to better monitor and control its abuse.