Although legally only available to doctors, the anesthetic propofol has been used recreationally and as a sleeping aid, to dangerous effects. Pop singer Michael Jackson died from an overdose of propofol, and his personal doctor was put on trial (and convicted of involuntary manslaughter) for giving him access to the drug to help him sleep and then leaving him unattended. The doctor’s defense team had theorized that Jackson gave himself the lethal dose, but either way, he should not have been permitted to use it without supervision.
Propofol is used as an induction agent, meaning a drug that causes loss of consciousness, for general anesthesia in major surgery. In lower doses, it is also used for conscious sedation of patients who are having procedures done on an outpatient basis at ambulatory surgery centers. This might include a gastrointestinal endoscopy or a colonoscopy. The main reason that propofol has become the induction agent of choice is that the traditional agent, a barbiturate called sodium thiopental, is no longer available. It used to be one of the drugs used to execute people with lethal injections, and various groups and governments opposed to the death penalty have put pressure on its suppliers. Propofol is the most commonly used intravenous anesthetic drug in the United States today.
Propofol takes effect in seconds and wears off quickly. It doesn’t cause nausea or vomiting like some other anesthetics, and there are no hangover-like symptoms. For this reason, many people, like Jackson, want to use it as a sleep aid. However, propofol does lower blood pressure and suppress breathing, so the heart function and breathing of patients need to be constantly monitored.
Of course, if the only use for propofol were for sedation, there would be little recreational incentive to abuse it. Studies have found that propofol also has pleasurable effects and even euphoria, similar to being high or drunk. There have also been cases of propofol giving anesthesia patients good dreams, sexual fantasies, and instances of sexual disinhibition. In some instances, patients even make physical advances on those nearby after waking from anesthesia. People who do abuse propofol can develop a tolerance to it, so they end up needing more of it to achieve the same sensation. The fact that it’s so fast-acting can be both a pro and con for users, as it’s easy to hide when the effects wear off quickly, but this could also lead to people using more often.
The American Society of Anesthesiologists states that the involvement of an anesthesiologist in the care of every patient undergoing anesthesia is recommended, but when this is not possible, non-anesthesia personnel who administer propofol should be qualified to rescue patients whose level of sedation becomes deeper than initially intended.
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