The abuse potential of propofol

Abstract

Propofol has alluring and addictive properties that lend itself to potential recreational abuse and dependence. We recommend that the U.S. Drug Enforcement Administration and other international agencies should consider regulating propofol as a controlled substance.

Propofol increases μ-opioid receptor expression in SH-SY5Y human neuroblastoma cells

“…Our findings suggest that by increasing MOR expression in neuronal cells, propofol has the potential to enhance the activity of the endogenous µ-opioid system and thus has the potential for abuse. A growing body of literature has documented propofol abuse in humans (4). The possibility of dependence and withdrawal is significant in determining propofol's potential for abuse.…”

“…Although its clinical properties are well described, information concerning its potential for abuse has been slow to emerge. However, a growing body of literature has documented propofol abuse in humans and abuse-like behavior in animal models (4). Propofol directly activates the γ-aminobutyric acid (GABA) receptors and inhibits the N-methyl-D-aspartate (NMDA) receptor in the nervous system (5).…”

Non-opioid anesthetic drug abuse among anesthesia care providers: a narrative review

“…29 The ability of propofol to act on the reward mechanisms in the brain as well as its widespread use and availability contribute to the potential for abuse. 30 In vivo studies after propofol administration have shown characteristics similar to other drugs of abuse, in particular, an increase in ventral tegmental dopaminergic excitability and elevated dopamine levels in the nucleus accumbens. 25,30 High lipid solubility and rapid accumulation in the brain account for the fast onset of anesthesia after propofol injection.…”

“…30 In vivo studies after propofol administration have shown characteristics similar to other drugs of abuse, in particular, an increase in ventral tegmental dopaminergic excitability and elevated dopamine levels in the nucleus accumbens. 25,30 High lipid solubility and rapid accumulation in the brain account for the fast onset of anesthesia after propofol injection. Its subsequent redistribution permits fast clinical recovery, thereby facilitating the ''hiding behaviour'' among drug abusers.…”

“…Other withdrawal symptoms described include somnolence and difficulties in concentration, anxiety, stress, and hyperhydrosis. 27,30,32 The currently available information is insufficient for proper characterization of propofol withdrawal syndrome. 30 Both tolerance and withdrawal reflect adaptation of the body to the drug effects and contribute to risk-taking and drug-seeking behaviour.…”