Anesthesiologist drug abuse: Fentanyl

Generic Clinical Sciences

In addition to abuse of IV agents, including propofol, [Wischmeyer et al], abuse of volatile agents has also been documents [Zacny and Galinkin].  It is estimated that the incidence of substance abuse among physicians is 2.1% annually (or 7.9% over one’s lifetime) [Hughes]. Drug abuse in anesthesiologists is estimated to be between 1 and 2% [Ward et al, Gravenstein et al, Menk et al]. That said, anesthesiologists comprise a disproportionate percentage of physicians in treatment centers, likely because they either a) are more likely to be reported b) are more likely to self-report or c) have access to more potent pharmacologic agents (in general, there is an inverse relationship between drug potency and time to discovery).

Characteristics of Addicted Anesthesiologists

Fentanyl

Three retrospective surveys suggest that the prevalence of drug abuse in anesthesiologists ranges from 1% to 2% [Hughes et al, Ward et al, Gravenstein et al].

When comparing the published incidence of substance abuse in physicians as a whole with that of anesthesiologists, it is apparent that the overall incidence of abuse is not consistently higher in the practice of anesthesia than in other specialties . However, it is notable that anesthesiologists are consistently over-represented in drug treatment centers.

The ASA Task Force on Chemical Dependence [Source 1] has identified the following characteristics of addicted anesthesiologists:

  • 50% are younger than 35 years
  • Residents are overrepresented
  • Many are members of AOA
  • 76-90% abuse opioids as their drug of choice
  • 33-50% are polydrug abusers
  • 33% have a family history of addictive disease
  • 65% are associated with academic departments

28%

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2014

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91%

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2010

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85%

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2009

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