July 28th, 2009
04:09 PM ET

Should Diprivan (propofol) be a controlled substance?

[cnn-photo-caption image="http://i2.cdn.turner.com/cnn/2009/SHOWBIZ/Music/07/09/jackson.wrap/art.jackson.dr.cnn.jpg" caption="Dr. Arnold Klein, who was Michael Jackson's dermatologist, said he warned the singer about drug use."]

Elizabeth Landau
CNN.com Health Writer/Producer

The general anesthetic Diprivan (propofol) has been making headlines as questions about Michael Jackson’s death abound. A nurse who had worked for the singer told CNN that Jackson requested the drug because he had trouble sleeping, and The Associated Press reported that it had been found in his home. Diprivan is not approved as a sleep aid by the Food and Drug Administration.

It turns out that propofol, used routinely for surgeries and procedures such as colonoscopies, has been a point of concern among some anesthesiologists because of the potential for abuse by health care workers. A 2007 study published by the International Anesthesia Research Society found that about 18 percent of the 126 academic anesthesia programs in the United States had at least one reported instance of propofol abuse within the previous 10 years.

Researchers also found that six out of 16 residents (about 38 percent) who abused propofol died from it. While these are small numbers, lead author Dr. Paul Wischmeyer, professor of anesthesiology at the University of Colorado, believes this is indicative of a larger problem.


Filed under: Health Care • Michael Jackson
soundoff (34 Responses)
  1. Joseph Woo

    I was watching the video by Dr Sanjay Gupta about using Propofol in the operating room.
    Dr. Gershon was right that Propofol can cause apnoea when given at the rate he was giving it. But Propofol can also be a very good sedative without stopping the breathing when given slowly. The effect of Propofol depends solely on the amount given at a given time for each person. If Dr. Gershon gives that 20 cc syringe to a 90 lb 86 years old lady at that rate I doubt he will find her blood pressure for some time.
    Joe Woo

    July 29, 2009 at 9:33 am |
  2. dottie

    it's unlawful for anyone to used this substance diprivan/propofol
    in the home setting period,with my understand spoken by expertise.
    if any physician are using this substance in home setting.
    they should be penalize & impose to penalty for breaking the law or rules.
    yeah, l think those goon's should be punish and deal with severely.,
    sentence by imprisonment and fines.
    these people are criminal,professional gangster,who work to
    dope up and endanger people lives.
    this substance should be ,control by the DEA and FDA..
    for real.....The goverment need to get on board.
    they, have killed ours lcon's M.J with this drugs or substance.

    July 29, 2009 at 8:14 am |
  3. dottie

    it's unlawful for anyone to used this substance diprivan/propofol
    in the home setting period,with my understand spoken by expertise.
    if any physician are using this substance in home setting.
    should be penalize,impose to penalty for breaking the law or rules.
    yeah, l think those goon's should be punish and deal with severely.,
    sentence by imprisonment and fines.
    these people are criminal,professional gangster,who work to
    dope up and endanger people lives.
    this substance should be ,control by the DEA and FDA..
    for real.....The goverment need to get on board.
    they, have killed ours lcons M.J with this stuff.

    July 29, 2009 at 8:09 am |
  4. Louis

    Funny how something like this is so easy to get and is legal yet something as harmless and useful as cannabis is not. This planet has 0 common sense. I hope a meteor wipes out the human race soon cause humans are just a virus eating away at the planet and we need to be cured as soon as possible.

    July 29, 2009 at 5:48 am |
  5. J.V.Hodgson

    The Debate about the effects or not of this Drug on MJ's death is not the point.
    The point forgive me for being simplistic is that if Anasthesiologists do not agree on the this drugs use or scientific effects by those using the drug outside recognised anasthetic reasons. Then it should be a severely controlled substance available only to to Anasthesiologists and hospitals.
    The only laxity that maybe should be allowed is it may be prescribed by a patients doctor who is also a qualified anasthesiologist, certainly not a Nurse.
    This kind of regulatory concept is totally separate to MJ's death.
    That said you link it in the media, but the doctor is going to be able to argue he used a permitted drug in permitted dosages that's the problem, and he will be exonerated accordingly, of any crime.

    July 29, 2009 at 2:49 am |
  6. Carolyn Williams, RN & Viet Nam Vet, US Navy Nurse Corps

    Control Diprovan?–of course not–that's like saying control all anesthesia drugs, as Diprovan doesn't fall into the classification or "perscribed drugs" to treat an illness. It's not even a narcotic. It is not being used at home anyway, & any drug out there can be abused.

    On another related subject, I've been wanting to write to you about is that: I'm surprised by now that no one on the news is reporting on M. Jackson's confirmed disease, Lupis Errythemadosis, (sp Lupus?). That disease takes over the body and lasts for years, even a lifetime, as opposed to cancer and one dies. It is a very painful disease with many life-altering, side affects, so as to support Michael's need for pain killers.
    Both Michael and his family should have been educated more thoroughly about his disease, so as both parties to accept his need for chronic-pain medications–NOT force him into thinking he was an ADDICT & needed rehab., as he did go into. He was given a variety of medications as he was suffering.
    Therefore, chronic-pain diseases, one of those being Lupis", needs more news-coverage, so as to educate the public about the real & ethical need for narcotics & pain medications, & possibly Jacksons problem, so the sterotyping of pain meds. be given it's true ethical position, instead of that being a "street-drug".
    Poor Michael, with all his medical help & money, to have been put through the mill with many drugs, couldn't sleep, and became desparet as many of us are today with all these physicians not giving true time & knowledge to their patients.

    Recaping, Lupus invades your whole body's organs–every one of them! I doubt he actually abused drugs–he thought he had, by what others were leading him into thinking. Drug rehab. is not the answer for everyone dependent on drugs. Study the Chronic-Illnesses catagories, & perhaps you'll understand what I'm trying to say in 10 words or less. Tahnk YOU, I love your program and you, AC! Keep up the good work.
    Carolyn Williams, Las Vegas, NV–coincedently, just down the street from Dr. Murray's office. H: 702-699-8196

    July 29, 2009 at 2:39 am |
  7. Jessica

    The problem here is that the doctor's that enabled Michael Jackson went against their medical knowledge and the safety of their patient due to greed. Diprivan does not need to be a controlled substance, unless doctor's are frequently stealing drugs from hospital/clinical settings. Hopefully there are safeguards in place to keep this from happening. This all boils down to morals, of which it appears Mr. Murray did not have any. He took advantage of Michael Jackson , who had the highest of morals. I hope that most doctors have better morals , and put their patient's health before their desire for money and fame.

    July 29, 2009 at 1:40 am |
  8. philip

    Anderson, no one seems to recall that MJ had lupus, and that is probably why he used diprivan to kill the chronic pain that illness causes.

    Considering this, it seems to me that it was mainly used as a pain killer, that may have also acted as a sleep aid. Perhaps MJ's LUPUS should be considered when discussing the alleged use of diprivan to better understand why he used it.

    July 29, 2009 at 1:33 am |
  9. mg

    Thank you Lois!!! I have been screaming the same thing about this RN Cherylynn........... What about Hippa!! how can she go on TV and talk about this. If she was truely the hero she is being made out to be she would have called in the authorities before mj ended up dead. Thank you for your comments. Let report her to the Board

    July 29, 2009 at 12:37 am |
  10. william

    Clearly MJ and this doc have experienced diprivan in the past. To the docs possible defense, perhaps MJ took other drugs before the diprivan and the doc was not aware of his intake. The combination of other respiratory depressing drugs and diprivan could have led to the deadly outcome.

    Would this somehow lessen the charge of homicide? Would the doc have given him the diprivan if he knew other drugs were in his system at that time? The toxicology report will be extremely important especially for the defense of Dr. Murray.

    July 28, 2009 at 11:49 pm |
  11. Tara

    Controlled or not, people who want to misuse it will get their hands on it anyway.

    July 28, 2009 at 11:47 pm |
  12. Richard

    People need to realize that propofol is an intravenous medication, which means that for it to work, it has to be given through an IV. Now, if you have the expertise to start an IV, you probably have seen medications such as propofol given through it and you should know how dangerous it is without proper monitoring equipment. If you are an IV drug user, propofol would probably one of the last drugs you'll abuse. It doesn't give you a high. It just makes you drowsy (in small doses). Plus, it burns like heck when injected! To anyone who's had surgery and remember the burning sensation in your IV before you go off to sleep, that's the propofol. Who is going to abuse that? (other than Michael Jackson?)

    July 28, 2009 at 11:43 pm |
  13. Angela, AZ

    It sounds like Michael Jackson got Diprivan because he had the money to pay for it and the influence of being Michael Jackson. So when used for its intended purpose I'd think it need not be conotrolled. I think the issue is more to the tune of should this doc. be allowed to continue his medical practice? It sounds like he may have acted recklessly and negligent for administering the drug in the first place.

    July 28, 2009 at 11:37 pm |
  14. Santosh

    I was surprised to see your reporting that propofol made patient paralytic n he stopped breathing. It is wrong coz dr used succinylcholine to paralyse his muscle few seconds b4 propofol. It is very short acting iv anesthetic n need to be given with muscle relaxant continuosly for operation use. It can be used alone also where pt will breath on its own. We use this drug often during bronchoscopy, chest tube placement! But don't take me wrong for correcting ur reporting .. I like ur show n my wife will not sleep until u finish ur show .. Twice a night!!! I m little chubby n c wants me to make my body like urs!!! May be someday !!!

    July 28, 2009 at 11:37 pm |
  15. Richard

    There has been cases of people dying from drinking too much water. Why don't you make make water a controlled substance?

    July 28, 2009 at 11:35 pm |
  16. Rodney

    Now we know why it is a controlled substance, and all controlled substances,, fools rush in where angels dare to trod

    July 28, 2009 at 11:27 pm |
  17. Johnny Neptune

    I went under surgery for priapism ( caused by an atypical anti-psychotic ) on Nov. 11th of last year. During the surgery, my heart stopped. This isn't rare as Profofol has only one REAL side effect, which is Cardiac Arrest. I was defribualted and recusitated, but during that proceedure I actually EXTUBATED myself ( pulled the breathing tube out )... I was kept in an induced come for 13 days, during which my wife Anji sat by my side the entire time.... My first words were, " I think I have Brain Damage.." scary stuff.. Profofol sucks... Yet, I am happy MJ died, as I have read the actual depositions from the molestation case that he settled to make go away, and Trust Me- He was GUILTY as sin. It was as obvious as the 'nose' (?) on his face

    July 28, 2009 at 11:26 pm |
  18. Matt

    It doesn't matter if it is a control or not, you cannot get it at a pharmacy and the only people who seem to abuse it are getting legal prescriptions (MD's and medical personnel), which they could still obtain if it is controlled. I don't understand how it is different then a drug like percocet, I could get percocet more easily then diprivan.

    How easy right now would it be for me, average joe to go and get some diprivan?

    And if it were controlled, couldn't a doctor obtain it anyway?

    So what will change if they decide either way? I don't understand what the problem is.

    July 28, 2009 at 11:24 pm |
  19. Audrey

    Yes, it should be controlled, however, what good does it make when it is provided to the physicians and personel and then distributed to people who request it (like Jackson) when it becomes controlled?

    July 28, 2009 at 6:29 pm |
  20. michelle

    i agree with cindy.diprivan should be a controlled substance. It by NO means should be able out of a hospital

    July 28, 2009 at 6:05 pm |
  21. Susan, Calif

    If we make everything that someone has abused to the point it has killed them a controlled substance, I wonder what we would have left? No booze, no food, no cars, and the list goes on and on.

    What in the world happened to personal responsibility for our own actions?

    July 28, 2009 at 5:59 pm |
  22. margreat

    I believe that diprivan is used in outpatient surgery. There is regualtion in CA AB595 that regulates IV sedation and defines IV sedation, ergo that giving diprivan or any IV sedation/analgesia in a home or even a physician office with a license, certification or accreditation – this is supposed to to regulate who can give and when and where any kind of sedation/analgesia anesthesia to provide safeguards for the safety of the patient.
    Call IMQ a subsidiary of CA med board and find this out, therefore whether Jackson was an addict or not, providing diprivan in a setting (even if monitors are used) without license, certification or accreditation is illegal.
    check this out

    July 28, 2009 at 5:59 pm |
  23. Christy

    It's a tragedy that we had to lose Michael Jackson in order to control a substance that decent physicians would not use in this manner. Propofol should be controlled to stop the money/fame seeking physicians from risking the lives of celebrities who need other types of help.

    July 28, 2009 at 5:44 pm |
  24. Vernice Bennett

    As a ER nurse, I use Diprivan to perform conscious sedation for painful procedures, such as resetting fractures. This is performed under the close supervision of an MD and the patient is closely monitored. This is a controlled substance and should never be used outside the hospital setting because of the risks associated with it, such as depression of rspiratory drive!!

    July 28, 2009 at 5:24 pm |
  25. Janet

    Of course it should be controlled. Why isn't it already? If someone can be put to sleep and never wake up from it then it should be a no-brainer to control it!

    July 28, 2009 at 5:20 pm |
  26. James

    Making propofol a controlled substance will have a small effect considering the vast majority of addicts are anesthesiologists. As MDs they have access to DEA scheduled drugs.

    July 28, 2009 at 5:08 pm |
  27. Larry

    Well, you can still get it online google the phrase 'buy diprivan'

    July 28, 2009 at 5:04 pm |
  28. susan

    why is this back up again? – see my earlier post about what constitutes a Controlled Substance – a Department of Justice designation, not FDA designation.

    According to Cindy, Diprivan, Vicodin, Ambien all should not be available except in a hospital. Note that actual anesthetics, Isoflurane, etc are not controlled substances. This would restrict their use so you can no longer have your scope in a "doctor's office" despite adequate procedure rooms, monitoring, personnel, or "ambulatory surgical centers" as these are not hospitals.

    Better is for Oral Demerol to be completely removed (high first pass metabolism so not an effective level for anything other than the accumulation of the toxic metabolite – which is also formed but not so excessively with parenteral dosing). Darvocet (propoxyphene) needs to be removed for the same reason. - This has good medical reasons for removal.

    July 28, 2009 at 4:57 pm |
  29. Michael

    No. The only control needs to be in the hands of whoever is taking it. We do not need more of a nanny state telling us what we can and cannot put into our bodies.

    July 28, 2009 at 4:52 pm |
  30. Triny

    No, it should not be labeled a controlled substance because it's an anesthetic.

    Obviously Michael Jackson was made to think one thing when in reality Diprivan does not help you sleep. It's used to put people in a medically induced "coma" for major surgical procedures. This isn't something a person can become addicted to. This is where the miscommunication is.

    At any event this is negligence. All doctors have a moral and ethical responsibility to follow proper protocol when it comes to anything medically speaking. Dr. Murray deserves to go to prison.

    July 28, 2009 at 4:44 pm |
  31. Isabel, Brazil

    Diprivan should definitely be a controlled substance. Diprivan and other substances that are used indiscriminately and irresponsibly in this same way.

    July 28, 2009 at 4:37 pm |
  32. lois

    Here is what I sent to the Office of Civil Rights about protected health information. I hope you will feel compel to do what the OCR can't, teach the public how their health information should be protected. I'm surprise that the OCR has not seized the opportunity to inform the American people that Deepak Chopra, and nurse/nutritionist Cherilyn Lee are in violation of HIPAA laws. What they are doing is wrong! In 2004 my employer took every person in their employment from the janitor to the chief medical officer through intensive HIPAA training, about our obligation to protect health information of each of our clients. It has been a challenging twenty years to earn the trust of our citizens to come forward to be tested for HIV/AIDS, to seek chemical dependency treatment, mental health care and for rape victims to report their victimization. To listen to Dr. Chopra and Ms. Lee casually reveal Michael Jackson health information as if they are doing a public service announcement is appalling.

    This is an absolutely teachable moment and I hope that the OCR will seize this moment to educate the public and re-establish patient/provider trust. Surely, ABC, NBC and CBS, as well as CNN and MSNBC would be happy to give you equal time to assure the public that their health information is protected and those in violation of the law will be reprimanded.

    Our nation is trying to progress toward electronic recordkeeping of medical records; and I know it isn't reassuring for me to know my health issues can wound up on the Larry King Show.

    July 28, 2009 at 4:35 pm |
  33. Cindy

    Yes...diprivan should definitely be a controlled substance. You should not even be able to get your hands on it at all unless it is in a hospital setting. It should be made very hard to obtain. It definitely shouldn't be so easily gotten that someone can use it in their home and die from it as it seems Jackson did.


    July 28, 2009 at 3:47 pm |