Anesthetics are generally administered with the aim of eliminating the pain experienced during treatment. Thanks to anesthesia, the patient can relax during the treatment, thereby allowing the dentist to concentrate on the procedure in hand.
Local anesthetics are seldom, if ever, discussed with the patient. The reason for this rests equally with the dentist as with the patient. For the dentist local, anesthesia is merely a means to an end, i.e. achieving an optimal result with the patient’s teeth. The dentist quite often lacks specific knowledge pertaining to the pharmaceutical characteristics of the anesthetic and other active ingredients present in the capsules. A general practitioner, dentist or dental surgeon certainly knows more than enough to administer a local anesthetic, but they are not pharmacists.
BACKGROUND AND OBJECTIVES: Physicians has a slightly higher rate of psychoactive substance use when compared to the population in general. Anesthesiology is one of the most affected medicine specialties, especially due to overwork and easier access to drugs. This paper aims to carry out a literature review on the topic. Therefore, research was conducted by searching topic-related keywords on papers from the last 30 years available on MEDLINE.
Despite the fact that alcohol abuse is the most common among anesthesiologists, the abuse of anesthetic agents causes more concern, due to its high dependence potential and consequences, which are often fatal. The most widely used drugs are opioids (fentanyl and sufentanil), propofol and inhalational anesthetics. Young professionals are the most affected. Among the consequences of drug abuse are workplace absence and even death. The return to operating rooms seems to increase the risk of relapse. In Europe and in the USA there are specialized treatment programs for the middle class, as well as preventive measures, such as strict control of drugs and identification of professionals at high risk of abuse. In Brazil, Anesthesiology is the second medicine specialty with most drug addicts, but the topic has not been much studied and there are few specialized programs in the field.
Ketamine: Ketamine is most often used in the dance club setting as a party drug. It produces an abrupt high that lasts for about an hour. Users report euphoria, along with feelings of floating and other “out of body” sensations. Hallucinations, similar to those experienced with LSD, are common.
Ketamine toxicity alone is unlikely to lead to death, according to the WHO. However, combining it with other substances, such as alcohol, can increase the sedative effects, possibly leading to a fatal overdose.
In the U.S., 1,550 emergency department (ED) visits were due to illegal ketamine use, and 71.5 percent of these also involved alcohol.
Propofol : Propofol is an injected drug that should only be used in controlled settings where emergency equipment and trained professional help are available. The reason is that just a little too much can cause death — just four teaspoons or about one-half an ounce over recommended levels can be fatal. Michael Jackson’s doctor was sentenced to four years in prison partly because he used Propofol in a home setting and did not stay in the room to monitor Mr. Jackson’s reactions.
Unlike most other drugs, there is no antidote for Propofol which means if you overdose, there is no medicine to bring you back. One study of healthcare professionals who were abusing Propofol found they had a 33% death rate.
Another danger of Propofol abuse is that the drug works so quickly that people injure themselves in falls or by collapsing into their desks and so forth.
The damage that long-term use of Propofol may cause to the human body has not been determined.
Buy Methoxetamine Online (MXE) was a newly reported ‘legal high’, now a Class B drug. Although there is very little evidence about the short and long term effects of methoxetamine, we know that it is chemically related to ‘dissociative anaesthetics’ like ketamine and PCP, and therefore has similar effects and risks. From anecdotal reports, MXE appears to be much stronger than ketamine, suggesting a higher risk of overdose. Read More
CONCLUSIONS: Substance abuse by anesthesiologists is an issue that needs to be discussed further, especially due to the possibility of severe consequences for professionals and patients.