Is it medicine or poison? What is the "propofol" that top Korean actors illegally use?

According to a report by Korean media on February 8, South Korea's top 30-year-old movie actor Yoo Ah-in is under investigation for suspected drug abuse. It is reported that the police found that Yoo Ah-in went to many hospitals and was prescribed propofol for non-medical purposes many times, so they suspected that he was addicted to injections. What exactly is this drug propofol, and what are its medical uses?

01

What is Propofol?

Propofol is known in Chinese as Propofol, in English as Propofol, and in chemical name as 2,6-diisopropylphenol. It is an organic compound with the chemical structure shown in the figure. Pure propofol at room temperature is a light yellow liquid that is insoluble in water but easily soluble in most organic solvents such as ethanol and ethyl acetate.

Image source: drawn by the author

Propofol is a short-acting intravenous anesthetic . Due to its insoluble nature in water, propofol injection is a milky white emulsion in clinical use, and anesthesiologists call it "milk". After intravenous injection, it can quickly spread throughout the body and produce a sleep state within forty seconds. At the same time, propofol is easily metabolized by the liver, and its half-life is between 1.8 and 8.3 minutes, so the anesthetic effect time is very short. In clinical medicine, especially in some minor surgeries, painless examinations and other fields, it plays an extremely important role.

02

How does propofol become addictive?

According to clinical data, the rational use of propofol rarely causes addiction , but the drug does have the problem of off-label use. In addition to the anesthetic and sedative effects, the "neural effect" of propofol after injection is the key to its addictiveness. Studies have shown that propofol can promote the release of dopamine by stimulating the neuronal γ-aminobutyric acid GABA receptors . As a result, after the injection, the patient has a strong sense of mental comfort, even accompanied by sexual excitement, so the abuse of this drug can easily lead to addiction. At present, Korean law stipulates that propofol can only be used for special treatments, but in places with lax supervision such as plastic surgery hospitals, many celebrities often use this drug in large quantities to relieve stress, seek relief or pursue excitement.

Image source: Tuchong Creative

03

How dangerous is Propofol?

When propofol is used as a drug, individual differences are great, so the dosage must be strictly controlled under the guidance of a professional doctor. Within a reasonable dosage range, the side effects of propofol on humans are controllable and the addiction is low. However, if used in excess, propofol may cause life-threatening adverse reactions such as shock and cardiac arrest. At the same time, since phenolic compounds are prone to allergic reactions, severe anaphylactic shock may also occur when injected in large quantities. Previously, Conrad Murray, the personal physician of the famous American singer Michael Jackson, injected Jackson with a fatal dose of propofol during treatment. Acute propofol and benzodiazepine poisoning caused Michael Jackson's cardiac arrest, which eventually led to the fall of a generation of superstars. In addition to causing death, propofol abuse also has side effects of other addictive drugs, such as depression, memory confusion, behavioral disorders, cognitive impairment, etc.

Image source: Tuchong Creative

Due to the rapid development of society, people are facing more and more pressure, and mental illnesses such as insomnia and depression have also received great attention. With the assistance of psychotropic drugs, the patient's mental state can be greatly improved, but remember that too much is as bad as too little. For our personal health, family happiness, and social harmony, psychotropic drugs must be used under the guidance of qualified doctors, and we must not abuse psychotropic drugs.

Author | Denovo

Review | Liu Guiyang, Chief Pharmacist, PLA Fourth Medical Center

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