Anesthesiologist drug abuse: Fentanyl


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).

The ASA Task Force on Chemical Dependence identified characteristics of addicted anesthesiologists [Model Curriculum on Drug Abuse and Addiction for Residents in Anesthesiology]:

Characteristics of Addicted Anesthesiologists

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


A national survey published in 1992 reported a 2.1% annual and a 7.9% lifetime prevalence of substance abuse among physicians. This rate was substantially lower than the corresponding rate of 16% reported for the general population and thus disproved the myth that physicians are more likely to become substance-addicted than the population in general. [Hughes et al.]

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].

Although anesthesiologists account for 12% to 14% of physicians treated in three well-known treatment programs, they constitute only 4% of physicians in the United States.

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.

In the initial published reports from state-run impaired physician treatment programs that began in the 1980s, all of the anesthesiologists were chemically dependent, whereas 10% of the remaining physicians had other forms of impairment, such as depression. Nearly 50% of anesthesiologists were younger than 35 years, and a third were residents. Half used both drugs and alcohol, 40% used drugs alone, and a minority used only alcohol. Fentanyl was the most commonly abused narcotic, followed by sufentanil, meperidine, morphine, and oral drugs.

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

Keyword history


See Also:

Anesthesiologists: substance abuse



  1. Hughes PH, Conard SE, Baldwin DC Jr, Storr CL, Sheehan DV. Resident physician substance use in the United States. JAMA 1991; 265:2069-2073.
  2. Ward CF, Ward GC, Saidman LJ. Drug abuse in anesthesia training programs, a survey: 1970 through 1980. JAMA 1983; 250:922.
  3. Gravenstein JS, Kory WP, Marks RG. Drug abuse by anesthesia personnel. Anesth Analg 62: 467, 1983
  4. Menk EJ, Baumgarten RK, Kingsley CP, Culling RD, Middaugh R. Success of reentry into anesthesiology training programs of residents with a history of substance abuse. JAMA 1990; 263:3060.
  5. Paul E Wischmeyer, Bradley R Johnson, Joel E Wilson, Colleen Dingmann, Heidi M Bachman, Evan Roller, Zung Vu Tran, Thomas K Henthorn A survey of propofol abuse in academic anesthesia programs. Anesth. Analg.: 2007, 105(4);1066-71, table of contents
  6. J P Zacny, J L Galinkin Psychotropic drugs used in anesthesia practice: abuse liability and epidemiology of abuse. Anesthesiology: 1999, 90(1);269-88