Proper Handling of Propofol Waste: Disposal in Anesthesia Setting
April 18, 2022 | Pharmaceutical Waste Disposal
What is Propofol?
Propofol, is an anesthetic that can cause relaxation and sleepiness before and during medical procedures. Also known under the brand name of Diprivan, it’s a non-barbiturate sedative used primarily by trained anesthetists in operating rooms to relax and sedate patients prior to invasive, surgical procedures. The drug causes loss of consciousness within 40 seconds of injection.
Propofol is not currently listed as a controlled substance under the Controlled Substance Act (CSA) but has been identified as a threat. In 2010, a proposed rule was submitted to the Drug Enforcement Administration (DEA) to place the drug as a schedule III substance under the CSA. At the time, the mortality rate was greater than 33% and growing. Propofol generally is abused for its sedative and relaxing properties and induction of euphoric effects. As of 2023, the drug is still not listed under the CSA.
Despite this, and the fact that Propofol does not fall under the same DEA regulations for drug disposal as controlled substances, the risks and dangers associated with recreational use of the drug require careful handling and disposal.
While proper handling of Propofol waste may be falling through the cracks, some states have taken the approach to treat Propofol as a controlled substance. Healthcare organizations, hospitals, and veterinary facilities have created their own drug disposal and drug diversion plans over the years.
The Risks of Misuse and Improper Disposal
The American Association of Nurse Anesthetists (AANA), reports in the December 2017 issue of the AANA Journal, (Volume 85, No. 6), that propofol makes up 41% of reported cases of substance abuse among anesthesia providers. Health organizations are taking notice of the risks associated with the misuse and improper handling of propofol waste, which include:
- An increase in the instances of propofol addiction at an alarming rate of fivefold over the last 10 years.
- Easy access by health care workers makes them more prone to drug diversion and addiction
- Certified Registered Nurse Anesthetists (CRNAs) have environmental concerns regarding pouring propofol into the sink
- CRNAs have limited access to sinks in the operating rooms
Although propofol is a pharmaceutical drug that is most commonly wasted in the OR, many hospitals do not have a secure disposal container as they do for controlled substances. The AANA reports that implementing a drug disposal system with an easily accessible pharmaceutical waste container significantly decreases the instance of propofol misuse and improper disposal.
Drug diversion and an increase in the instances of Propofol addiction were noted at an alarming rate between 1990 and 2010, with a 25% increase of individuals seeking drug addiction programs, with anesthesia professionals making up most of those cases. According to a position statement by the American Association of Nurse Anesthesiology, Propofol is listed among the most abused drugs by anesthesia professionals. As such, easy access by health care workers makes them more prone to drug diversion and addiction.
Environmental Concerns of Improper Propofol Disposal
Certified Registered Nurse Anesthetists (CRNAs) have environmental concerns regarding discarding unused Propofol into sinks or other drains, in addition to the fact that many CRNAs have limited access to sinks in operating room. However, disposal practices are changing to decrease not only environmental risk and negative impact of medicines flushed or poured down sinks, but to dispose of such drugs safely and securely.
Propofol has been shown to be toxic to aquatic life and does not degrade in nature. It can only be destroyed through incineration following proper collection in secure storage containers.
Improving Proper Handling of Propofol Waste
The AANA conducted an evidence-based practice project at a large, Midwestern teaching facility to address the proper handling of Propofol waste. By implementing a fast-acting disposal container in each operating room, the practice of sink disposal decreased significantly and the percentage of unemptied vials of Propofol that remained in unsecured bins decreased to 3.4% from 25.8%. The new method replaced sink disposal and provided a more convenient method of Propofol disposal.
Rx Destroyer Provides Disposal Solutions
Rx Destroyer drug disposal works with hospitals and healthcare facilities to establish drug disposal systems, including in operating rooms. Our chemical drug destruction meets DEA non-retrievable standards and exceeds pharmaceutical waste disposal regulations in most states. Contact us to learn more about our easy-to-use, eco-friendly drug disposal solutions and the proper handling of Propofol waste.