Gangnam doctors keep self-administering propofol — and regulators can barely tell

Medical professionals in South Korea keep self-administering controlled substances, and they are finding no shortage of ways to do it. Doctors, who have ready access to medical narcotics, have been caught siphoning off propofol stored at their own clinics, issuing prescriptions for zolpidem under patients' names and taking the drugs themselves, and deliberately leaving small amounts of anesthetic behind after patient procedures to use later.

On Tuesday, the Gangnam Police Station in Seoul said it had booked a doctor identified only as A on charges of violating the Act on the Management of Narcotics, with the investigation proceeding without detention. A is suspected of self-administering propofol — a psychotropic drug — at his clinic in Sinsa-dong, Gangnam-gu, on Thursday. He had built a public profile appearing on television programs and YouTube channels to share health information for women.

Medical professionals work in close proximity to controlled substances every day. About 100,000 healthcare workers handle medical narcotics annually for clinical purposes.

The Act on the Management of Narcotics explicitly prohibits licensed narcotics handlers from administering controlled substances to themselves or issuing prescriptions for their own use (Article 30). Even so, cases of doctors succumbing to the temptation continue to emerge.

In 2023, police arrested a doctor who had been prescribing drugs to actor Yoo Ah-in after discovering, during the investigation into Yoo's drug use, that the doctor had also been self-administering. Officers found evidence of the propofol self-administration while conducting a search and seizure at the clinic that had issued the irregular prescriptions.

In July, police arrested several doctors operating clinics in the Gangnam area who had been using controlled substances. The investigation revealed that as their tolerance grew, some had been consuming hundreds of zolpidem tablets a day.

The Ministry of Food and Drug Safety introduced a ban on self-prescribing of medical narcotics early last year, designating propofol as the top-priority prohibited substance in consultation with medical associations. Violations carry a prison term of up to five years or a fine of up to 50 million won ($35,300).

Despite the ban, propofol self-administration persists because there are ways to divert the drug without detection. Even special judicial police officers tasked with catching narcotics abuse say it is nearly impossible to determine from documents alone whether a drug has been misused or self-administered.

The government operates the Narcotics Information Management System, known as NIMS, to monitor in real time the entire chain of medical narcotics — retail distribution, manufacturing, prescribing and dispensing. But those working enforcement on the ground agree: if a doctor is determined to divert drugs, there is no catching them.

"A doctor prescribes five ampoules to a patient but actually administers only three, then diverts the remaining two," a police official with expertise in narcotics investigations said. "Another method is to leave a small amount in each ampoule when multiple ampoules are used on a patient." Propofol diverted this way effectively disappears from the paper trail, leaving the doctor free to use it however they wish.

A drug abuse enforcement specialist who previously worked as a special judicial police officer with a background in pharmacy said the challenge is compounded by wide dosage variation. "The amount of propofol a patient needs varies considerably depending on factors like their drinking habits," the specialist said. "There is a per-patient ceiling, but the range is broad, which limits what you can do. A paper record showing that three ampoules were used on one patient simply is not enough to determine whether self-administration occurred."

The specialist said on-site inspections are essential. "Because documents tell you so little, we focus on field enforcement," the specialist said. "When you actually visit clinics, you sometimes find high-end beds instead of the standard medical cots you would normally expect. A clinic with an unusually large number of beds is also a red flag for propofol abuse."