Overdose Raises Questions About Stress and Drug Abuse in Hospitals

DRUG USE, DRUG ABUSE January 1995

The overdose death of a young pediatric critical care doctor in San Diego has focused attention on the problem of drug abuse by doctors (Rex Dalton, "He Saved the Lives of Children, But Lost His Own: Drugs, Doctors, and Death," San Diego Union-Tribune, Dec. 4, 1994, p. A1; Associated Press, "Hospital Dealing With Death From Drugs of Young Doctor," Oakland Tribune, Dec. 7, 1994, p. A5).

On Sept. 18, 1994, Dr. Michael Pautler, 30, of Children's Hospital treated a child for an acute and nearly-fatal asthma attack and went home. Colleagues said he left the hospital that morning "on top of the world." He had some drinks with a nurse friend and they injected the narcotic fentanyl, which they had apparently stolen from the hospital. The next afternoon when the nurse woke up, Pautler was dead.

Fentanyl is a very powerful synthetic narcotic that is one of the most widely used painkillers for surgery. Like most narcotics, it produces euphoria and is a popular drug used illegally by addicted or drug-using doctors and medical personnel. About a dozen anesthesiologists die from overdoses of fentanyl every year, according to "medical authorities" unnamed in the Tribune article.

"Perhaps the dues they are asked to pay are part of the problem," Pautler's father Paul said. "Working 65, 70 hours a week. Who's using who? Does that create stress? Does that induce you to drink? Does that make you use fentanyl?"

Pautler graduated from the University of Kansas Medical School and was at Children's Hospital to finish his training.

The hospital has instituted new programs to prevent the theft of drugs and to help medical professionals deal with stress.