Anaesthetic drug regulations need overhaul to curb doctor suicides, experts say
Synopsis
Key Takeaways
Anaesthetists across Kerala and other parts of India are calling for urgent regulatory reform governing high-risk anaesthetic drugs, warning that unrestricted in-hospital access to these medicines has created a distinct occupational hazard for healthcare professionals. The appeal, voiced by senior doctors on 27 June, follows a concerning shift in the pattern of suicides among medical professionals — with an increasing number of recent deaths reportedly involving anaesthetic agents available within hospital settings.
A Changing and Alarming Pattern
According to the doctors, more than 20 medical professionals are believed to have died by suicide in Kerala and other states in recent years. Experts caution that unsuccessful attempts are likely several times higher than officially recorded fatalities, pointing to a significant under-reporting problem that systematic research has yet to adequately address.
Dr S. Anzar, an anaesthetist at Government Medical College, Pariyaram, said healthcare workers possess specialised knowledge of anaesthetic drugs and have legitimate professional access to them — a combination that creates a unique and largely unacknowledged occupational risk. 'These medicines are indispensable for patient care, but the present system does not adequately regulate access once they are available within hospitals. This is no longer just a mental health issue; it is also one of access, accountability and regulation,' he said.
Dr Anzar noted that while earlier cases among medical professionals largely mirrored methods seen in the general population, recent deaths have increasingly involved hospital-grade anaesthetic drugs — a shift he described as both clinically significant and policy-relevant.
Key Regulatory Reforms Proposed
Doctors have outlined a multi-pronged response. Central to their demands is the reclassification of commonly used anaesthetic drugs from the current Schedule H category under the Drugs and Cosmetics Rules to the stricter Schedule X classification, which carries tighter dispensing controls. Under the existing Schedule H framework, such drugs can be dispensed on the prescription of any registered medical practitioner — a provision critics argue is ill-suited to the risk profile of these agents.
The doctors also recommended installing Automated Drug Dispensing Cabinets (ADCs) in operation theatres, intensive care units, and emergency departments to electronically monitor and restrict access to high-risk medicines. Expanding counselling and psychological support for healthcare workers was also cited as a parallel imperative.
Industry Voices Back the Push
Dr Harris Azees, a private-sector anaesthetist, argued that the existing regulatory framework has failed to keep pace with modern hospital practice. 'Most anaesthetic drugs continue to be classified under Schedule H, allowing them to be dispensed on the prescription of any registered medical practitioner. That framework no longer adequately reflects the risks associated with these medicines. It is time the regulations were revisited and oversight strengthened,' he said.
Dr Azees further noted that certain anaesthetic agents leave only a very narrow window for life-saving medical intervention, making upstream prevention through institutional safeguards especially critical.
Historical Perspective and the Road Ahead
Veteran anaesthetist Dr Thomas Kurian recalled that during his early years in the profession, suicides involving anaesthetic drugs among medical professionals were virtually unheard of. 'Most cases then involved conventional methods. The change we are witnessing today should prompt serious introspection within the medical community and among policymakers,' he said.
The doctors collectively emphasised that medical professionals spend years navigating intense academic competition before entering one of the country's most demanding careers. Protecting their mental well-being while simultaneously tightening safeguards around high-risk medicines, they argued, must now become an urgent priority for governments, regulators, and healthcare institutions alike. A comprehensive scientific study into suicides within the medical fraternity has also been called for, with experts stressing that the issue demands a response that goes beyond mental health support alone.