Background: Substance abuse as a major social and medical problem can be job-dependent. Objectives: Among various occupations, medical personnel have greater access to narcotic drugs, leading to mood, behavior, and occupational disorders and ultimately death due to lack of control. Methods: The present study reported a death of medical personnel with migraines owing to colleagues' inattention to substance abuse. Results: The case was a 44-year-old man with 24 years of clinical experience, good social relationship, no symptoms of psychiatric disorder, an expert in the field of anesthesiology, and a popular manager among hospital colleagues. Diagnosed with migraine headaches one year ago, he worked for several treatment centers. According to some reports, he showed ataxia in some cases due to the exacerbated headache. Additionally, ataxia and drowsiness after a headache attack were not considered the cause of drug abuse so that they were always attributed to the disease. Eventually, in a shift, he had a respiratory failure and then died of the overdose or non-control of fentanyl abuse. Conclusion: Medical personnel with migraine are at high risk of substance abuse in therapeutic settings. Therefore, it is suggested that periodic and intangible examinations be conducted for medical personnel, especially those with migraines in the field of substance abuse, and preventive counseling be provided.