S. Korea designates general anesthetic etomidate as narcotic following abuse cases

Vials of etomidate are pictured with identifying information, including packaging barcodes, removed to evade law enforcement tracking. (Seoul Metropolitan Police Agency’s Drug Crime Investigation Unit)

Etomidate, a short-acting intravenous anesthetic primarily used in operating rooms and emergency departments, was designated a narcotic in South Korea on Friday, following cases of abuse.

Under the new classification, all products containing etomidate will be subject to mandatory tracking under the government’s Narcotics Information Management System at every stage, including import, distribution, purchase, disposal and administration.

The move comes amid growing concerns that etomidate had been used as a substitute for propofol after the latter was placed under tighter controls. Etomidate had been classified as a medication of concern for misuse since 2020.

In one recently uncovered abuse case of etomidate, police on Wednesday said that it had booked 17 suspects, including the head of a pharmaceutical wholesale firm, three gang members, and the operators of an illegal clinic where the injections were administered, for violating the Pharmaceutical Affairs Act. Ten of them were taken into custody. Police also confiscated 49 million won ($34,000) in suspected criminal proceeds.

According to officials at the Seoul Metropolitan Police Agency’s drug crime investigation unit, two suspects, including the wholesale firm’s head, sold 3,160 boxes totaling 316,000 milliliters to three gang members for 100,000 to 250,000 won per box. They allegedly received about 400 million won in return.

The wholesaler is accused of procuring etomidate from pharmaceutical companies and falsely reporting the shipments as exports to countries including Vietnam, while actually selling them domestically to gang members.

The volume sold was enough to provide doses to as many as 63,200 people, police said.

The three gang members then allegedly resold the drug to operators of an illegal clinic for 300,000 to 350,000 won per box. Twelve suspects, including clinic operators, are accused of running an illegal establishment disguised as a skincare clinic in central Gangnam and injecting 44 drug users for 200,000 won per vial.