Medical Community Voices Concern Over Etomidate's Narcotic Classification... "Emergency Care May Become More Difficult"

As the government has designated the general anesthetic induction agent Etomidate as a narcotic, concerns are rising within the medical community. While there is a clear need for strict control over narcotic drugs, medical professionals warn that such a measure could seriously disrupt the treatment of emergency and critical patients. They emphasize that while misuse must be prevented, a balanced approach is needed-such as targeted regulations prohibiting use for cosmetic purposes, rather than a blanket ban.

General anesthetic Etomidate. Gangnam Police Station

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According to the medical community on September 5, there are growing concerns among essential medical staff that designating Etomidate as a narcotic could cause problems in emergency treatments for patients whose vital signs are unstable and whose lives are at risk.

Etomidate is primarily used in emergency rooms for procedures such as endotracheal intubation. It is administered in various emergency situations, including when patients are in too much pain to undergo CT or MRI scans, or when dislocated joints need to be set. The drug is particularly valued in the medical field for providing sedation without side effects such as hypotension, making it more effective and safer than other drugs like propofol.

The Ministry of Food and Drug Safety designated Etomidate as a narcotic last month after continued reports of misuse. Since 2020, Etomidate has been managed as a drug of concern due to risks of illegal distribution and abuse. However, ongoing misuse cases eventually led to its classification as a narcotic. In particular, the practice of mixing Etomidate with liquid e-cigarettes for inhalation has become a global issue. In South Korea, seven individuals were arrested by police last month for distributing Etomidate smuggled from Hong Kong to nightlife establishments in Gangnam.

As a result of this government measure, the continued domestic supply of Etomidate has become uncertain. Once designated as a narcotic, every stage from import to administration requires mandatory reporting and real-time government monitoring. Domestic distribution partners also need narcotics management licenses. Hanall Biopharma, the domestic distribution partner for the German manufacturer B. Braun, has not obtained a narcotics management license. Because of this situation, B. Braun is reportedly considering whether to continue exporting Etomidate to South Korea.

Kim Taehoon, Policy Director of the Korean Society of Emergency Medicine, pointed out that while widespread misuse-including at cosmetic clinics-could become a broader problem, "If doctors are forced to use alternatives like propofol, which are relatively more dangerous, instead of Etomidate, it will become more difficult for them to respond confidently and proactively in emergency situations."

Director Kim further stated, "To prevent misuse, sophisticated and targeted regulatory alternatives are needed, such as blocking smuggling and restricting or strengthening oversight of use at cosmetic clinics. Making it difficult to use Etomidate even in essential medical care fails to consider the realities of emergency and critical patient treatment in the medical field."

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Dr. A, an emergency medicine specialist working in the emergency room of a general hospital in a provincial area, said, "While the principle of sedating emergency patients to induce sleep is broadly similar, Etomidate is fundamentally different in its application compared to other alternatives. Given that Etomidate is less likely to cause sudden drops in blood pressure or other major disruptions to vital signs, and that it is the global standard for airway intubation protocols, authorities need to consider supplementary measures."

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