TAIPEI (Taiwan News) — The anesthetic etomidate has become the focus of increased police attention in Taiwan after it began appearing for sale in vape cartridges for recreational use.

Authorities have seized significant quantities of the drug since it surfaced in 2023. On Wednesday (Sept. 4), the Coast Guard apprehended two men smuggling enough etomidate to produce 85,000 vape cartridges into Taiwan. The drug also made national headlines in July after a police officer was killed by a driver high on the substance.

Etomidate is a short-acting anesthetic typically used in hospitals, where it is injected for “procedural sedation.” Recreational use is much less common, and there are limited studies on its effects; however, research suggests that long-term use may cause damage to the brain and nervous system.

Taiwanese authorities report that criminal groups are falsely promoting etomidate as a safer alternative to marijuana. In August, the Ministry of Justice added etomidate to Taiwan’s list of class three controlled drugs and implemented more robust measures to prevent its sale and importation.

Hung Pei-lin (洪培倫), section chief at the Criminal Investigation Bureau’s (CIB) Drug Enforcement Center, told Taiwan News in a recent interview that there has been some reduction in etomidate cases since the law was amended. The August change made selling etomidate punishable under narcotics legislation, whereas it was previously handled under the pharmaceuticals act.

Hung said recreational use of etomidate accounts for about 5% of all drug cases in Taiwan, according to CIB statistics. He noted that while this is relatively low, the public may feel it is more prevalent due to recent high-profile incidents involving the drug.

The first time authorities found etomidate being used recreationally was in late 2024, and Hung indicated it was a surprise when a test produced a positive result for the drug.

Hung added that while the bureau was aware of etomidate’s use in hospitals, the Food and Drug Administration confirmed that no factories produce the drug in Taiwan. As a result, the CIB has essentially ruled out the possibility of domestic production.

Two etomidate smuggling cases uncovered by the CIB since then were found to have originated in Southeast Asia. Hung noted there are suspicions that the drug may also be coming from China, but this remains uncertain.

Local media have referred to etomidate for recreational use as “zombie vape cartridges” (喪屍煙彈) due to the drug’s apparent effect on users. “It can cause people to lose control of their bodies, like a zombie,” Hung said.

Hung explained that dealers put the substance in vapes because ingesting it this way only requires a tiny amount to achieve the desired effect. He added that CIB investigations have not uncovered any instances of the drug being snorted, injected, or taken in any way other than by vaping.

The CIB also considers it highly unlikely that the substance is being secretly mixed into nicotine or other vapes by drug dealers. Hung said etomidate is much more expensive than nicotine vape oil, making it unprofitable for dealers to mix the two.

All vapes, e-cigarettes, and heated tobacco products were made illegal in Taiwan in March 2023. Hung explained that since etomidate is now classified as a drug, possession of a vape or e-cigarette can give police grounds to request a search or test the item for drugs.

While the CIB has not recorded any deaths from etomidate abuse, Hung emphasized that recreational use poses significant risks. Ho I-chun (何逸群), an addiction specialist at Taipei City Hospital, told CNA in July that abusing the drug affects the central nervous system and can cause confusion, vomiting, loss of consciousness, and loss of control over the body.

Ho also noted that the risk of dying from the drug increases significantly when mixed with alcohol or other substances. He explained that etomidate is a depressant, and combining it with other depressants can result in fatal respiratory failure.

To prevent the import and sale of etomidate, Taiwan’s border police and airport staff have been equipped with mobile drug inspection tools and use databases on high-risk individuals to reduce the chances of smuggling, Hung said.

Hung added that since the investigation of etomidate was made a priority in late July, all instances in which the drug is uncovered will be referred to the CIB for investigation.