South Korea Elevates Etomidate to Controlled Substance After Illegal Clinic Bust

"Just one more shot, please."

A video recently surfaced showing a woman kneeling and begging a man in a white coat at what appeared to be a skin clinic. The footage captured the disturbing reality of illegal etomidate operations that have proliferated across Seoul's Gangnam district.

Authorities have referred to prosecutors a criminal ring that operated fake medical clinics disguised as dermatology centers, illegally administering etomidate under the guise of "skin boosters" and "fat-dissolving injections." The operators had no medical licenses.

The pharmaceutical wholesale company executive and associates arrested in the case distributed enough etomidate between October 2024 and June 2024 to simultaneously dose 63,200 adults. The drug, which costs approximately 38,000 won ($27) per box at wholesale, was sold at more than 50 times that price through intermediary distributors.

Starting today, South Korea's Ministry of Food and Drug Safety has reclassified all etomidate-containing products as controlled narcotics.

Etomidate is a general anesthesia inducer with effects similar to propofol, commonly known as "milk injection." Unlike propofol, which can cause blood pressure drops and slowed heart rate upon administration, etomidate offers greater cardiovascular stability, making it essential in intensive care units and operating rooms.

The drug had escaped classification as a psychotropic substance because its euphoric and hallucinogenic effects were not scientifically proven, and its addictive properties were considered relatively low. This regulatory gap was exploited for illicit use.

The reclassification follows high-profile abuse cases, including reports that a former national baseball team player who had previously served prison time for habitual drug use obtained large quantities of etomidate through acquaintances.

Under the new regulations, etomidate must be stored in locked facilities. All processes from import and sales to administration and disposal must be reported in real-time through the government's integrated narcotics management system.

Penalties for illegal use will increase significantly. Previously, weak legal grounds often resulted in offenders being released with warnings. Now, unauthorized administration constitutes a narcotics offense.

China designated etomidate as a controlled substance in 2023 after reports emerged of adrenal dysfunction and endocrine disorders in patients aged 15 to 20 who had used etomidate-laced e-cigarettes over extended periods. Hong Kong and Taiwan have also strengthened regulations following widespread abuse of so-called "zombie cigarettes."

In contrast, Western countries including the United States and European nations continue to classify etomidate as a standard prescription drug, as such abuse patterns remain rare in those regions.