Seoul cracks down on etomidate, an anesthetic with abuse potential similar to propofol

Inspections covered 77 medical facilities across 23 districts

15 facilities found in violation of the Narcotics Control Act in 18 cases

City vows continued monitoring of medical narcotic management

Etomidate and other narcotics seized by the Seoul Metropolitan Police Agency's drug crime investigation unit. [Provided by Seoul Metropolitan Police Agency drug crime investigation unit. Redistribution and database storage prohibited. Yonhap]

Amid growing public concern over the misuse of medical narcotics — highlighted by the recent discovery of a woman collapsed in the heart of Gangnam while in possession of propofol vials and syringes — the Seoul Metropolitan Government has completed a targeted inspection of medical facilities and found 15 in violation of narcotics regulations.

The city said it conducted a preemptive joint inspection with district offices, covering 77 medical facilities that handle etomidate, to assess compliance with narcotics management rules.

Etomidate is a short-acting intravenous anesthetic used to induce general anesthesia and sedation. Its effects and applications closely resemble those of propofol, including use in procedures such as sedated endoscopies. As cases of illegal use as a propofol substitute emerged and concerns over misuse mounted, authorities designated the drug a psychotropic substance under the Act on the Management of Narcotics starting Feb. 13 this year.

The driver in the so-called "Lamborghini incident" of 2023 — in which a motorist sparked public outrage by wielding a weapon during a parking dispute — was also confirmed to have used etomidate.

All medical narcotics must be handled and stored in compliance with the Narcotics Control Act, and illegal diversion is strictly prohibited.

The inspection deployed more than 50 city and district personnel, organized into two-person teams, who conducted on-site visits over a one-month period beginning May 20. The city selected 77 facilities that either had a record of receiving etomidate supplies or had inventory registered in the Narcotics Information Management System for inspection.

Key compliance areas checked included whether facilities met narcotics storage standards, whether actual inventory matched records in the Narcotics Information Management System (NIMS), whether narcotics past their expiration date were being kept on the premises, and whether narcotics handling was being reported properly.

The inspections uncovered 18 violations across 15 medical facilities. The city plans to impose administrative penalties on the offending facilities in accordance with relevant laws — including warnings, fines and suspension of narcotics-handling operations — and will also pursue criminal referrals depending on the severity of each violation.

Etomidate. [Provided by Seoul Metropolitan Government]

The Seoul Metropolitan Government said it plans to further strengthen its medical narcotics management framework following the inspections. In the second half of the year, the city will conduct intensive inspections of facilities handling propofol, which carries a high risk of misuse, to prevent illegal diversion and improper use and to reinforce the management responsibilities of medical institutions.

Meanwhile, to mark World Drug Abuse Prevention Day on Thursday, the city plans to run a three-day public awareness campaign at Seoul City Hall Plaza, operating an information booth to spread anti-drug messaging in everyday settings.

"When medical narcotics are not properly managed, the consequences can be serious — illegal diversion and misuse — which is why responsible management by medical institutions is paramount," said Jo Yeong-chang, director of the Seoul Metropolitan Government's Public Health Bureau. "We will continue to inspect how medical institutions manage narcotics, so that we can ease public concern and ensure a safe medical environment."

ikson@heraldcorp.com