Expert calls for stricter supervision of etomidate supply chain

Jakarta (ANTARA) - Pulmonary specialist Prof. Dr. dr. Erlina Buranc, MSc, Sp.P(K), stated that government supervision of the etomidate supply chain needs to be tightened.

“This phenomenon is developing quite rapidly in several Asian countries, so I believe Indonesia needs to utilise an early warning system approach and implement prevention before its use among the younger age group becomes more widespread,” Erlina said when contacted by ANTARA in Jakarta on Monday.

Erlina, a graduate of the University of Indonesia, stated that the approach to supervising etomidate must be integrated and not rely solely on enforcement after the product has already entered circulation.

This includes monitoring distribution, sales, imports, and the potential diversion of the drug from legal channels to illegal use.

Furthermore, there is a need for a surveillance system and the reporting of clinical cases so that doctors and healthcare facilities can recognise patterns of etomidate poisoning more quickly.

Erlina also recommended expanding education for young people, with the message that vapes containing etomidate are not ordinary vapes and are not a safe way to achieve relaxation, a “high”, or loss of consciousness. The substance is an anaesthetic drug that can affect consciousness and the body’s hormonal system.

Another point raised by Erlina is that etomidate is actually an intravenous anaesthetic used in medical settings, for example, for anaesthesia induction or specific procedures.

Therefore, the presence of etomidate in vape liquids constitutes drug abuse outside of its intended indications and administration routes. The phenomenon of using etomidate via vapes has indeed been reported in several Asian countries, particularly in recent years.

Etomidate is an anaesthetic drug that works primarily through GABA-A receptors in the central nervous system. Its effects can cause sedation, changes in consciousness, and impaired coordination, and at certain exposure levels, can lead to loss of consciousness.

A significant issue with etomidate is its ability to inhibit the 11β-hydroxylase enzyme in the adrenal glands. As a result, the production of cortisol hormones can decrease.

This effect is well-known in medical use and becomes more concerning if etomidate is used repeatedly or in an uncontrolled pattern of use.