This week on The Tox Lab, we’re diving into the emerging world of “space oil”, the anesthetic drug etomidate, which has begun appearing in the recreational drug supply across parts of Asia and beyond.

We explore several cases involving etomidate vaping, where repeated exposure led to adrenal insufficiency due to its potent inhibition of 11β-hydroxylase. We also discuss a fatal ingestion case, highlighting just how dangerous this drug can become when used outside controlled medical settings.

Etomidate’s presence isn’t limited to Asia: it has recently been detected alongside fentanyl in Philadelphia and identified in a handful of UK seizures, raising important questions about its evolving role in the illicit drug market. With emerging analogues starting to surface, the landscape may become even more complex.

Join us as we unpack the pharmacology, the clinical consequences, and why etomidate is now a substance toxicologists are watching closely.

Hope you enjoy!

Links to the papers we discussed:

https://www.hkmj.org/system/files/hkmj2412244.pdf

https://link.springer.com/article/10.1007/s12024-024-00813-8

https://hip.phila.gov/document/4686/PDPH-HAN-429U-Etomidate-08.12.2024-1.pdf/

https://www.gov.uk/government/publications/acmd-review-of-the-evidence-on-the-use-and-harms-of-etomidate

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