Etomidate vaping: A new form of anesthetic abuse.

Background

The emergence of etomidate-containing e-cigarettes represents a significant and rapidly evolving public health challenge, marking a transition of this clinical anesthetic into illegal use of an anesthetic agent. Originally utilized as a short-acting intravenous anesthetic for intubation induction, etomidate's high lipophilicity allows it to be easily aerosolized for inhalation via vaping devices. Misuse is primarily driven by its rapid-onset effects, including relaxation, dissociation, and transient euphoria, as well as a pervasive "illusion of safety" among users who perceive hospital-grade medications as less harmful than traditional illegal drugs.Method: A PubMed search was conducted to identify literature on etomidate vaping and e-cigarette use published between 2024 and May 2026. The retrieved publications were critically reviewed and evaluated across four core scientific dimensions: geographic distribution, clinical manifestations, publication types, and analytical detection methods.

Results

The clinical implications of repeated exposure are severe, notably involving the suppression of 11-β hydroxylase, which leads to clinical hyperaldosteronism (hypertension and hypokalemia), virilization but apparent biochemical hypoadrenalism, and electrolyte imbalances. While analytical advances like Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS) and novel zirconium-based extraction materials have improved detection capabilities in biological samples and e-liquids, the discreet nature of vaping continues to lower barriers to misuse.

Conclusions

Addressing this trend necessitates urgent regulatory intervention, expanded toxicological screening, and targeted education to dismantle misconceptions regarding the safety of etomidate inhalation.