Singapore just made its first arrest for etomidate abuse. A man was found vaping a surgical anesthetic — the same drug doctors use to sedate patients before intubation — and he’s now in a Drug Rehabilitation Centre. The Central Narcotics Bureau announced it in March 2025 with the usual language: vigilance, emerging threats, zero tolerance.
I’ve lived in Singapore for three years. I moved here partly for the business environment, partly for tax efficiency, and partly — if I’m being honest — because I wanted to be around wealth. The city-state runs on a specific bargain: safety, order, prosperity, in exchange for certain freedoms. Harsh drug laws are part of that bargain. The death penalty for trafficking. Mandatory rehabilitation for users. A system designed to make Singapore feel impervious to the chaos that drugs supposedly represent.
But here’s what caught my attention about this case. It’s not just that someone found a new substance to abuse. It’s that the substance found them through a delivery mechanism that didn’t exist a decade ago — the e-vaporizer. And the way Singapore is responding reveals something about how states try to maintain control in an era when chemistry, technology, and global supply chains move faster than any law can follow.
What etomidate actually is
Etomidate is a short-acting intravenous anesthetic. It’s been around since the 1970s. Doctors use it for rapid sequence intubation — when they need to put a tube down your throat quickly and you need to be unconscious for about ten minutes. It works fast, wears off fast, and has a relatively stable cardiovascular profile, which makes it useful for patients who can’t handle the blood pressure drops that other anesthetics cause.
It’s not a controlled substance in most countries. That’s important. It sits in a regulatory gray zone — clearly a medical drug, but not classified alongside heroin or methamphetamine. You can’t walk into a pharmacy and buy it, but it doesn’t trigger the same alarm bells in customs systems or dark web monitoring that scheduled drugs do.
The high, according to the limited reports that exist, is dissociative. Users describe a dreamy detachment, a sense of floating outside their bodies. The effects last only minutes, which means users dose repeatedly. And because it was designed for medical settings where patients are monitored and supported, using it alone — vaping it in your apartment — carries risks that the drug’s developers never contemplated.
Respiratory depression. Loss of consciousness in environments without medical support. Seizure-like movements that aren’t technically seizures but look terrifying. The CNB’s statement noted these dangers, but what they didn’t say is that etomidate abuse isn’t a Singapore phenomenon. It’s been spreading quietly through East and Southeast Asia for years.
The supply chain no one talks about
China banned etomidate in 2023. That fact alone tells you something. China doesn’t ban substances preemptively. They banned it because domestic abuse had become significant enough to warrant action — reports of people collapsing in internet cafes, vape shops selling pre-mixed etomidate cartridges, a supply chain that had industrialized around a loophole.
Before the ban, Chinese chemical manufacturers were producing etomidate at scale. Not for hospitals. For export. The same infrastructure that produces fentanyl precursors and novel psychoactive substances — the labs in Hebei and Zhejiang that can synthesize almost anything if there’s demand — had identified etomidate as a growth market. Unscheduled in most countries. Easy to ship. Growing appetite in Asia for dissociative experiences.
When China banned it domestically, production didn’t stop. It went underground and export-focused. The chemicals still move through the same channels that have always moved gray-market pharmaceuticals: mislabeled shipments, transshipment through third countries, online vendors who accept cryptocurrency and ship in nondescript packaging.
Singapore, for all its reputation as an impenetrable fortress against drugs, sits at the center of these trade routes. The port handles more container traffic than almost anywhere on earth. The airport is a regional hub. The country’s entire economic model depends on being a frictionless conduit for global trade. That same frictionlessness makes interdiction difficult in ways the official narrative doesn’t acknowledge.
The vaporizer problem
What makes this case different from traditional drug enforcement is the delivery mechanism. E-vaporizers have created an entirely new category of drug consumption — one that’s portable, discreet, doseable, and designed for substances that were never meant to be inhaled.
The technology was developed for nicotine. Then cannabis extracts. Then, inevitably, anything else that could be dissolved in propylene glycol or vegetable glycerin and heated into vapor. Synthetic cannabinoids. Ketamine analogs. Now surgical anesthetics.
The vaporizer industry operates in its own regulatory void. The devices themselves are legal in most places. The cartridges can contain anything. Customs officials scanning packages see small electronics and tiny bottles of liquid. Without testing every shipment, there’s no way to know what’s inside.
Singapore banned vaporizers entirely in 2018, ostensibly for health reasons related to nicotine. Possession can result in fines up to $2,000. But enforcement has been inconsistent, and the devices remain common. Walk through certain neighborhoods, certain clubs, and you’ll see them. The ban pushed the practice underground without eliminating it — a pattern that should be familiar to anyone who’s studied prohibition.
What the etomidate arrest reveals is that vaporizers aren’t just a nicotine issue or even a cannabis issue. They’re a platform. A delivery system that can be adapted to any substance that someone figures out how to formulate. The enforcement challenge isn’t catching people with vaporizers. It’s that the vaporizer makes almost any drug portable and concealable in ways that previous drug paraphernalia never achieved.
How states respond when they can’t keep up
Singapore’s response to the etomidate case followed a predictable script. Announcement of the arrest. Warning about the dangers. Reminder that the Misuse of Drugs Act covers emerging substances. Statement that authorities are “monitoring the situation closely.”
This is how states signal control even when control is slipping. The language of vigilance, of monitoring, of comprehensive legislation — it reassures citizens that someone is watching. But the structure of the problem has changed in ways that traditional enforcement can’t address.
The old drug war was about borders and busts. Interdiction at ports. Raids on dealers. The drugs were physical, bulky, and moved through established trafficking networks that could be infiltrated and disrupted. The new landscape is different. Chemical formulas cross borders as information. Precursors are legal until they’re combined. Novel substances emerge faster than scheduling processes can respond.
The United Nations Office on Drugs and Crime tracked over 1,100 novel psychoactive substances by 2022. Most countries can’t schedule them fast enough. By the time a substance is banned, chemists have already tweaked the molecule to create a legal analog. The law plays whack-a-mole with chemistry, and chemistry always wins.
Singapore addresses this through blanket scheduling of chemical analogs — if something is structurally similar to a banned substance, it’s automatically banned. This approach is more aggressive than most countries, but it creates its own problems. It potentially criminalizes legitimate research. It requires technical expertise that most enforcement agencies lack. And it doesn’t stop determined suppliers from finding substances that fall outside even broad structural definitions.
Etomidate isn’t a novel psychoactive substance. It’s been in medical use for fifty years. It’s not structurally similar to recreational drugs that Singapore has banned. It occupied a blind spot — medically legitimate, not traditionally abused, unremarkable in shipments of pharmaceutical supplies. The arrest happened not because the system is working, but because someone got caught. How many others haven’t?
The deeper pattern
I keep coming back to something about this story that bothers me, and it’s not the drug itself.
It’s the way the official response assumes that enforcement is the answer. That the right combination of surveillance, harsh penalties, and border control can maintain the clean separation Singapore promises between order and chaos, between here and elsewhere, between us and them.
Singapore’s drug policy is built on deterrence. The theory is that severe consequences prevent use. The death penalty for trafficking. Mandatory rehabilitation for users. Public messaging that frames drugs as an existential threat to social stability. And by certain measures, it works. Drug use rates here are lower than in most developed countries. The streets feel safe