Space oil and kpods - what’s going on with etomidate in vapes?

What is etomidate?

Etomidate is a fast-acting medication that is used to start and maintain anaesthesia  during short medical procedures. It’s a central GABA agonist which means it activates gamma-aminobutyric acid (GABA) receptors in the central nervous system (CNS) and slows the body down. In New Zealand, etomidate is controlled as a prescription medicine under the Medicines Regulations 1984.

What are the effects of etomidate?

Etomidate has a rapid time of onset and a short duration of effect. Etomidate vapes are advertised as producing an effect similar to nitrous oxide combined with ketamine.

The effects of etomidate can include:

• Involuntary muscle jerking or twitching
• Loss of coordination
• Drowsiness
• Dizziness
• Confusion
• Breathing difficulties, or hyperventilation
• Low blood pressure
• Slow heart rate
• Nausea or vomiting
• Loss of consciousness

What are the risks of etomidate?

Etomidate may result in the rapid development of effects like loss of coordination or muscle control (ataxia), sedation and hypoventilation. The effects can be increased when combined with other depressant drugs like alcohol, benzodiazepines, ketamine or opioids. Mixing them can lead to nausea, breathing problems, choking, losing consciousness, and even death.

Chronically, with long-term use, etomidate use has been linked with significant adrenal insufficiency, often requiring medical management including hospitalisation. These symptoms appear to be reversible with proper medical support and no further etomidate use.

Internationally, addiction to etomidate has been reported, with a typical GABA-related withdrawal syndrome identified following abstinence. Withdrawal can pose serious health risks. If you’re worried about your use of etomidate and want to stop using it, please get medical advice. You can also call the Alcohol Drug Helpline on 0800 787 797, or text 8681, for confidential, non-judgmental expert advice. It’s free and open 24 hours every day. Check out The Level for more information on managing withdrawal.

While no drug use is safest, there are some steps that can help reduce the risks.

Drug checking is recommend to help lower the risks. You can't tell what something is by sight and smell alone. Drug checking is free, legal and confidential. KnowYourStuffNZ, the New Zealand Drug Foundation and the New Zealand Needle Exchange Programme's DISC Trust run regular drug checking clinics across the country, and a drop off service is now available in Auckland. A calendar of upcoming clinics can be found on The Level. 

Lower dosages usually pose less risk. Start off with a small amount to check how it affects you. Remember, every person is different and can respond differently to a substance. Don’t assume every dose will produce the same effects.

Avoid combining etomidate with other substances, especially other depressants like alcohol, benzos and opiates as the combined sedative effect increases the risk of choking, overdose or losing consciousness. Mixing any combination of drugs and alcohol can be dangerous. The impact on your body and mind become even more unpredictable, and harder to manage.

Avoid using alone. As with all drug use, it’s better to have people around that you trust and who can help, and call an ambulance, if things go wrong.

What to do in an emergency

If you think someone is in distress or suffering from an overdose:

• Call 111 immediately and ask for an ambulance.
• Don’t panic. Stay calm.
• Keep yourself safe. Watch out for used needles and blood on the bed or floor etc.
• Check if the person is conscious by gently shaking them and calling their name or asking if they’re ok. This may bring the person round.
• If the person does not respond, check whether they are breathing.
• Check their airway. Tilt their head back enough to open their airway. Remove anything from their mouth like food or vomit.
• Are they breathing? Put you ear next to their mouth. Can you feel any breath? Is their chest rising?
• If they are breathing put them in the recovery position.
• If they are not breathing start CPR.

If you have had unexpected or concerning effects from etomidate vapes, or any substance, please tell us about your experience through our ‘Report unusual effects’ page. It’s completely confidential and will help keep others safe.

The National Poisons Centre is also available 24/7 to help members of the public and healthcare professionals with clinical advice for exposures to this, or any other substance - please call 0800 764 766 (0800 POISON).

If you have any concerns about your own drinking or drug taking, get in touch with the Alcohol Drug Helpline Call 0800 787 797, or text 8681, to speak with a trained counsellor – they’ll be able to provide you with helpful information, insight and support. They’re available 24/7, all calls are free and confidential. You can also chat with the team through the website.