What does it mean for etomidate to be listed under the Misuse of Drugs Act?: ST Explains
Source: Straits Times
Article Date: 22 Jul 2025
Author: Joyce Lee
Authorities taking stronger action amid growing trend of vapes containing the substance.
Etomidate, which is increasingly being abused through e-vaporisers, will be reclassified under the Misuse of Drugs Act (MDA).
Offences under the Act carry heavier sentencing and mandatory rehabilitation.
Announcing this on July 20, Health Minister Ong Ye Kung said it was now necessary to take stronger action, with the growing trend of e-vaporisers or vapes containing the drug.
Kpods, which are vape juice mixed with etomidate, have been touted by online sellers to be undetectable by urine tests.
What other drugs fall under the MDA, and what are the penalties for the trafficking, possession and consumption of these? The Straits Times explains.
What is etomidate?
Etomidate is an anaesthetic agent used in clinical practice to induce sedation. It is currently controlled under the Poisons Act, which restricts its use to licensed medical professionals.
Under the Poisons Act, those caught possessing, using or trafficking pods containing etomidate face a maximum fine of $10,000 and a prison term of two years.
Why is there a need to reclassify etomidate?
Vapes, often used to deliver nicotine, are banned in Singapore under the Tobacco (Control of Advertisements and Sale) Act. Besides nicotine, vapes have been found to contain even more harmful substances such as etomidate and ketamine.
Mr Ong said that in a recent seizure of over 100 vapes, a third were found to contain etomidate.
Etomidate is meant to be administrated intravenously under strict medical supervision. Inhaling etomidate into the lungs through vapes can cause failure of vital organs. It can also induce confusion, tremors and unsteady gait, leading to falls and accidents.
Accounts have surfaced of Kpods triggering erratic, violent and zombie-like behaviour in users. Like other substance addictions, etomidate can alienate the addict from loved ones. Readers have recounted their experiences of etomidate-laced vapes destroying their marriage and straining relationships with their children.
Many have called for harsher penalties for those trafficking Kpods, and for better coordination among agencies to help children curb their addiction rather than hand them fines. This would include ordering mandatory treatment for addicts and those caught using the vapes.
Professor Teo Yik Ying, dean of the NUS Saw Swee Hock School of Public Health, for one, had proposed that current laws keep up with the technology – e-cigarettes and vapes – used to deliver synthetic drugs.
'If I am a police officer and I catch someone with a vape, and I detect that the vape cartridge is actually a Kpod... the person is not just caught for vaping, but also caught for possession of narcotics,' he said.
Former Jurong GRC MP Tan Wu Meng, who had previously brought up the vaping issue in Parliament, said the scourge is concerning as Kpods could be a gateway for users to try harder drugs.
What does listing etomidate under the Misuse of Drugs Act mean?
There are plans to reclassify etomidate as a Class C drug under the MDA. It will share this category with other substances that have lower potential for harm than Class A and Class B drugs, but are still dangerous enough to warrant strict control.
Stimulants like mephentermine and pipradrol, and the hypnotic drug Erimin-5 (nimetazepam), are examples of Class C drugs. These substances may have legitimate medical uses, but are harmful when used in an unregulated manner.
Here is what listing etomidate as a Class C drug would entail:
Stiffer penalties
Under the MDA, illegal possession and use of a Class C drug carry a maximum sentence of 10 years' jail and a $20,000 fine. Those who traffic such drugs may be jailed for up to 10 years and given five strokes of the cane.
This is compared with the maximum penalty of two years' jail and a $10,000 fine under the Poisons Act.
The MDA also provides for supervision and mandatory rehabilitation for drug addicts. The addict must remain at a rehabilitation centre for 12 months unless he or she is discharged earlier.
Whole-of-government effort in enforcement against etomidate-laced vapes
The classification of etomidate as a Class C drug is a recognition of the scale of the vape problem here. The Health Sciences Authority (HSA) has seen an increase in reports on vaping-related offences, from more than 3,000 reports in 2024 to more than 2,500 reports in the first half of 2025.
How have agencies stepped up efforts recently?
Mr Ong said on July 20 that various agencies – the National Parks Board, National Environment Agency, police, HSA and Land Transport Authority – are already coordinating enforcement against the consumption of e-vaporisers. When seized by agencies, the vapes first go to the Ministry of Health for testing.
'If it is just nicotine, we will process and fine them (those involved)... In the most serious cases involving drugs, the Central Narcotics Bureau will have to come in, so it will have to be a concerted effort,' said Mr Ong.
From July 21, the HSA has also extended the operating hours for its hotline to report vaping-related offences. The hotline now operates from 9am to 9pm daily, including on public holidays. Previously, it operated only on weekdays, from 9am to 5.30pm.
The HSA has also launched a new online portal to report vaping-related offences at www.go.gov.sg/reportvape
If you need help to quit vaping, you can join the Health Promotion Board's I Quit programme by calling the QuitLine on 1800-438-2000.
Participants need not worry about being prosecuted, as it does not presume they use or have used vaping products.
But those caught using or possessing such items will be prosecuted.
If you have a story to share about vapes, e-mail us at [email protected]
Source: The Straits Times © SPH Media Limited. Permission required for reproduction.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Straits Times
2 hours ago
- Straits Times
Malaysia considering nationwide vape ban, says Health Minister
Find out what's new on ST website and app. Terengganu and Perlis will ban the sale of vape products on Aug 1. KUALA LUMPUR - Putrajaya is considering a nationwide ban on the use and sale of e-cigarettes or vapes, according to Health Minister Dzulkefly Ahmad. Datuk Seri Dzulkefly stated that a special committee from the Health Ministry will propose the ban to address the abuse of electronic cigarettes. 'It will come in the form of a proposal where the ministry will bring this agenda to ban vapes,' said Dr Dzulkefly during a press conference in Parliament on July 28. He also mentioned the Control of Smoking Products for Public Health Act 2024 (Act 852), which regulates vape use. 'It does not cover the banning of vapes. I hope this can be clarified,' added Dr Dzulkefly. He also said the ban on vaping products requires careful assessment from legal, industry, government revenue, and licensing perspectives. 'We will also hold discussions with four main ministries: the Finance Ministry, Domestic Trade and Cost of Living Ministry, Investment, Trade and Industry Ministry, and the Attorney General's Chambers (AGC),' said Dr Dzulkefly, adding that a committee meeting was held recently on July 22. Dr Dzulkefly said his ministry welcomes the decision by six state governments - Johor, Kelantan, Terengganu, Perlis, Kedah, and Pahang - to stop issuing or renewing vape sales licence. Top stories Swipe. Select. Stay informed. Singapore Tanjong Katong sinkhole backfilled; road to be repaved after LTA tests Singapore MRT platform screen doors at 15 underground stations to undergo renewal Singapore 'Medium risk' of severe haze as higher agricultural prices drive deforestation: S'pore researchers Singapore Jail for former pre-school teacher who tripped toddler repeatedly, causing child to bleed from nose Singapore Police statements by doctor in fake vaccine case involving Iris Koh allowed in court: Judge Singapore Authorities say access to Changi intertidal areas unaffected by reclamation, in response to petition Singapore No change to SIA flights between S'pore and Cambodia, S'pore and Thailand, amid border dispute Singapore Not feasible for S'pore to avoid net‑zero; all options to cut energy emissions on table: Tan See Leng 'This is in line with public health aspirations and the premise licensing powers under local governments. This ruling is still limited and does not cover all premises, including grocery stores,' added Dr Dzulkefly. Meanwhile, Dr Dzulkefly said the Health Ministry is enforcing Act 852 which covers the registration of smoking and vaping products, a ban on underage individuals, and restrictions on the sale of smoking and vape products, among other measures. Up until June 30, the Health Ministry conducted 15,775 operations, issued 78,424 notices, and opened 524 investigation papers, according to Dr Dzulkefly. He added that there were 3,200 brands consisting of 6,800 variants of vaping products before the enforcement of Act 852, which began on Oct 1, 2024. 'Now, there are only 390 brands, consisting of 2,794 variants that were registered,' added Dr Dzulkefly. He also said that 2,619 smoking notices have been issued to underage smokers and 27 notices to underage individuals who bought smoking products. At the same time, Dr Dzulkefly said the Health Ministry has assisted 36,780 secondary school students in a smoking cessation intervention programme. '230 primary school students and 44,211 secondary school students have been identified for that programme. 'The 111 one-stop centres for addiction (OSCA) and 857 smoking cessation clinics are ready to serve,' he said. Dr Dzulkefly also said that beginning Aug 1, the Health Ministry will launch 'Selamat PaPa' (save the lungs) and 'Ops Selamatkan MaMa' (for passive smoking) to drive the agenda of smoking cessation. According to Dr Dzulkefly, this initiative is in response to the latest figures from the cancer registry from 2022 to 2023, which show 8,091 males and 5,251 females with lung cancer. 'The difference is not huge, and this reminds us that saving 'papa' is also about saving 'mama',' he added. Presently, Johor and Kelantan have completely banned the sale of vape products, while Kedah will stop issuing new licences for vape shops. Terengganu and Perlis will ban the sale of vape products on Aug 1. THE STAR/ASIA NEWS NETWORK
Straits Times
10 hours ago
- Straits Times
Forum: MOH supports healthcare providers in safeguarding patient databases
Find out what's new on ST website and app. We refer to Dr Yik Keng Yeong's letter ' Doctors may need help preventing cyber attacks on patient databases ' (July 22). Cyber security is a shared responsibility. Government systems such as the National Electronic Health Record (NEHR) are designed with robust cyber and data security measures in place to protect Singaporeans' health information. These include technical safeguards such as firewalls, security tools to detect and mitigate attacks, and ongoing monitoring and investigation of suspicious activities. In turn, systems connected to the NEHR are also required to have appropriate security measures in place. We understand the concern that GPs may have, and have ensured that white-listed clinic management systems meet the requisite cyber-security standards. Healthcare providers play an important role in ensuring that they have robust arrangements in place as to how their clinic management systems or electronic medical record systems are managed and used. They should put in place good practices, such as using strong passwords and two-factor authentication, be vigilant against phishing attempts, use anti-malware and anti-virus solutions, and keep computers/systems updated with security patches. The Ministry of Health supports healthcare providers through funding, and training and educational materials on cyber and data security practices. There are also the Cyber and Data Security Guidelines and Guidebook which help healthcare providers understand and meet the essential security requirements. The Ministry of Health is also exploring ways to work with cyber and data security providers to support healthcare providers in strengthening their security posture. We strongly encourage all healthcare providers to familiarise themselves with essential cyber and data security practices. Raymond Chua (Adjunct Professor) Deputy Director-General of Health (Health Regulation) Ministry of Health
Straits Times
10 hours ago
- Straits Times
What to know about 2 new Alzheimer's disease drugs approved in Singapore
Find out what's new on ST website and app. One factor that could stand in the way of wider acceptance of these drugs is their costliness. SINGAPORE – Tackling Alzheimer's disease in Singapore received a boost earlier in 2025, when the authorities approved two new drugs for the neurodegenerative disease. Although these drugs – lecanemab and donanemab – cannot cure or reverse the effects of Alzheimer's, they have been shown to slow the progression of the disease, which accounts for almost 70 per cent of dementia cases worldwide. Simply Science looks at what these drugs do, how effective they are, as well as the risks and costs. How do they work? The two new drugs are monoclonal antibodies, which are lab-produced proteins that mimic natural antibodies. They work by targeting and removing beta-amyloids – molecules that accumulate in the frontal cortex and hippocampus of the brain – causing Alzheimer's disease. Lecanemab, which is marketed as Leqembi, is developed by pharmaceutical firms Eisai, Biogen and BioArctic. Donanemab, marketed as Lormalzi in Singapore and Kisunla in other countries, is developed by Eli Lilly. Top stories Swipe. Select. Stay informed. Singapore Sewage shaft failure linked to sinkhole; PUB calling safety time-out on similar works islandwide Singapore Tanjong Katong Road sinkhole did not happen overnight: Experts Singapore Workers used nylon rope to rescue driver of car that fell into Tanjong Katong Road sinkhole Asia Singapore-only car washes will get business licences revoked, says Johor govt World Food airdropped into Gaza as Israel opens aid routes Sport Arsenal beat Newcastle in five-goal thriller to bring Singapore Festival of Football to a close Singapore Benchmark barrier: Six of her homeschooled kids had to retake the PSLE Asia S'porean trainee doctor in Melbourne arrested for allegedly filming colleagues in toilets since 2021 Both are intravenous injections – lecanemab is administered every two weeks over about 1½ years, and donanemab is administered every four weeks over the same period. How effective are they? During clinical trials, both drugs demonstrated the ability to slow Alzheimer's disease. Findings from the clinical trial of lecanemab, published in the New England Journal of Medicine, showed that it slowed decline for people with early Alzheimer's disease by about 27 per cent to 37 per cent. Meanwhile, results from donanemab's Phase 3 clinical trial, published in the Journal of the American Medical Association, showed that the drug slowed cognitive decline by about 20 per cent to 29 per cent. Eisai medical director Amitabh Dash said lecanemab differs from existing drugs, which treat symptoms and manage memory or behavioural issues only temporarily. 'It works by clearing these protofibrils and amyloid plaques, which are believed to contribute to the progression of the disease,' said Dr Dash. Protofibrils refer to protein aggregrates such as beta-amyloids. Lecanemab was approved by the US Food and Drug Administration (FDA) in 2023, and by the Medicines and Healthcare products Regulatory Agency in Britain in 2024. Donanemab received FDA approval in 2024, and was also approved in Britain that year. In Singapore, the Health Sciences Authority (HSA) confirmed that the two drugs had been approved for use earlier in 2025. 'They are prescription-only medicines, and the treatment should be initiated by a physician experienced in the diagnosis and treatment of Alzheimer's disease,' HSA told The Straits Times. What are the side effects? For both drugs, the common side effects include infusion-related reactions such as fever, body aches and joint pains. However, the drugs have also been known to cause amyloid-related imaging abnormalities, known as Aria, a condition that can cause brain swelling or bleeding. In many cases, the condition is asymptomatic. But in more severe cases, it can cause seizures, or even death in rare instances. 'MRI monitoring is recommended during treatment to manage this risk safely,' said Dr Dash, referring to magnetic resonance imaging. What has been the response in Singapore to the drugs? Doctors in Singapore who have prescribed lecanemab described their experience as largely positive. Dr Lee Kim En, a neurologist at Mount Elizabeth Hospital, prescribed the drug to 27 patients, who had symptoms such as memory loss affecting their daily lives and difficulty in performing familiar tasks, including handling personal and financial matters. Most patients had shown a favourable response to the treatment, with a slowing in disease progression and preservation of cognition. 'Only one patient experienced mild confusion, disorientation for several hours after his first treatment,' Dr Lee added. He described lecanemab as a 'breakthrough treatment' for patients in the early stages of Alzheimer's disease. 'Without intervention, the time course of deterioration may take four to eight years, requiring full-time care and assistance for all aspects of daily living,' he said. Associate Professor Adeline Ng, a senior consultant at the National Neuroscience Institute's neurology department, had prescribed lecanemab to two women below the age of 65 who were diagnosed with mild Alzheimer's and had gradual mild cognitive decline. While on treatment, they were able to be more engaged with their families and maintain their ability to look after their daily needs, Prof Ng said, noting that neither had side effects. She intends to continue prescribing lecanemab, describing the treatment as 'the start of an era of new drug treatments' that could potentially modify the disease course for patients. Prof Ng stressed that such drugs are effective only in the early stages of Alzheimer's and are not a cure. Rather, they delay progression to the next stage of the disease by about six to eight months. 'The drug is also not suitable for some patients, such as those who have had previous strokes or who take certain blood thinning medication, due to the increased risk of bleeding in the brain,' she added. What are the costs? One factor that could stand in the way of wider acceptance of these drugs is their costliness. In the United States, lecanemab treatment is priced at US$26,500 (S$33,900) per year, while donanemab costs about US$32,000 annually. Britain's National Institute for Health and Care Excellence has declined to recommend both drugs for routine use under the publicly funded National Health Service, due to the high costs of purchasing and administering the drugs, and a lack of evidence on their long-term effects. In Singapore, the prices of the two drugs are not publicly available. However, the Ministry of Health said it is evaluating the clinical efficacy and cost-effectiveness of the two drugs to decide whether to subsidise them in the future. Dr Dash said such drugs represent a paradigm shift in the approach to Alzheimer's, noting that early diagnosis and treatment will become increasingly important due to the ageing populations in Singapore and across the region. 'The availability of Leqembi may drive healthcare systems to adopt biomarker-based diagnosis, improve infrastructure for safe infusion and monitoring, and offer patients more hope for slowing disease progression rather than only managing symptoms,' he said. Simply Science is a series that looks at the science behind everyday questions.
