The Federal Register pre-publication notice published today (here) lists Etomidate as a product with possible abuse potential that will be reviewed for scheduling under the Controlled Substances Act. It is a short-acting anesthetic and mentioned often on TV medical shows when a patient is brought into the ER either unresponsive or in need of immediate sedation.
As noted in the FR notice cited above, “Etomidate has an established medical use profile and is used in clinical settings including emergency medicine and procedural sedation”. However, “[d]espite its recognized medical utility, increasing concerns have emerged regarding its non-medical use, particularly across East and Southeast Asia and Oceania”. The United Nations Office of Drugs and Crime (UNODC) “issued an alert in March 2025 regarding the growing detection of etomidate and its analogues in illicit drug markets…
“The United States is a party to the 1971 Convention on Psychotropic Substances (Psychotropic Convention). Article 2 of the Psychotropic Convention provides that if a party to the convention has information about a substance, which, in its opinion, may require international control or change in such control, it shall so notify the Secretary-General of the United Nations (U.N. Secretary-General) and provide the U.N. Secretary-General with information in support of its opinion.”
The FR notice goes on to say that “[t]he Food and Drug Administration (FDA or Agency) is providing interested persons with the opportunity to submit comments concerning abuse potential, actual abuse, medical usefulness, trafficking, and impact of scheduling changes on availability for medical use of eight drug substances”. The comments received in response to the FR Notice “will be considered in preparing a response from the United States to the Expert Committee on Drug Dependence (ECDD) regarding the abuse liability and diversion of these drugs. The ECDD will use this information to consider whether to recommend that certain international restrictions be placed on these drug substances.” The ECDD will be meeting in Geneva, Switzerland on October 19-22, 2026. The FR notice also lists certain other previously unapproved analogs of various opioids and benzodiazepines of concern.
Other countries have issued warnings regarding the abuse potential of these drugs or have taken action to use appropriate measures to “schedule” the drug in their respective countries. We will have to wait and see what the ECDD says regarding international restrictions on access to this widely used anesthetic. We will keep you posted!
