Illegal distribution organization posing as overseas export of etomidate uncovered by prosecutors

The Seoul Central District Prosecutors' Office's specialized investigation team for medical narcotics has arrested a group that disguised the illegal distribution of the general anesthetic etomidate as overseas exports.

On the 21st, the prosecution announced that it had arrested and indicted five individuals, including the representative of pharmaceutical wholesale company A, Mr. Lee (41), on charges of violating the Pharmaceutical Affairs Act, while four others were indicted without detention.

This organization falsely reported that they were exporting etomidate to Thailand, then illegally distributed it domestically. It was revealed that they attempted to evade related regulations by claiming that 'sale' under the Pharmaceutical Affairs Act does not include exports.

However, the prosecution began an investigation after suspecting the unusually light weight of parcels sent to Thailand. They subsequently secured testimony from the local recipient in Thailand, who stated, "I have not received etomidate; I only ordered functional cosmetics," which uncovered the methods of the illegal distribution organization.

The modus operandi of the illegal distribution organization was revealed.

Establishment of an organized sales network targeting etomidate addicts

According to the prosecution, the top supplier, Mr. Lee, is accused of selling 35,000 mL of etomidate for 100 million won to a former employee of Company A, Mr. Choi (38), between May and August of last year.

The etomidate that was distributed in this way was delivered to addicts through sales and administering agents.

They opened a fake dermatology clinic called "Skin Clinic" in Gangnam, Seoul, and from May of last year to January of this year, they sold and administered etomidate worth approximately 1.068 billion won over about 600 transactions within eight months.

Roles were divided within the organization, including clinic operators, financial managers, nurses, and proxy presidents, with Mr. Yang (39), who has experience as a plastic surgery consultation room manager, introducing addicts, thus establishing a systematic crime structure.

In particular, when a 112 report was received stating that addicts were seen at the hospital, they continued sales by avoiding detection through direct visits to their homes or the homes of the addicts.

The prosecution revealed that the amount paid by addicts in a single day reached up to 15.8 million won (for 79 doses).

Seriousness of the illegal distribution of etomidate and response measures

The cost of one 10 mL ampule of etomidate is only 4,200 won, but it was sold to mid-level suppliers for an average of 28,000 won and to sellers for an average of 52,000 won.

The sellers then sold it to addicts for an average of 200,000 won, generating profits up to 47 times the original cost.

Etomidate is a general anesthetic that induces loss of consciousness and has effects similar to propofol, but it is not classified as a narcotic, leading to a growing trend of misuse.

Even when illegal distribution is discovered, only the Pharmaceutical Affairs Act applies, resulting in low penalties, and there are no penal provisions for those who use the drug.

Recognizing these issues, the Ministry of Food and Drug Safety designated etomidate as a drug with potential for misuse in October 2020. In February, a legislative notice was issued for an amendment to the Narcotic Control Act to designate it as a narcotic, which is currently under review by the National Assembly.

The prosecution has proposed strengthening monitoring and supervision measures, including improvements to the monitoring of exported pharmaceuticals by the Health Insurance Review & Assessment Service, until etomidate is officially designated as a narcotic to prevent illegal distribution. They also stated, "We will do our best to ensure that the public can live safely from criminal organizations that create drug addicts solely for economic gain."

Image source: Provided by the Seoul Central District Prosecutors' Office, etomidate illegal distribution structure / Provided by the Seoul Central District Prosecutors' Office