In response to Channel News Asia’s recent news article (CNA, 12 July 2025), on the troubling rise of “K-Pods” – vapes laced with drugs like etomidate, I was heartened to see the growing much-needed attention to this issue in Singapore.

Etomidate, a potent anesthetic, is indeed a dangerous and emerging substance of abuse. However, I was also dismayed by one comment featured in the article, suggesting that methamphetamine may be more desirable “because you know what you’re getting”.

While perhaps intended to illustrate the unpredictability of new substances, such statements materially misrepresent the danger to public health and law and order of each of these substances – and creates serious unintended consequences for measured, effective and efficacious responses to them in our community.  

This is not a sematic issue. As clinicians working on the frontlines of addiction treatment, we have seen how oversimplified narratives around “drugs” contribute to confusion, stigma and misinformed policies.

Conflation of Psychoactive Substances Harms Public Understanding

CNA’s article echoes a persistent trend in media and public discourse: the conflation of vastly different psychoactive substances – methamphetamine, heroin, ketamine, nicotine, THC, caffeine, and now etomidate, into a single undifferentiated category. While all are psychoactive, they differ drastically in their pharmacology, harm profiles and therapeutic potential.

This conflation risks skewing public understanding and undermining evidence-based responses. It also fuels unhelpful stigma that can deter those in need from seeking much-needed support.

Not All Drugs Are the Same

For example, methamphetamine and heroin have no accepted medical use in Singapore, and are associated with high rates of dependence, psychosis, organ damage and death (UNODC, 2022).

In contrast, other substances discussed in the article do have legitimate medical applications:

• Etomidate is a short-acting anaesthetic used in emergency intubation.

• Ketamine is used in Singapore under strict clinical protocols to treat treatment-resistant depression (Singapore General Hospital).

• Tetrahydrocannabinol (THC), the psychoactive compound in cannabis, has been used under specialist control in limited medical cases such as treatment-resistant epilepsy (National Academies of Sciences, 2017).

• Nicotine itself is not the major cause of smoking-related illness. The harms of smoking largely come from the combustion of tobacco and inhalation of carcinogenic byproducts (World Health Organization, 2019).

Nicotine and NRT: A Case for Public Health

Nicotine Replacement Therapy (NRT), available in Singapore’s pharmacies – mimics the psychoactive effect of smoking, helping smokers gradually taper off their dependence.

NRT products have been endorsed by the World Health Organization for over 45 years, as a central pillar of public health efforts against the global epidemic of cigarettes and inhaling burning tobacco.

Demonising all nicotine products, including harm-reduction tools like NRT or regulated vapes, undermines decades of global public health efforts.

The Real Crisis: Methamphetamine and Heroin

Singapore’s Central Narcotics Bureau (CNB) data paints a stark picture. In 2024 alone:

• Methamphetamine (“meth”) accounted for 61% of all drug-related arrests

• 75% of new drug users arrested used meth

• 90% of youth below the age of 20 drug arrests involved meth use

• 1,931 meth users were arrested – a 20% increase over 2023, and a 33% increase since 2022

In contrast, arrests for heroin and cannabis declined by 14% and 27% respectively (CNB Drug Situation Report 2024).

These figures point to a concentrated crisis. Methamphetamine demands urgent, targeted, and compassionate responses.

Don’t Blame the Device – Focus on the Substance

There has also been growing alarm over vaping devices. But we must be careful not to be mistaken the tool for the problem. Vaporisers, like water pipes or even cigarette papers, are delivery mechanisms. The public health concern lies not in device, but in what is consumed through it.

Banning the device without addressing the root cause of substance misuse distracts from meaningful solutions and creates enforcement challenges without reducing them.

A Call for Science-Based, Compassionate Policy

At Promises Healthcare, we advocate for a public health response to a substance misuse that is science-based, balanced and compassionate. Sweeping generalisations about “drugs” are not helpful. Nor is sensationalism or moral panic. What is needed instead is education, honest dialogue and access to professional, evidence-based care.

Etomidate is a concerning new substance of abuse. It is unpredictable in its addictive potential, and families should be aware of the risks. But we must not let one emerging threat overshadow the far more widespread and entrenched crisis of methamphetamine and heroin use.

We urge a shift toward science-informed, clinically sound, and compassionate public discourse. Here is to what an effective response should look like:

1. Stop conflating vastly different substances. Treat heroin and methamphetamine as the serious threats they are, but distinguish them clearly from substances with legitimate clinical use.
2. Focus on treatment and education. Addiction is a health issue, avoid sensationalism, public awareness is vital, but should be based on fact, not fear. Support should be accessible, stigma-free and professional.
3. Support families and communities. Addiction affects more than just the user. Families deserve clear information, guidance and seek help.

A Better Way Forward

Families affected by substance use need support, not shame. Individuals struggling with addiction need clinical care, not condemnation. And policymakers need clear, differentiated insights – not blanket assumptions to make informed decisions.

Let’s commit to deeper understanding, better education and a public narrative grounded in science, compassion and truth.

If you or someone you know is affected by addiction, please reach out to trained professionals. Recovery is possible, and help is available.

References

• Channel News Asia (CNA), (2024). They look like regular vapes, but drug-laced ‘Kpods’ are more lethal and pernicious. (Source: https://www.channelnewsasia.com/today/big-read/kpods-drugs-vapes-legal-grey-areas-5230556?cid=telegram_cna_social_28112017_cna)

• Central Narcotics Bureau (CNB), (2024) Annual Drug Situation Report 2024. (Source: https://www.cnb.gov.sg/docs/default-source/drug-situation-report-documents/cnb-annual-statistics-2024_final.pdf)

• World Health Organization (WHO). (2019). Tabacco fact sheet. (Source: https://www.who.int/news-room/fact-sheets/detail/tobacco)

• National Academies of Sciences, Engineering, and Medicine. (2017). The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research. National Academies Press. (Source: https://www.nap.edu/read/24625/chapter/1)

• UNODC. (2022). World Drug Report 2022. (Source: https://www.unodc.org/unodc/en/data-and-analysis/world-drug-report-2022.html)