AccScience Publishing / HPR / Online First / DOI: 10.36922/HPR026320198
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RESEARCH ARTICLE

Psychosocial pathways of etomidate misuse among Chinese youth in drug rehabilitation institutions

Lan Wang1† ,  Zhuo Chen2† ,  Chengzhi Zheng2 ,  Ao Li2 ,  Yanping Bao3 ,  Bo Yang4 ,  Yan-Xue Xue3 ,  Cunfeng Yuan5* ,  Shaobo Lv2*
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1 Department of Criminal Justice, School of Criminal Justice, China University of Political Science and Law, Beijing , China
2 Hebei Key Laboratory of Mental Health and Brain Science, School of Psychology and Mental Health, North China University of Science and Technology, Tangshan, Hebei , China
3 National Institute on Drug Dependence and Beijing Key Laboratory of Innovative Intervention Techniques and Translational Research for Mental Disorders Rehabilitation, Peking University, Beijing , China
4 Department of Applied Psychology, School of Sociology, China University of Political Science and Law, Beijing , China
5 Drug Rehabilitation Administration of the Ministry of Justice, Beijing , China
†These authors contributed equally to this work.
HPR, 026320198 https://doi.org/10.36922/HPR026320198
Received: 8 August 2026 | Revised: 20 September 2026 | Accepted: 22 September 2026 | Published online: 26 October 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Background: Etomidate, an ultra-short-acting gamma-aminobutyric acid type A anesthetic, has been widely misused across East and Southeast Asia. By 2024, it became the most frequently misused anesthetic or psychotropic substance in China, with 86.4% of users younger than 35.

Objective: This study explored how young people recruited from Chinese drug rehabilitation institutions initiated and sustained etomidate vaping, attempted to stop, and understood the psychosocial factors associated with continued use and return to use.

Methods: Semi-structured interviews were conducted with 103 participants (aged 15–35) with a history of etomidate misuse, recruited from drug rehabilitation institutions. Transcripts were analyzed using codebook-oriented thematic analysis.

Results: Five themes concerned uninformed initiation, motivational pathways, device-related habituation, harms, and cessation attempts followed by returning to use. Nearly half were initially unaware that the product contained etomidate. A rapid, short-lived effect was described as promoting repeated inhalation, and negative emotion regulation was the most common motive for continued use. Device portability and concealability were associated with use across settings and everyday urges. Commonly self-reported harms included cognitive and motor difficulties, emotional changes, and hazardous driving. Cessation strategies included distraction, avoiding other users, and changing environments; however, online peer contact and drug-related digital content were described as re-evoking urges and contributing to return to use.

Conclusion: Among young users in drug rehabilitation institutions in China, self-reported etomidate vaping experiences were characterized by limited risk awareness, emotion-regulation motives, device affordances, and digital social exposure. These findings suggested the potential value of emotion-regulation-focused interventions and platform-level governance.

Keywords
Etomidate
Electronic cigarette
Thematic analysis
New psychoactive substance
Emotion regulation
Funding
None.
Conflict of interest
Yanping Bao Sing is the Editor-in-Chief of this journal, but was not in any way involved in the editorial and peer-review process conducted for this paper, directly or indirectly. Separately, other authors declared that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper.
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