How Zombie Juice Became Japan's Latest Drug Threat

The abuse of the unapproved sedative etomidate is spreading in Okinawa Prefecture, prompting police crackdowns. A dangerous substance and classified as such, the drug is typically consumed by inhaling e-liquids through electronic cigarettes. Users often experience violent convulsions in their arms and legs, earning it the nickname "zombie juice."

Arrests have already included high school students. As the United States grapples with a fentanyl crisis, Japan is confronting its own growing threat of drug misuse.

From Sedative to Street Drug

Overseas, doctors widely use etomidate for general anesthesia and endoscopic procedures, but Japan does not authorize its manufacture or sale. While it suppresses central nervous system activity, it also carries severe risks, including disorientation, numbness in the limbs, and adrenal dysfunction.

According to the Ministry of Health, Labour and Welfare (MHLW) and investigative authorities, etomidate abuse has spread across Asia over the past year and is now taking root in Okinawa. Reports suggest dealers are marketing the drug under names such as "laughing gas."

*An e-cigarette cartridge containing the designated drug etomidate (provided by Okinawa Prefectural Police).*

Since May 2025, Okinawa police have arrested seven people between their teens and 30s for possession of the drug. Most users are believed to be in their teens and twenties among those detained.

Investigations have found that sales are often solicited on platforms like X and completed through encrypted messaging apps.

Difficult to Detect, Hard to Contain

One of the most troubling aspects is that using etomidate looks no different from ordinary vaping, making violations hard to detect and dulling users' sense of guilt.

In May 2025, the MHLW classified etomidate as a "Designated Substance" under the Act on Pharmaceuticals and Medical Devices. The MHLW's Kyushu Regional Bureau, together with prefectural authorities, police, and customs officials, issued a joint warning urging the public to "neither buy, use, nor get involved."

Okinawa police's Organized Crime Countermeasures Division also pledged to coordinate with other agencies in cracking down on social media activity related to the drug.

Ryoji Takahama, former head of the Narcotics Control Department at the Kinki Regional Bureau, warned that Okinawa's geographic location makes it especially vulnerable.

"Etomidate spread in places like Hong Kong, Singapore, and Taiwan, and appears to have flowed into Okinawa because of that proximity," he said. "Its impact on other prefectures is still limited for now, but further expansion cannot be ruled out."

A Wider Net Needed

The distribution routes for etomidate in Japan remain murky, with most arrests in Okinawa arising by chance, through traffic stops, or unrelated drug investigations. Unlike the past, when illegal drugs were largely the domain of organized crime groups, today even amateurs can buy and sell through social media. This makes enforcement far more difficult.

Complicating matters further, drugs like etomidate and cannabis liquids leave no visible traces such as injection marks, rendering abusers outwardly indistinguishable from ordinary smokers. Careful, sustained investigation is critical.

Curbing the spread will also require the cooperation of ordinary citizens. Reporting unusual behavior to police can help identify cases early, while authorities outside Okinawa must not dismiss the problem as remote. A wider net of information-sharing and vigilance is essential.

(Read the article in Japanese.)

Author: Yusaku Uchida, The Sankei Shimbun

Okinawa, zombie juice, fentanyl, drugs,