The ‘K-Podemic’: a narrative review on drug-laced vaping for frontline clinicians

Over the last decade, the use of e-cigarettes (colloquially known as 'vaping') has risen sharply worldwide. Although e-cigarettes were initially promoted in some countries as a tool for nicotine replacement and restricted in others due to concerns about potential misuse, there is now growing concern over drug-laced e-cigarettes containing illicit substances such as etomidate, ketamine, heroin and methamphetamine, which pose serious public health risks. In Singapore, there has been a rise in the consumption of drug-laced e-cigarettes (also referred to as 'Kpods', 'zombie vapes' or 'space oil'), predominantly affecting young people in the community. In this review, we sought to provide practical guidance for frontline clinicians in the identification and management of suspected cases of drug-laced e-cigarette use and its associated medical complications. We also highlight the current preventative and mitigating strategies adopted by the government to address this public health epidemic.