Death Drug on the Death Row

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In the lethal injections used to execute prisoners on the death row, one of the major components is an important anesthetic drug called sodium thiopental.

Under a three drug protocol, sodium thiopental is used to anaesthetise the prisoner, then pancuronium bromide paralyses him, before potassium chloride is administered to cause a fatal heart attack. (1)

Hospira was one of the few pharma houses still producing the drug in the US, but they have now decided to close shop owing unspecified problems with the raw materials pipeline. They have been planning to shift their production base to Italy, but, they could do so only under the condition that the drug would not be used for capital punishments and would only serve as an anesthetic agent. Now understandably, that is a difficult situation to monitor, and the risks of facing liability charges on the count of misuse of their product for capital punishment is significant.

This might also be a reason to stop the production and export of sodium thiopental to the US.

Now if you have read this far and are condemning me for being pro-execution, please stop. I am not. I am more worried about the fact that with none but small, local (and often, unregulated) producers becoming the key providers of this drug, its use in the anesthetic field will suffer. Agreed, there are several alternatives to this drug, and newer and faster drugs are emanating from the pharmalands every year. But this was a particularly safe and efficient drug.

I am wondering whether this campaign against the death row, by banning the agent of death rather than trying to break the principle of the law, is the best way to go. Would there be any casualties of this missing drug? In my opinion, even if a single life is lost due to non availability of sodium thiopental, it is going to reverse all the good work done in saving the lives of the death row prisoners.

Surely, I cannot be the only one to realize that stopping the pipeline of sodium thiopental is not going to stop death sentences. All it might do is precipitate some unanticipated anesthetic emergencies. This appears to be largely, a symptomatic therapy to cure the ailment of capital punishment, and sometimes, when aggressive management of the underlying disease is the need of the hour, symptomatic treatment is just not the way to go!

2009-10-02-trial-medication

Reference:

1. Dyer C. Last US manufacturer of drug used in executions stops production. BMJ 2011; 2011; 342:d590 doi: 10.1136/bmj.d590 (Published 27 January 2011)

Skeptic Oslerphile, Scientist at the Indian Council of Medical Research, National Institute of Cholera and Enteric Diseases. Interests include: Emerging Infections, Public Health, Antimicrobial Resistance, One Health and Zoonoses, Diarrheal Diseases, Medical Education, Medical History, Open Access, Healthcare Social Media and Health2.0. Opinions are my own!

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