While propofol appears to be on the wane for use in executions by lethal injection, midazolam is on the upswing. Florida will use the drug as part of its three-drug execution protocol on November 12 (assuming a court hearing on the 6th doesn’t delay things), and Ohio will follow suit on November 14.
The Buckeye state is turning to a combination of midazolam and hydromorphone, due to a lack of pentobarbital. The two-drug combination is Ohio’s designated backup protocol in the event of a shortage of pentobarbital. The November 14 execution would be the first using that combination of drugs.
As usual, the concern over a new execution drug is about how effective the new sedative – midazolam – will be in sedating the prisoner. As this requires a deeper sedation than the typical use for the drug, it has not been clinically tested. There is speculation that midazolam is not as effective, based on the observations of a reporter who witnessed the latest Florida execution. He felt that it took longer for the inmate to lose consciousness compared to an execution involving pentobarbital. His execution did take twice as long as other executions, but the drugs may be only one possible explanation. One observation does not a scientific conclusion make, but the circumstances of executions make it difficult to conduct a meaningful experiment (and certainly not a large sample size).
For what it’s worth, not all recent lethal injections have received scrutiny for the drugs used. Arizona’s latest execution was appealed for traditional reasons connected to the handling of the case. It was carried out last week.
While shortages will continue, the increasing reliance of states on compounding pharmacies (which are not tightly regulated) to develop the drugs they need is likely a second front in stopping executions. It won’t stop states from innovating ways around these barriers, at least not for a while.
Pasco Phronesis 