Understanding controversial lethal injection drug Midazolam


A prison official says the death-row inmate whose life was spared pending a legal battle over the drugs to be used for his lethal injection just hours away has been placed on suicide watch as a precaution. Nevada Department of Corrections spokeswoman Brooke Santina characterized the decision Wednesday to monitor Scott Raymond Dozier as prison policy in cases when an execution is postponed. Santina says it was not because of any outburst or overt act.

The sedative at the center of the execution and lawsuit has been previously used in other executions out of state, including some that have been botched.  But, Dozier’s execution could set a precedent because it appears to be the first time a drug company is suing a state for attempting to use their product in an execution, although the sedative Midazolam has been used more than 30 other times to carry out a death sentence.

Midazolam is one of three drugs that make up the cocktail in the execution plan for Dozier.  It’s the first time any state is using this combination of drugs and the first time Nevada is using the sedative Midazolam.

“The sedative that had traditionally been used, Sodium Thiopental, was taken out the market, and since then states have been looking for other drugs and many of them settled on a drug called Midazolam,” said Robert Dunham, executive director at the Death Penalty Information Center. 

Dunham says the organization doesn’t take a position on capital punishment but they are critical of the way in which its administered.

“Midazolam is supposed to render the prisoner unconscious and keep them unconscious while the paralytic agent and the killing drug do their work,” Dunham said.

Out of the 30-plus executions where Midazolam is believed to have been used, Dunham says at least four have been botched including in Ohio, Oklahoma, Alabama, and Arizona.

“The problem was that the prisoners were being jolted back into consciousness or because of their particular medical situations weren’t rendered unconscious,” said Dunham.

It’s unclear if the drug was solely to blame for the botched executions, but in the Arizona case, the state decided to stop using Midazolam after a 2014 execution.

“The example in Arizona was that Joseph Wood was observed gasping and described as flopping about like a fish for almost two hours,” Dunham said. 

He says Arkansas and Virginia have also had complications using the sedative in combination with other drugs.

The controversial use of Midazolam made it all the way up to the U.S. Supreme Court.  A 2015 ruling allowed states to continue using the sedative in lethal injections, saying it was not a constitutional violation of cruel and unusual punishment.

Nevada has had issues buying the drugs for Dozier’s execution. In fact, the state will be the first to use the opioid Fentanyl and the paralytic Cisatracurium. 

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