...Butt Stuff being rectal route of administration.
It could benefit someone to know the fruits of my research into Sodium Pentobarbital (barbiturate) and specifically getting it up from the other end. This post can also inform those considering the rectal route for other end-of-life substances. There are reasons for preferring a rectal over the oral route.
Where
Sodium pentobarbital is available for veterinary use in various cities of Peru, and allegedly in Mexico. The product in Peru, Halatal, comes in a sterile form, in 50ml bottles where each bottle contains 3.25g Sodium Pentobarbital intended for lethal injection. Some vet stores ask for a prescription, but many others are happy to sell several bottles without further questions. It seems they are currently not restocking them for the time being, but the situation may change. Either way, bottles have been available in February/March 2024. Their cost is 42-46 soles each. Powdered Nembutal appears in online markets, but it's not what I personally opted for. Bear in mind that in general, it is illegal to import Nembutal.
Dose
The amount for euthanasia recommended by Peaceful Pill Handbook (PPhB) is 2-10g. Some institutions practicing euthanasia rely on up to 15g per person. This is the highest amount used for euthanasia that I've come across online. Articles for humane animal euthanasia (sources: a, b) have actually been the most helpful because their recommendations are based on body mass. The consensus within that area for a peaceful death of an animal of any size is 0.086g/kg. It's likely that the upper range (8-15g) is most commonly used for heavier individuals, so calculating a required amount makes more sense if it's done by body mass. PPhB further states that in the vast majority of cases 6g is enough to lead to a peaceful death within 1-2 hours. If you are taking potentiating substances like alcohol or opioids, which increase the effectiveness of barbiturates, the lethal dose threshold is even lower.
Bio-availability
PPhB's recommendation for a lethal Pentobarbital dose doesn't specify the method of administration, but most people seem to prefer to take the drug orally. However, drugs received rectally tend to be absorbed better than those taken orally (c). They partially bypass the liver and so do not get eliminated to the same extent. According to Wikipedia oral bio-availability of Sodium Pentobarbital is 70-90%, and rectal 90%. Another source I found also seems to agree that a barbiturate (they used phenobarbital) mean relative rectal bio-availability was 90 percent (d). The animal euthanasia manual's recommendations assume that the method of administration is intravenous, which could be seen as 100% bio-available. Based on this it should be possible to calculate a pretty precise dose taking into account a person's body mass and the assumed 90% rectal absorption rate. It's worth rounding up to reduce the tiny risk that the amount may not, for some reason, be enough.
So for a 56kg healthy female taking Nembutal rectally (assuming 90% bio-availability), 5.34g is very likely to be lethal. 100mL of Halatal contains this amount. Combined with alcohol this should be pretty reliable.
Rectal infusion and anti-emetics
The benefit of taking Nembutal rectally, besides the increased bio-availability among other reasons, is not needing to worry about expelling the drug via emesis (vomiting). Nembutal is very bitter-tasting. If taken orally in amounts needed to achieve death, vomiting is possible. Taking an anti-emetic in these circumstances is not only recommended, it is essential. Considering that the pharmaceutical anti-emetics recommended by PPHB are not vegan, and have unpleasant side effects, some individuals would prefer an alternative option. Pepto-Bismol is vegan, but it is not in its primary function an anti-emetic. Ginger has been studied extensively, and it has been found to work better than placebo, as an anti-emetic and anti-nausea "drug". It has been found to be a good alternative to pharmaceuticals such as matoclopramide (e) – a drug recommended by PPhB. Whether ginger would be sufficiently strong to work with Nembutal is a matter of speculation. Having said that, even with only rectal infusion, it might be a good idea to take ginger just for the sake of reducing any accidental expulsion of the rectal content due to vomiting contractions, even if the stomach is empty.
Rectal retention of solutions
Based on ACAMAiD, a solution of 100mL is usually well-tolerated. Anything above 250mL and a person might have an urge to void their bowels (f). Solution volumes under 60-80mL are the "safest" and should be easily retained (g, h). I would recommend getting a large enough syringe to accommodate whatever dose you would calculate you need, and practising to retain water of that amount or slightly more. I have personally been able to retain 110mL easily once the initial discomfort goes away (a few minutes). I haven't tried to hold a larger volume. Make sure you lie on your left side (a) to allow the infusion to flow deeper into the colon and so reduce the risk of losing any liquids unintentionally.
Tools and Process
Here's what I have obtained and found to be necessary:
- 100ml (allowing slightly more) industrial syringe with insertion parts sold for animal feeding and plant care purposes (I only mention industrial syringe because I haven't been able to find a medical one that would be large enough)
- enema kit used to clear the bowels of feces to increase absorption of the drug (ACAMAiD recommends 4 hours between doing an enema and taking lethal drugs rectally)
- optional but recommended ginger (even having substances up your butt, such as heroin, can induce some nausea, so it could be that sodium pentobarbital is no different)
- alcohol (see barnivore.com for vegan brands, mostly for English-speaking countries)
- lube for bum hole (e.g. coconut oil)
One way to go about this process would be in this order:
0. fasting is a good idea, about 8 hours before taking the drug via bum (ACAMAiD)
1. enema 4 hours before drug
2. ginger juice shot (with a little grape or apple juice) 1-2 hours before (B6 vitamin also helps with nausea so you could take it with the ginger)
3. alcohol taken orally 30 minutes before
4. drug infusion
Sleep would follow within minutes, death normally occurs within 1 or 2 hours through CNS depression (stopping to breathe).
A friend of mine will have access to my account on here and might come to tell the story after my departure…
Sources:
(a) https://humanepro.org/sites/default/files/documents/euthanasia-reference-manual.pdf
(b) https://www.cliniciansbrief.com/article/euthanasia-protocols
(c) https://cdn.ps.emap.com/wp-content/...rug-administration-in-adults-how-when-why.pdf
(d) https://journals.sagepub.com/doi/abs/10.1177/1060028089023007-806
(e) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073360/
(f) https://link.springer.com/content/pdf/10.1007/s40138-023-00258-3.pdf
(g) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6805701/
(h): https://enclarapharmacia.com/palliative-pearls/approach-to-rectal-administration-a-refresher
It could benefit someone to know the fruits of my research into Sodium Pentobarbital (barbiturate) and specifically getting it up from the other end. This post can also inform those considering the rectal route for other end-of-life substances. There are reasons for preferring a rectal over the oral route.
Where
Sodium pentobarbital is available for veterinary use in various cities of Peru, and allegedly in Mexico. The product in Peru, Halatal, comes in a sterile form, in 50ml bottles where each bottle contains 3.25g Sodium Pentobarbital intended for lethal injection. Some vet stores ask for a prescription, but many others are happy to sell several bottles without further questions. It seems they are currently not restocking them for the time being, but the situation may change. Either way, bottles have been available in February/March 2024. Their cost is 42-46 soles each. Powdered Nembutal appears in online markets, but it's not what I personally opted for. Bear in mind that in general, it is illegal to import Nembutal.
Dose
The amount for euthanasia recommended by Peaceful Pill Handbook (PPhB) is 2-10g. Some institutions practicing euthanasia rely on up to 15g per person. This is the highest amount used for euthanasia that I've come across online. Articles for humane animal euthanasia (sources: a, b) have actually been the most helpful because their recommendations are based on body mass. The consensus within that area for a peaceful death of an animal of any size is 0.086g/kg. It's likely that the upper range (8-15g) is most commonly used for heavier individuals, so calculating a required amount makes more sense if it's done by body mass. PPhB further states that in the vast majority of cases 6g is enough to lead to a peaceful death within 1-2 hours. If you are taking potentiating substances like alcohol or opioids, which increase the effectiveness of barbiturates, the lethal dose threshold is even lower.
Bio-availability
PPhB's recommendation for a lethal Pentobarbital dose doesn't specify the method of administration, but most people seem to prefer to take the drug orally. However, drugs received rectally tend to be absorbed better than those taken orally (c). They partially bypass the liver and so do not get eliminated to the same extent. According to Wikipedia oral bio-availability of Sodium Pentobarbital is 70-90%, and rectal 90%. Another source I found also seems to agree that a barbiturate (they used phenobarbital) mean relative rectal bio-availability was 90 percent (d). The animal euthanasia manual's recommendations assume that the method of administration is intravenous, which could be seen as 100% bio-available. Based on this it should be possible to calculate a pretty precise dose taking into account a person's body mass and the assumed 90% rectal absorption rate. It's worth rounding up to reduce the tiny risk that the amount may not, for some reason, be enough.
So for a 56kg healthy female taking Nembutal rectally (assuming 90% bio-availability), 5.34g is very likely to be lethal. 100mL of Halatal contains this amount. Combined with alcohol this should be pretty reliable.
Rectal infusion and anti-emetics
The benefit of taking Nembutal rectally, besides the increased bio-availability among other reasons, is not needing to worry about expelling the drug via emesis (vomiting). Nembutal is very bitter-tasting. If taken orally in amounts needed to achieve death, vomiting is possible. Taking an anti-emetic in these circumstances is not only recommended, it is essential. Considering that the pharmaceutical anti-emetics recommended by PPHB are not vegan, and have unpleasant side effects, some individuals would prefer an alternative option. Pepto-Bismol is vegan, but it is not in its primary function an anti-emetic. Ginger has been studied extensively, and it has been found to work better than placebo, as an anti-emetic and anti-nausea "drug". It has been found to be a good alternative to pharmaceuticals such as matoclopramide (e) – a drug recommended by PPhB. Whether ginger would be sufficiently strong to work with Nembutal is a matter of speculation. Having said that, even with only rectal infusion, it might be a good idea to take ginger just for the sake of reducing any accidental expulsion of the rectal content due to vomiting contractions, even if the stomach is empty.
Rectal retention of solutions
Based on ACAMAiD, a solution of 100mL is usually well-tolerated. Anything above 250mL and a person might have an urge to void their bowels (f). Solution volumes under 60-80mL are the "safest" and should be easily retained (g, h). I would recommend getting a large enough syringe to accommodate whatever dose you would calculate you need, and practising to retain water of that amount or slightly more. I have personally been able to retain 110mL easily once the initial discomfort goes away (a few minutes). I haven't tried to hold a larger volume. Make sure you lie on your left side (a) to allow the infusion to flow deeper into the colon and so reduce the risk of losing any liquids unintentionally.
Tools and Process
Here's what I have obtained and found to be necessary:
- 100ml (allowing slightly more) industrial syringe with insertion parts sold for animal feeding and plant care purposes (I only mention industrial syringe because I haven't been able to find a medical one that would be large enough)
- enema kit used to clear the bowels of feces to increase absorption of the drug (ACAMAiD recommends 4 hours between doing an enema and taking lethal drugs rectally)
- optional but recommended ginger (even having substances up your butt, such as heroin, can induce some nausea, so it could be that sodium pentobarbital is no different)
- alcohol (see barnivore.com for vegan brands, mostly for English-speaking countries)
- lube for bum hole (e.g. coconut oil)
One way to go about this process would be in this order:
0. fasting is a good idea, about 8 hours before taking the drug via bum (ACAMAiD)
1. enema 4 hours before drug
2. ginger juice shot (with a little grape or apple juice) 1-2 hours before (B6 vitamin also helps with nausea so you could take it with the ginger)
3. alcohol taken orally 30 minutes before
4. drug infusion
Sleep would follow within minutes, death normally occurs within 1 or 2 hours through CNS depression (stopping to breathe).
A friend of mine will have access to my account on here and might come to tell the story after my departure…
Sources:
(a) https://humanepro.org/sites/default/files/documents/euthanasia-reference-manual.pdf
(b) https://www.cliniciansbrief.com/article/euthanasia-protocols
(c) https://cdn.ps.emap.com/wp-content/...rug-administration-in-adults-how-when-why.pdf
(d) https://journals.sagepub.com/doi/abs/10.1177/1060028089023007-806
(e) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073360/
(f) https://link.springer.com/content/pdf/10.1007/s40138-023-00258-3.pdf
(g) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6805701/
(h): https://enclarapharmacia.com/palliative-pearls/approach-to-rectal-administration-a-refresher
