Mitigate N vomit risk

[greyhound]

I'm starting to get a bit concerned with the risk of vomiting up N.

From the PPH: "Note - If, after using your chosen anti-emetic, vomiting does 'occur, even if only a small amount, the plan to die must be
abandoned. This is because it is impossible to know what quantity of drug remains in your stomach. Because of this it would be dangerous to proceed. It is advised to move quickly and initiate further vomiting. Place your fingers down the throat to physically induce vomiting It is critical to remove as much of the ingested lethal drug as
possible. Follow this procedure by drinking a large amount of Water. Try to rest until the fraction of the lethal drug ingested has been processed. When things calm, select an alternative suitable date in the future".

These instructions seem a bit ridiculous to me especially as it seems people generally pass out within several minutes of ingesting N. I am trying to think of the best way to mitigate this risk.

I realize that the actual likelihood of vomiting is much less than SN. Apparently in many people it works without even taking an anti-emetic. But the advantage of N (losing consciousness quickly) actually becomes a liability in case you vomit and don't have enough time to call someone or anything. I do not want to risk respiratory depression without actually dying.

Qs:

- Does anyone know if the vomiting will primarily occur while conscious prior to passing out?

- What is the true LD50 of pentobarbital? Euthanasia guidelines for small animals target 100 mg / kg. So that would mean 1 bottle of 6.5 g would be enough for a smallish person. But the data suggests practically everyone dies from 1 bottle so the true LD50 must be much lower.

Ideas:

- Use drip IV setup instead of ingesting. Seems complicated, unsure of how long it would take to drip in 200ml and the risk of IV coming out is not clear.

- Drink only 1 bottle and keep one waiting in case of vomit, like people do with SN.

- Drink 1 bottle and 'boof' the other bottle rectally with some kind of syringe. I know euthanasia doctors never administer the drugs rectally but they are mainly concerned with death with dignity of which this certainly diminishes. But the pento wiki page lists 90% bioavailability rectally so I'm sure it would work.

- Have a 'hot-shot' syringe loaded with a heavy opiate dose. Taking opiates prior to N seems inadvisable due to the potential nausea, but in the event vomiting up N could jab this in to a big muscle and do an IM shot before passing out.

If anyone has any other ideas they would certainly be appreciated.

 

[boc]

I think you're over thinking things. Take the anti emetics and having a safety bottle sounds like plenty of insurance to me.

 

[greyhound]

I think you're over thinking things. Take the anti emetics and having a safety bottle sounds like plenty of insurance to me.

So you think it's worth drinking only 1 and saving 1?

 

[boc]

So you think it's worth drinking only 1 and saving 1?

I'm no doctor. But I would say it depends on your weight. The great news is that there are still sellers available for N. Even if you took 2, and you threw up and it didn't work, you could buy more. I know it would suck, but the likelihood is pretty low.

 

[Thegoldenapples]

So you think it's worth drinking only 1 and saving 1?

Vomiting is extremely rare. Think rain and sadness did a post on it a while ago. Another user mentioned her nausea when she was doing Ketamime trials and once she took meto the nausea left so meto seems very effective and she only took 10mg. I think its best to take both bottles. If you don't know the exact mg of N in your bottles, could just be under what is required. There's been test results of 80% which causes the need for 2 bottles to be safe.

I also think it's best to sit up on the bed to allow N to go through your system and not lie down flat. Exit did a video about vomiting a while back and it was targeted at those who can't keep food down and on lots of meds for nausea. Think that's when it's more of a concern.

 

[greyhound]

Vomiting is extremely rare. Think rain and sadness did a post on it a while ago. Another user mentioned her nausea when she was doing Ketamime trials and once she took meto the nausea left so meto seems very effective and she only took 10mg. I think its best to take both bottles. If you don't know the exact mg of N in your bottles, could just be under what is required. There's been test results of 80% which causes the need for 2 bottles to be safe.

I also think it's best to sit up on the bed to allow N to go through your system and not lie down flat. Exit did a video about vomiting a while back and it was targeted at those who can't keep food down and on lots of meds for nausea. Think that's when it's more of a concern.

Thanks yeah it does sound like a rare event. I just want to be prepared in the case it happens. Just having some sort of a backup plan I think would go a long way to reducing my anxiety surrounding the whole process which I am trying to do. The PPH instructions to try to abort the attempt and puke up the rest of it doesn't sound like a great idea to me.

I did find the human LDLO, which is the least amount known to kill:

Pentobarbital - Toxicity Data: Oral LDLO (Human): 36 mg/kg;

So for most people that is significantly less than the 6.5 g and would explain 1 bottle seems to almost always work.

https://www.caymanchem.com/msdss/20965m.pdf

 

[Thegoldenapples]

Thanks yeah it does sound like a rare event. I just want to be prepared in the case it happens. Just having some sort of a backup plan I think would go a long way to reducing my anxiety surrounding the whole process which I am trying to do. The PPH instructions to try to abort the attempt and puke up the rest of it doesn't sound like a great idea to me.

I did find the human LDLO, which is the least amount known to kill:

Pentobarbital - Toxicity Data: Oral LDLO (Human): 36 mg/kg;

So for most people that is significantly less than the 6.5 g and would explain 1 bottle seems to almost always work.

https://www.caymanchem.com/msdss/20965m.pdf

Yeah I get concerned about vomiting as well. I think that's natural when you don't want it to fail. Interesting we need less. More must just quicken the process. Following the regime is important and a small meal apparently reduces the need to vomit. If you're in the states and can get SN easy, I'd get that as a back up in case.

This is the regime if you haven't seen it https://sanctioned-suicide.net/threads/n-protocol-regime-regimen-notes.27092/

 

[greyhound]

Yeah I get concerned about vomiting as well. I think that's natural when you don't want it to fail. Interesting we need less. More must just quicken the process. Following the regime is important and a small meal apparently reduces the need to vomit. If you're in the states and can get SN easy, I'd get that as a back up in case.

This is the regime if you haven't seen it https://sanctioned-suicide.net/threads/n-protocol-regime-regimen-notes.27092/

Yeah that's not a bad idea, mix up some SN as a backup and drink it in the event you puke up the N. Would probably still pass out from whatever N is absorbed so would still get the benefits of loss of consciousness.

 

[whitefeather]

I'm starting to get a bit concerned with the risk of vomiting up N.

From the PPH: "Note - If, after using your chosen anti-emetic, vomiting does 'occur, even if only a small amount, the plan to die must be
abandoned. This is because it is impossible to know what quantity of drug remains in your stomach. Because of this it would be dangerous to proceed. It is advised to move quickly and initiate further vomiting. Place your fingers down the throat to physically induce vomiting It is critical to remove as much of the ingested lethal drug as
possible. Follow this procedure by drinking a large amount of Water. Try to rest until the fraction of the lethal drug ingested has been processed. When things calm, select an alternative suitable date in the future".

These instructions seem a bit ridiculous to me especially as it seems people generally pass out within several minutes of ingesting N. I am trying to think of the best way to mitigate this risk.

I realize that the actual likelihood of vomiting is much less than SN. Apparently in many people it works without even taking an anti-emetic. But the advantage of N (losing consciousness quickly) actually becomes a liability in case you vomit and don't have enough time to call someone or anything. I do not want to risk respiratory depression without actually dying.

Qs:

- Does anyone know if the vomiting will primarily occur while conscious prior to passing out?

- What is the true LD50 of pentobarbital? Euthanasia guidelines for small animals target 100 mg / kg. So that would mean 1 bottle of 6.5 g would be enough for a smallish person. But the data suggests practically everyone dies from 1 bottle so the true LD50 must be much lower.

Ideas:

- Use drip IV setup instead of ingesting. Seems complicated, unsure of how long it would take to drip in 200ml and the risk of IV coming out is not clear.

- Drink only 1 bottle and keep one waiting in case of vomit, like people do with SN.

- Drink 1 bottle and 'boof' the other bottle rectally with some kind of syringe. I know euthanasia doctors never administer the drugs rectally but they are mainly concerned with death with dignity of which this certainly diminishes. But the pento wiki page lists 90% bioavailability rectally so I'm sure it would work.

- Have a 'hot-shot' syringe loaded with a heavy opiate dose. Taking opiates prior to N seems inadvisable due to the potential nausea, but in the event vomiting up N could jab this in to a big muscle and do an IM shot before passing out.

If anyone has any other ideas they would certainly be appreciated.

Thank you for this post.

Agree with you - that PPH makes no sense , scientifically >

Survival after fatal pentobarbital ingestion

www.ncbi.nlm.nih.gov

Excerpt : "In this case, we were presented with a patient who had taken a fatal barbiturate overdose. The unfamiliarity with the drug led us to treat it as phenobarbital overdose which was similar, but less effective. None of the local laboratories were able to process the pentobarbital levels due to the rarity. The patient had cardiac, respiratory and central nervous system failure from the overdose. The myocardial depressant effects of pentobarbital were marked, lasting more than 48 hours, but resolved first. Respiratory drive returned with spontaneous breathing on day 6. Central nervous system was the last to recover, which though delayed was complete. Although a suspicion of global hypoxic/hypoperfusion brain injury was raised earlier in the course of treatment, there was no functional deficit noticed on extubation. This was possibly also due to the neuroprotective effect of barbiturates.[8] The patient recovered without any neurological sequelae."

 

[checkouttime]

Thank you for this post.

Agree with you - that PPH makes no sense , scientifically >

Survival after fatal pentobarbital ingestion

www.ncbi.nlm.nih.gov

Excerpt : "In this case, we were presented with a patient who had taken a fatal barbiturate overdose. The unfamiliarity with the drug led us to treat it as phenobarbital overdose which was similar, but less effective. None of the local laboratories were able to process the pentobarbital levels due to the rarity. The patient had cardiac, respiratory and central nervous system failure from the overdose. The myocardial depressant effects of pentobarbital were marked, lasting more than 48 hours, but resolved first. Respiratory drive returned with spontaneous breathing on day 6. Central nervous system was the last to recover, which though delayed was complete. Although a suspicion of global hypoxic/hypoperfusion brain injury was raised earlier in the course of treatment, there was no functional deficit noticed on extubation. This was possibly also due to the neuroprotective effect of barbiturates.[8] The patient recovered without any neurological sequelae."

Makes no sense? these people have first hand experience of assisted suicide, in fact there was a video posted recently that they are actually in , so they have very good close up experience. What about the assisted suicide clinics do they not make sense aswell, as the pph follows the same protocol as they do. Don't forget this drug was banned because people were accidentally overdosing on it alot.

what has happened is that the OP has read something and not understood it. Its clearly aimed at people with stomach issues etc and they are providing the information to cover every eventuality, which is good protocol IMO.

As for that article you posted , that person was found. which is exactly why people are told NOT to get FOUND too soon. The impression that article gives is you can take it and survive with no repercussions. That may increase people chances of thinking lets give it a whirl, rather than putting them off. People are mainly put off by thinking they might suffer long term side effects, that article seems to imply nothing of the sort and everything would be fine.

 

[greyhound]

Makes no sense? these people have first hand experience of assisted suicide, in fact there was a video posted recently that they are actually in , so they have very good close up experience. What about the assisted suicide clinics do they not make sense aswell, as the pph follows the same protocol as they do. Don't forget this drug was banned because people were accidentally overdosing on it alot.

what has happened is that the OP has read something and not understood it. Its clearly aimed at people with stomach issues etc and they are providing the information to cover every eventuality, which is good protocol IMO.

As for that article you posted , that person was found. which is exactly why people are told NOT to get FOUND too soon. The impression that article gives is you can take it and survive with no repercussions. That may increase people chances of thinking lets give it a whirl, rather than putting them off. People are mainly put off by thinking they might suffer long term side effects, that article seems to imply nothing of the sort and everything would be fine.

I reread the PPH and now realize that those instructions were provided as a generic sort of abort process if vomiting occurs after ingesting any potentially lethal substance, of which it lists many different ones. I think I stand by my original assertion that for N, this is not going to work that well as you will probably be extremely sedated and on the verge of passing out.

So for N I think it would make sense to have a different abort procedure, and also a sort of plan B proceed option which is what I was trying to brainstorm.

For an abort procedure maybe having a bottle of charcoal pills and glass of water at the ready would be a good option. I believe charcoal is generally used in hospitals to try to absorb anything toxic a person ingests. Quickly slugging down some pills seems like it might be more doable than forced vomiting.

I'm more interested in a plan B option, and am still on the fence regarding the few I listed above, and other ideas suggested. Having a glass of SN at the ready might be a good plan B. I'm also leaning towards a syringe of opiates preloaded and ready to go.

I just think I'm going to be extremely nervous leading up to CTB and I find I get nauseous when anxious. Just trying to make sure everything goes according to plan.
Here's research that shows that charcoal prevented the absorption of phenobarbitone

"Absorption of the drugs was almost completely prevented (more than 95%) when charcoal 50 g was ingested within five minutes of taking the drugs."

Admittedly this was only 200mg of barbituates that were absorbed by the charcoal rather than grams worth. But still could be a decent option.

Effect of activated charcoal on absorption and elimination of phenobarbitone, carbamazepine and phenylbutazone in man - European Journal of Clinical Pharmacology

The effect of activated charcoal, given as a water suspension, on the absorption and elimination of phenobarbitone 200 mg, carbamazepine 400 mg and phenylbutazone 200 mg, was studied in five healthy volunteers, using a randomized crossover design. Absorption of the drugs was almost completely...

link.springer.com

 

[checkouttime]

I reread the PPH and now realize that those instructions were provided as a generic sort of abort process if vomiting occurs after ingesting any potentially lethal substance, of which it lists many different ones. I think I stand by my original assertion that for N, this is not going to work that well as you will probably be extremely sedated and on the verge of passing out.

So for N I think it would make sense to have a different abort procedure, and also a sort of plan B proceed option which is what I was trying to brainstorm.

For an abort procedure maybe having a bottle of charcoal pills and glass of water at the ready would be a good option. I believe charcoal is generally used in hospitals to try to absorb anything toxic a person ingests. Quickly slugging down some pills seems like it might be more doable than forced vomiting.

I'm more interested in a plan B option, and am still on the fence regarding the few I listed above, and other ideas suggested. Having a glass of SN at the ready might be a good plan B. I'm also leaning towards a syringe of opiates preloaded and ready to go.

I just think I'm going to be extremely nervous leading up to CTB and I find I get nauseous when anxious. Just trying to make sure everything goes according to plan.
Here's research that shows that charcoal prevented the absorption of phenobarbitone

"Absorption of the drugs was almost completely prevented (more than 95%) when charcoal 50 g was ingested within five minutes of taking the drugs."

Admittedly this was only 200mg of barbituates that were absorbed by the charcoal rather than grams worth. But still could be a decent option.

Effect of activated charcoal on absorption and elimination of phenobarbitone, carbamazepine and phenylbutazone in man - European Journal of Clinical Pharmacology

The effect of activated charcoal, given as a water suspension, on the absorption and elimination of phenobarbitone 200 mg, carbamazepine 400 mg and phenylbutazone 200 mg, was studied in five healthy volunteers, using a randomized crossover design. Absorption of the drugs was almost completely...

link.springer.com

I think you are over thinking the situation.

If you take the 2 bottles and are not found, you WILL die 100%. Now if you threw up the N straight away, i could see there being a problem. Now the chances of that happening are slim (although maybe in certain circumstances it may be possible). You can openly watch old people drinking it and not one of them looks even close to being sick. there have been plenty of people who haven't even taken an anti e.

If you wanted to potentiate the N, they recommend alcohol afterwards. there is also a drug called dilantin that increases potency. but i doubt many people need to go that far as the stuff is already deadly alone.

 

[new.solution1]

So if you vomit do you have to vomit the rest of the N or no?

I read on another thread here that it will still work if you vomit.

Which is true?

 

[ChrisLeeHZ]

Why can't we inject?Too slow?

 

[BrokenBliss]

Why can't we inject?Too slow?

Exactly. You go unconscious too quickly. And involving someone to administer puts them at legal risk.

 

[ChrisLeeHZ]

Exactly. You go unconscious too quickly. And involving someone to administer puts them at legal risk.

I mean IV drop

 

[BrokenBliss]

I mean IV drop

That I don't know. The specifics of that idea may be covered in PPH. There's a lot of conversation on it here if you use search function.

 

[Sunset Limited]

I mean IV drop

Setting up a drip infusion is easy. It is difficult to insert a cannula into the vein. Especially alone. It's not impossible though, but it's not very realistic for ninety percent of people.

 

[BrokenBliss]

Setting up a drip infusion is easy. It is difficult to insert a cannula into the vein. Especially alone. It's not impossible though, but it's not very realistic for ninety percent of people.

I'm thinking there could be unforseen issues that might occur while you're unconscious. Whereas drinking a glassful takes a few seconds, no equipment, and you're all set. Outcome is pretty assured.

 

[Sunset Limited]

I'm thinking there could be unforseen issues that might occur while you're unconscious. Whereas drinking a glassful takes a few seconds, no equipment, and you're all set. Outcome is pretty assured.

You are right. Drip infusion is unreliable.

 

[raghu1977]

I'm thinking there could be unforseen issues that might occur while you're unconscious. Whereas drinking a glassful takes a few seconds, no equipment, and you're all set. Outcome is pretty assured.

This! The only way for IV to work reliably is there is a trained nurse to first hook you up with an IV and then monitor to make sure the full dose is delivered sufficiently quickly.

And thats not going to happen. Unless you personally know a nurse who is willing to risk prosecution.

 

[Lost Magic]

I'll be sitting up on my bed while drinking the N. I'm going to just take the anti-sickness pills, drink two bottles (in a large glass) and go to sleep. That's the hope anyway

 

[Sunset Limited]

This! The only way for IV to work reliably is there is a trained nurse to first hook you up with an IV and then monitor to make sure the full dose is delivered sufficiently quickly.

And thats not going to happen. Unless you personally know a nurse who is willing to risk prosecution.

In fact, an infusion pump provides this guarantee. It is quite expensive. Maybe second hand can be half cheap.

 

[_Seeking]

This is pretty funny to me, but I had abdominal surgery last year and this doctor decided he would fix a small hiatal hernia while he was at it. This surgery did nothing to help my chronic nausea, and it instead gives me painful dry heaves because the fix takes away your ability to vomit. So it did nothing to benefit my life but will benefit my death by not being able to vomit the N.

 

[ClaudeKersey]

This is pretty funny to me, but I had abdominal surgery last year and this doctor decided he would fix a small hiatal hernia while he was at it. This surgery did nothing to help my chronic nausea, and it instead gives me painful dry heaves because the fix takes away your ability to vomit. So it did nothing to benefit my life but will benefit my death by not being able to vomit the N.

Life is full of interesting ironies, isn't it?

 

[romanticdoom]

Anyone know if vicodin (hydro/acetaminophen) taken before N would potentiate or if the acetaminophen would just do more harm than good by increasing nausea? i'm planning on using domperidone as my only vomiting mitigation. sorry if this has been discussed elsewhere but I don't have access to the search function