PPH’s 3-Drug mixture - no go !

[enjolras]

Directed at those who'd get lazily tempted by the "3-Drug" lethal cocktail instead of 4 (DDMP/DDMP2/DDMA).



Long story short, the PPH does specify the following warnings :
- "common reports of an unpleasant burning sensation at the back of the throat with Chloral Hydrate"
- "difficulties with swallowing the mix"

These 2 descriptive articles depict the history of the in-vivo R&D which occurred to replace Seconal in Oregon, and why the 3-drug mixture was rapidly interrupted.

The Doctors Who Invented a New Way to Help People Die

The two lethal medications used by terminal patients who wish to end their own life recently became unavailable or prohibitively expensive.

www.theatlantic.com

Docs In Northwest Tweak Aid-In-Dying Drugs To Prevent Prolonged Deaths - KFF Health News

Some terminal patients, typically high-dose opioid users, who choose to end their lives have taken many hours, even days, to die.

khn.org

 

[Aap]

This is important to note regarding Chloral hydrate. Honestly, I'm shocked they even considered using it given how badly it burns. I wouldn't read more into this than that. Concentrated CH is much more caustic than concentrated pentobarbital. There isn't really a way to avoid that.

the digitalis/diazepam /morphine/propranolol 2 is the way to go. (The dosages we're doubled to speep death.) Note the morphine and diazepam would render unconscious before the dgititalis or propranolol heart stoppage occur. Death by digitalis has historically been confused with an MI. If digitalis for some reason doesn't work, the morphine/diazepam/propranolol will from apnea, but much slower though under an anesthetised state.

 

[enjolras]

MI = Myocard Infarctus ?

In Oregon, they now also go hand in hand with the DDMA instead of DDMP2 (50%/50%). Propranolol is then replaced for Amitriptyline (I donno the amount), which is sedating + cardiotoxic. It appears the max time to death dropped from 47hrs to 19hrs. I'm unsure if it was the sole justification or if there are other motivations. Can you ?

The PPH is lagging behind, indicating both the outdated DDMP1 dosages and missing on the DDMA. Let's send to Exit Curriculum Vitaes ! lol You seem knowledgeable. Do you have a medical background ?

 

[Aap]

Yes amytryptiline is both heavily sedating in high doses and cardiotoxic. The therapeutic index is somewhat low in the sense that a months dose can be fatal. It's one of the reasons first gen antidepressants are not used as first line in favor of the ssnri's and/or ssnri's. You are correct regarding justification. It's massively more sedating and much more cardiotoxic than propranolol (though they could be used together), especially if digoxin is present.

yeah, MI is comm9nly called a heart attack

 

[Elbarado]

This is important to note regarding Chloral hydrate. Honestly, I'm shocked they even considered using it given how badly it burns. I wouldn't read more into this than that. Concentrated CH is much more caustic than concentrated pentobarbital. There isn't really a way to avoid that.

the digitalis/diazepam /morphine/propranolol 2 is the way to go. (The dosages we're doubled to speep death.) Note the morphine and diazepam would render unconscious before the dgititalis or propranolol heart stoppage occur. Death by digitalis has historically been confused with an MI. If digitalis for some reason doesn't work, the morphine/diazepam/propranolol will from apnea, but much slower though under an anesthetised state.

so is pentobarbital also caustic? does it make you feel pain too? why are they using it at dignitas and stuff?

 

[Aap]

Well it's acidic, but from all accounts bitterness is the issue. Heavily concentrated vet solutions almost certainly would burn if injected IV, but plenty of compounds burn, sometimes badly when injected, such as toradol or propofol.

The concentrations used by AS orgainizations likely are not felt or only very mildly uncomfortable. N is peaceful. Chloral hydrate isn't used IV for this purpose. The solutions given in Oregon were very concentrated. It (concentrated Chloral)would be like drinking 95% grain alcohol but much, much worse.

 

[Elbarado]

Well it's acidic, but from all accounts bitterness is the issue. Heavily concentrated vet solutions almost certainly would burn if injected IV, but plenty of compounds burn, sometimes badly when injected, such as toradol or propofol.

The concentrations used by AS orgainizations likely are not felt or only very mildly uncomfortable. N is peaceful. Chloral hydrate isn't used IV for this purpose. The solutions given in Oregon were very concentrated. It (concentrated Chloral)would be like drinking 95% grain alcohol but much, much worse.

Well bitterness is one thing, just one shot it like a beer, but i hope it wont burn, ordered from C

 

[enjolras]

N doesn't burn. There's only the taste to deal with

 

[Aap]

Sorry if not clear; it doesn't burn orally.

 

[SleepyTime]

I'm surprised the cocktails with Chloral Hydrate are even talked about anymore. The original DDMP has now been improved to the DDMP2 cocktail and we also have the alternate DDMA cocktail. I am grateful for the doctors who looked (and are still looking) for better methods. Oregon used to publish the actual ingredients in the cocktails but have now removed them from their website. The last time they had shown the specifics for DDMP2, but now prescribing physicians need to call the state to get the latest formula. So I am left wondering if they have improved on DDMP2 or DDMA and we don't have any new information.

My aunt was living in the Pacific Northwest when she was dying from cancer. After the laws passed, she obtained what we now consider the holy grail - a prescription for Seconal. Unfortunately, she died before using the Seconal - and her stupid daughter flushed the drug down the toilet after her mom died.

I had been working on collecting the drugs for DDMP2, but then I was recently put on Amitriptyline (low dose unfortunately) so now that is an additional method that I am adding to my arsenal.

In Oregon, they now also go hand in hand with the DDMA instead of DDMP2 (50%/50%). Propranolol is then replaced for Amitriptyline (I donno the amount), which is sedating + cardiotoxic.

The last time Oregon published the formula for DDMA - they listed 7-8 grams for the Amitriptyline

 

[Aap]

Yeah chloral hydrate was a bad idea. Even if one has never tasted it, it is very easy to look at the usual dose, dose concentration being given, and organic structure to know this was a bad, bad idea.