MorsVoluntaria
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- Dec 27, 2018
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Yoon, Jae Chol MD, PhD; Kim, So Eun MD, PhD,*. Suicide attempt using sodium nitrite ordered on the internet: Two case reports. Medicine: July 15, 2022 - Volume 101 - Issue 28 - p e29355 doi: 10.1097/MD.0000000000029355
Case 1
A 24-year-old previously healthy female intentionally ingested approximately 10 g of powdered sodium nitrite in a suicide attempt, following the instructions she obtained from a suicide blog. She recently felt depressed, was unable to work, and had trouble sleeping. She described her distress as increasing over the course of a few days, and she finally made plans to commit suicide. She purchased sodium nitrite online without difficulty or the need for any permissions. However, she stated that she regretted her decision immediately after ingesting sodium nitrite. She confessed to her family member that she was attempting suicide. She was admitted to the emergency department (ED) by her mother, 30 minutes after ingestion with acute dyspnea and cyanosis (Fig. 1).
Within 1 hour of methylene blue administration, her symptoms improved significantly, and methemoglobin levels decreased to 10.2% and then to 1.6% four hours later (Fig. 2). The patient experienced no complications throughout her hospital stay. She was discharged after neuropsychiatric evaluation and treatment for mental illness, suicidal ideation, and suicide attempts.
Case 2
A 20-year-old man presented to the ED after intentional ingestion of 750 mg of powdered sodium nitrite (98% by weight). He had been experiencing major depressive disorder for the last 6 months but had not taken medicine recently. He was under stress from a college issue and felt pressured to succeed in the future. He remained depressed for most of the day and repeatedly thought of death. He prepared a pill by filling an empty pill capsule with sodium nitrite powder and taking it with water at home. One hour later, the patient visited the ED. He stated that he obtained information on how to make the suicide pill from an online suicide forum and purchased sodium nitrite online. He brought a bottle containing 500 grams of 98% sodium nitrite by weight that he purchased online (Fig. 3).
He experienced only mild nausea a few minutes after ingesting a self-produced suicide pill. A physical examination revealed no signs of central or peripheral cyanosis, and the patient was hemodynamically stable. His methemoglobin level returned to normal 2 hours after ingestion. The patient recovered without any problems with conservative supportive treatment.
Discussion
The individuals confessed that they had learned about this suicide method in online forums and blogs. We searched the internet for "sodium nitrite" and "suicide" and found that several websites provide step-by-step instructions for suicide with sodium nitrite at home. They advertised sodium nitrite as an ideal suicide method, describing it as an "easy, quick, and painless recipe."
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Also interesting, "Sodium Nitrite Suicide: Frightening Trend in Young Adults" from Missouri Poison Center, USA
"Local poison centers have records that explicitly state patients researched this method of suicide in an online blog or forum. The records also show that half of these patients obtained sodium nitrite online."
"It's important to note that the survival rate depends heavily on the amount ingested, but the toxicity of sodium nitrite is a significant concern. Reports show that nearly 15 percent of nitrites and nitrates self-poisoning cases have ended in death since 2018. And 88 percent of individuals require care in healthcare facilities."
I wonder if the statistic above includes sodium nitrAte as well as other non-sodium nitrites/nitrates?
Case 1
A 24-year-old previously healthy female intentionally ingested approximately 10 g of powdered sodium nitrite in a suicide attempt, following the instructions she obtained from a suicide blog. She recently felt depressed, was unable to work, and had trouble sleeping. She described her distress as increasing over the course of a few days, and she finally made plans to commit suicide. She purchased sodium nitrite online without difficulty or the need for any permissions. However, she stated that she regretted her decision immediately after ingesting sodium nitrite. She confessed to her family member that she was attempting suicide. She was admitted to the emergency department (ED) by her mother, 30 minutes after ingestion with acute dyspnea and cyanosis (Fig. 1).
Within 1 hour of methylene blue administration, her symptoms improved significantly, and methemoglobin levels decreased to 10.2% and then to 1.6% four hours later (Fig. 2). The patient experienced no complications throughout her hospital stay. She was discharged after neuropsychiatric evaluation and treatment for mental illness, suicidal ideation, and suicide attempts.
Case 2
A 20-year-old man presented to the ED after intentional ingestion of 750 mg of powdered sodium nitrite (98% by weight). He had been experiencing major depressive disorder for the last 6 months but had not taken medicine recently. He was under stress from a college issue and felt pressured to succeed in the future. He remained depressed for most of the day and repeatedly thought of death. He prepared a pill by filling an empty pill capsule with sodium nitrite powder and taking it with water at home. One hour later, the patient visited the ED. He stated that he obtained information on how to make the suicide pill from an online suicide forum and purchased sodium nitrite online. He brought a bottle containing 500 grams of 98% sodium nitrite by weight that he purchased online (Fig. 3).
He experienced only mild nausea a few minutes after ingesting a self-produced suicide pill. A physical examination revealed no signs of central or peripheral cyanosis, and the patient was hemodynamically stable. His methemoglobin level returned to normal 2 hours after ingestion. The patient recovered without any problems with conservative supportive treatment.
Discussion
The individuals confessed that they had learned about this suicide method in online forums and blogs. We searched the internet for "sodium nitrite" and "suicide" and found that several websites provide step-by-step instructions for suicide with sodium nitrite at home. They advertised sodium nitrite as an ideal suicide method, describing it as an "easy, quick, and painless recipe."
—-
Also interesting, "Sodium Nitrite Suicide: Frightening Trend in Young Adults" from Missouri Poison Center, USA
"Local poison centers have records that explicitly state patients researched this method of suicide in an online blog or forum. The records also show that half of these patients obtained sodium nitrite online."
"It's important to note that the survival rate depends heavily on the amount ingested, but the toxicity of sodium nitrite is a significant concern. Reports show that nearly 15 percent of nitrites and nitrates self-poisoning cases have ended in death since 2018. And 88 percent of individuals require care in healthcare facilities."
I wonder if the statistic above includes sodium nitrAte as well as other non-sodium nitrites/nitrates?
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