2017 Summary of Drugs Used for Doctor-Prescribed Suicide

According to Oregon’s February 2017 official report, deaths occurring during the first 19 years under that state’s “Death with Dignity Act” took place after patients took the following drugs[1]:

Secobarbital  (Seconal)                        59.3%
Pentobarbital (Nembutal)                   34.3%
Other                                                        6.5%

Secobarbital (Seconal) and Pentobarbital (Nembutal) are barbiturates (sedatives).
In recent years, Pentobarbital has become unavailable due to protests about its use in capital punishment.[2]  Therefore, Seconal has become the most widely use drug to cause death.

The usual therapeutic dosage[3] for Seconal is:
100 mg. to treat insomnia.  200-300 mg. for preoperative sedation.

The usual doctor-prescribed suicide dosage[4] for Seconal is:
9000 mg. in capsule form.  The capsules are opened and contents mixed with a sweet substance to mask the taste.

Alternatives to Seconal:
None of the doctor-prescribed suicide laws require a particular type of drug and, due to the high cost of Seconal, alternatives are being tested.  One such alternative was so harsh that it burned patients’ mouths and throats and caused some to scream in pain.[5]

Methods of administration:
Although oral self-administration is generally thought to be the only route of administration, taking the drugs by mouth is not the only means. There are reported assisted-suicide cases of using a syringe or IV infusion to administer the lethal dose.[6]  In addition, California’s Sutter Health states that the patient must “be able to take (eat, drink or inject) the aid-in-dying drug by themselves.”[7]

Payment for doctor-prescribed suicide drugs:
Private insurance companies determine whether to cover the cost of the lethal prescription and, while federal funds may not be used, state funds can also pay for the drugs.  California covers the cost of prescriptions for assisted suicide under the state’s “End-of-Life Option Act.”[8]   For example, after one patient’s insurance company denied coverage for her chemotherapy, she was told that the state would pay for all but $1.20 for a prescription to end her life under the state’s law permitting assisted suicide.[9]
[1]  Oregon Health Authority, Public Health Division, “Oregon Death With Dignity Act Data Summary,” Available at:     http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year19.pdf, p. 10.  (Last accessed 3/8/17.)

[2]  Kimberly Leonard, “Drug Used in ‘Death with Dignity’ Is the Same Used in Executions,” US News and World Report, October 16, 2015.  Available at: https://www.usnews.com/news/articles/2015/10/16/drug-shortage-creates-hurdle-for-death-with-dignity-movement. (Last accessed 3/9/17.)

[3] Drugs.com, “Secobarbital Dosage ,” Available at: http://www.drugs.com/dosage/secobarbital.html. (Last accessed 3/8/17.)

[4] Jennifer Fass and Andrea Fass, “Physician-assisted Suicide: Ongoing Challenges for Pharmacists, ” Am. J. Health Syst. Phar. 2011:68(9): 86-849.  Available at: http://www.medscape.com/viewarticle/742070_print. (Last accessed 3/8/17.)
See also: KQED, “Pharmaceutical Companies Hiked Price on Aid in Dying Drug,” March 22, 2016. Available at: http://ww2.kqed.org/stateofhealth/2016/03/22/pharmaceutical-companies-hiked-price-on-aid-in-dying-drug. (Last accessed 3/8/17.)

[5] “JoNel Aleccia, “Docs in Northwest tweak aid-in-dying drugs to prevent prolonged deaths,” USA Today, February 16, 2017, Available at: http://www.usatoday.com/story/news/2017/02/16/kaiser-docs-northwest-tweak-aid–dying-drugs-prevent-prolonged-deaths/98003110.  (Last accessed 3/10/17.)

[6] Molly Harbarger, “Legislator’s promise to a dying friend,” Oregonian, May 1, 2015. Available at: http://www.oregonlive.com/politics/index.ssf/2015/04/legislators_promise_to_a_dying.html. (Last accessed 3/10/17.)

[7] Sutter Health, “What Patients Need to Know About California’s End of Life Option Act,” June 2016, Available at: http://www.sutterhealth.org/eloa, pg. 1. Emphasis added. (Last accessed 3/10/17).

[8] Kimberly Leonard, “Californians Can Choose to Die – With the Help of Taxpayers,” U.S. News and World Report, March 21, 2016. Available at: https://www.usnews.com/news/articles/2016-03-21/in-california-government-to-pick-up-the-tab-for-death-with-dignity. (Last accessed 3/10/17.)

[9] Bradford Richardson, “Assisted-suicide law prompts insurance company to deny coverage to terminally ill California woman,” Washington Times, October 20, 2016.  Available at: http://www.washingtontimes.com/news/2016/oct/20/assisted-suicide-law-prompts-insurance-company-den. (Last accessed 3/10/17.)

© 2017 Patients Rights Council