Pentobarbital: Texas’s drug of choice in carrying out its lethal injection executions.

Texas was the first state in 1982 to use a lethal three-drug protocol to execute people. The three-drug protocol, which was eventually adopted by most other states, was: sodium thiopental (powerful barbiturate), pancuronium bromide (muscle paralytic), and potassium chloride (heart suffocation).

According to the Death Penalty Information Center (DPIC), Texas carried out 466 executions between December 1982 and February 2011 using this three-drug protocol.

In the wake of number of botched executions, U.S. drug manufacturers in 2011 decided they did not want their lethal products used in state sanctioned executions. Most either quit making execution drugs or placed conditions on their purchase that they would not be used in executions.

One of the execution drugs that quickly disappeared from the execution scene was sodium thiopental.

Texas Seeks Alternative Drugs to Kill Condemned Inmates

Texas, being the execution machine it is, was forced to adjust its execution protocol.

In 2011, it replaced sodium thiopental with another powerful barbiturate: pentobarbital.

Between May 2011 and April 2012, DPIC reports that Texas carried out 16 executions with the pentobarbital-led three-drug protocol.

By 2012, as with sodium thiopental, pancuronium bromide and potassium chloride also became scarce in the states’ lethal injection process.

That scarcity forced Texas in 2012 to adopt pentobarbital as its sole drug for carrying out its lethal injection executions.

One Drug Protocol

The DPIC reports that between July 2012 and February 2019, Texas executed 78 people using the one-drug protocol: pentobarbital.

The Texas Tribune reported on May 17, 2019 that Texas has only 23 doses of pentobarbital left in stock, and the state has six executions scheduled between July 31and October 2.

Based on the secondhand evidence available, as there will never be any firsthand evidence, it appears the one drug pentobarbital protocol is preferable to the traditional three-drug protocol. Death by potassium chloride or pancuronium bromide, standing alone, produces an excruciating death: the first drug literally squeezes the life out of the heart while the second drug paralyzes muscle reactions to mask the pain of caused by the former. That’s why a powerful sedative like sodium thiopental or pentobarbital is necessary to render the condemned inmate unconscious so he does not experience the pain of the other two drugs for very long.

Pentobarbital Becoming Scarce for State Executions

Once used by the state of Oregon in assisted suicides, pentobarbital has also become increasingly difficult to secure through reputable medical supply sources because of its death penalty association. Death With Dignity, an end-of-life website, explains:

“Pentobarbital in liquid form cost about $500 until about 2012, when the price rose to between $15,000 and $25,000. The price increase was caused by the European Union’s ban on exports to the US because of the drug being used in capital punishment, a practice that is illegal and deemed deplorable there; many international pharmaceutical companies don’t export the drug to the United States for the same reason. Users then switched to the powdered form, which cost between $400 and $500.”

Texas Resorts to Compounding Pharmacies

The Texas Tribune reported in November 2018 that Texas has turned to unreliable compounding pharmacies to secure pentobarbital. According to BuzzFeed News, one of those pharmacies is the Houston-based Greenpark Compounding Pharmacy which has been cited for 48 practice violations by the Texas State Board of Pharmacy in the past eight years, and even had its license suspended in 2016. These violations include “keeping out-of-date drugs in stock, using improper procedures to prepare IV solutions, and inadequate cleaning of hands and gloves.”

Improper Compounding Leads to Extraordinary Pain

BuzzFeed pointed out that five of the eleven inmates put to death in Texas in 2018 said they could feel burning sensations upon injection of the compound-made pentobarbital prior to being rendered unconscious. The news outlet quoted Dr. David Waisel statements in a 2016 affidavit about compounding pharmacies:

“Improper compounding and testing procedures may leave fine particles undetectable by the naked eye in the solution or larger particles that would not be detected by an untrained eye. These particles can cause great irritation to the vein, resulting in extraordinary pain.”

Because of the sketchy reputations compounding pharmacies have throughout the United States, and especially throughout the international community (such as in China and India), the Texas Legislature in 2015 passed a bill preserving the confidentiality of any drug manufacturer who supplies execution drugs to the state.

That same year, according to the Texas Tribune, the Texas Department of Criminal Justice “tried to ship in 1,000 vials of the anestheticsodium thiopental from overseas. But the FDA seized the drugs at a Houston airport and, nearly two years later, officially banned their import, ruling that the drugs could not be admitted into the United States because they appeared to be unapproved and misbranded.”

Trump Administration Allows Unapproved/Misbranded Drugs into U.S.

Texas appealed the FDA’s confiscation, and as might be expected, the Trump administration’s Department of Justice issued a May 3, 2019 opinion that said the FDA does not have any regulatory authority over drugs used by states in carrying out executions.

In effect, the Justice Department opinion gives the states a legal license to procure execution drugs from whomever they choose with little or no regard for the manufacturing integrity of those drugs.

Texas will now get its one thousand vials of sodium thiopental, and since the state has carried out 561 of the nation’s 1497 executions since 1977, the Texas Department of Criminal Justice stands both ready and receptive to put those vials to work in the state’s death process.

There is no death with dignity in a state-sanctioned execution. Just another compelling reason to ban state-sanctioned murder.