Fentanyl and The Death Penalty
In August 2019 Carey Dean Moore, a 60-year-old inmate on death row in Nebraska was executed. After having spent over half his life knowing that he could end his days on the seat of a barbaric contraption that is the electric chair he went to meet his maker saying that he would not try to stop or it, and nor did he want anyone to intervene.
After killing two cab drivers back in 1979 his story would probably not have received much attention in the normal course of events. This however was the first execution in the state for 21 years and just three years after the state had abolished capital punishment, only for the decision to be overturned. What was also a first was that the method of execution involved the administration of the powerful opioid fentanyl.
Fentanyl may have been responsible for just one death in this instance but it has been estimated to have been implicated in the deaths of around 30,000 people a year across the United States as a whole. Notable deaths have included the musician Prince who died from an accidental overdose in April 2016 and the rappers Lil Peep and Mac Miller a year later.
The drug was first synthesized in Belgium way back in 1959 with the first branded product ‘Sublimaze’ entering medical use as a general anaesthetic. Later the Duragesic patch was developed by utilising an inert alcohol gel infused with a dose of fentanyl. It provided for constant administration of the opioid over a 48–72 hour period. Later developments saw the appearance of flavoured lollipops (under the brand name Actiq) and even soluble film used for certain forms of cancer pain management.
The use throughout the medical world continued apace, with many seeing it as an effective product for many aspects of pain management. Although some overdose deaths do occur (4%) when a prescription is misused, the vast majority of incidents involve illegally manufactured fentanyl or one of its analogues, which are often given the street name of ‘China White’.
Lawmakers in Nebraska decided to restore the death penalty following a statewide ballot in 2016 where 60% of voters voted ‘for’, but with sort a more ‘humane’ method of execution. Four drugs were to be used in total; potassium chloride to stop the heart, cisatracurium besylate to paralyze the muscles, and Valium and fentanyl would render the subject unconscious. Nebraska officials obtained the said drugs legally and legitimately, but some argued their choice of drugs used was governed not by the principle of ‘humaneness’ but rather by the fact that their purchasing options were very limited. Drug companies began to object to their products being used in this way and use legal devices to stop the practice. To counter this development, the state of Ohio is currently considering legislation that would allow prison officials to obtain fentanyl from drug seizures.
The Ohio state patrol recovered over 108 pounds of fentanyl in 2018, according to state records. The state has over 20 scheduled execution lined up running through to 2022. Local representative Rep. Scott Wiggam said “This is certainly a workaround,” and added “This is something that we know can bring deaths quickly to individuals”. That would include the 3,431 overdose deaths in the state seen during 2017. Some commentators see this particular approach as not only being crass, but also disrespectful to those who have passed away in overdose incidents.
This approach has also had the unintended consequence of some states considering the use of other methods of execution. These have included sticking to the use of the electric chair, nitrogen gas, firing squad or even untested drug combinations. For much of its’ history the primary method of execution in the United States was hanging. It was a simple method and sent a strong message to the entire community about the consequences of crime as it usually took place in the centre of a town. Hangings, like the games of ancient Rome, became public spectacles with tens of thousands attending. When the State of New York conducted the first electrocution in 1890 it also changed the public perception of the death penalty. With few witnesses it minimised the unruliness and sometimes sympathetic nature of hangings. Some argued that such technology would make the death penalty more humane by making it less human. As electric chairs began to be seen as antiquated and risky it is not surprising that lethal injection began to be seen as better alternative. Whilst there has been a significant drop in the number of states of the US that still have the death penalty on their books it remains to be seen if lethal injections leads to a renewed rise in calls for its adoption or reintroduction in other US States and in other countries around the world.
On 14th August 2019, as rain fell heavily outside the State penitentiary in Lincoln, Nebraska the witnesses to Moore’s execution gathered — four were people who Moore himself had chosen, including his twin brother and four members of the news media. The first drug was injected into Moore at 10:24 A.M. and the coroner announced his time of death at 10:47 A.M.
