‘Strange and confusing’: Nevada to execute murderer with fentanyl, as critics wonder how drug was obtained

Fentanyl is the drug at the heart of the US opioid epidemic

PUBLISHED : Wednesday, 11 July, 2018, 12:48pm
UPDATED : Wednesday, 11 July, 2018, 10:15pm

Nevada plans to carry out the first execution using fentanyl, a drug at the heart of the US opioid epidemic, on Wednesday.

The state intends to use a synthetic opioid – involved in more than 20,000 overdose deaths in 2016 alone – to kill Scott Dozier, a double murderer, after finding it difficult to obtain other drugs for Nevada’s first execution in 12 years because of opposition from pharmaceutical manufacturers.

But questions have been raised about whether Nevada’s department of corrections broke the law to obtain the fentanyl, and whether the multibillion-dollar distribution company that provided the drug ignored evidence it was to be used in an execution.

Fentanyl has moved to the centre of the opioid epidemic as a powerful and dangerous illicit powder, one hundred times more potent than morphine and frequently mixed with heroin or pressed into fake prescription pills. But it is also sold as a prescription painkiller, including a version for injection which can kill in higher dosages.

“Using fentanyl in an execution is particularly strange and confusing because of its place in the opioid epidemic,” said the legal director of the American Civil Liberties Union in Nevada, Amy Rose. “But on top of that it’s never been used in an execution before. It’s extremely experimental. There is a very real risk of a botched execution.”

Dozier will be injected with fentanyl and two other drugs. One of them is a sedative, midazolam, involved in a number of executions where the condemned man has been seen convulsing, gasping and in evident pain before death.

“It has been at the centre of executions that have gone visibly wrong in every single state in which it has been used,” said Maya Foa, the director of the ant-death penalty group Reprieve. “Now it’s being used with fentanyl. This is an entirely novel protocol across the United States.”

Foa said that states are usually obliged by the appeals process to subject the planned method of execution to legal scrutiny, particularly when a new drug protocol is being used. But Dozier has waved appeals and said he wants to die so the combination of medicines to be used to kill him has not been examined in court.

Death penalty states have been forced to find different cocktails of drugs for executions in the face of opposition from manufacturers to having their medicines used in lethal injections. That has led states to try whatever mix of drugs they can buy, often in secrecy.

The Nevada authorities refused to make public how they obtained the fentanyl and other drugs, but last week the ACLU won a court ruling forcing the department of corrections to hand over invoices. They show that it placed multiple small orders over a number of months, sometimes just one day after the previous order. It is not clear if this was an attempt to avoid drawing the attention a single large order of fentanyl would bring.

The drugs were ordered from one of the US’s largest pharmaceutical distribution companies, Cardinal Health, which is among wholesalers facing a barrage of lawsuits accusing them of profiteering from the opioid epidemic by delivering vast quantities of prescription painkillers to small pharmacies and ignoring evidence they were being used by people addicted to the drugs.

Rose said the rights group is examining why the distributor delivered the drug to the Nevada prison authorities even after it was publicly known they intended to use fentanyl to kill Dozier.

“It’s concerning that Cardinal Health would sell it to the department of corrections if it knew the drugs would be used in executions,” she said.