COLUMBUS, Ohio — Ohio says it’s resuming executions in January with a three-drug protocol similar to one it used for several years. The concept is one adopted for decades by many states. The first drug sedates inmates, the second paralyzes them, and the third stops their hearts. The key difference comes with the first drug the state plans to use, midazolam, which has been challenged in court as unreliable.
Some things to know about the drug.
Midazolam is an anti-anxiety drug in the benzodiazepine class, similar to Valium or Ativan. It can be used to reduce anxiety before surgery as well as sedate patients. Some states have used it to calm inmates before an execution began, including Missouri, and in Ohio under the brand name Versed.
USE IN EXECUTIONS
Two states, Ohio and Arizona, have used midazolam as the first in a two-drug protocol. In Ohio, inmate Dennis McGuire repeatedly gasped and snorted over 26 minutes during his January 2014 execution. The state abandoned that method afterward and hasn’t put anyone to death since. Arizona put executions on hold after the July 2014 death of convicted killer Joseph Rudolph Wood, who took nearly two hours to die. Louisiana and Kentucky also proposed using it in a two-drug method, with Kentucky later dropping the idea.
Two states, Florida and Oklahoma, have used midazolam as the first in a three-drug protocol. Oklahoma’s use of the drug was challenged after the April 2014 execution of Clayton Lockett, who writhed on a gurney, moaned and clenched his teeth for several minutes before prison officials tried to halt the process. Lockett died after 43 minutes. Two states, Alabama and Virginia, proposed it as part of a three-drug protocol.
Last year, the U.S. Supreme Court ruled 5-4 in the case from Oklahoma that midazolam can be used in executions without violating the Eighth Amendment prohibition on cruel and unusual punishment. Justice Samuel Alito said the drug could not be used effectively as a sedative in executions were speculative, and he dismissed problems in executions in Arizona and Oklahoma as “having little probative value for present purposes.”
In announcing its new three-drug protocol, Ohio cited the Supreme Court decision, while noting it used the same approach — though with different drugs — in executing 32 inmates from 1999 to late 2009.
The execution policy used to put McGuire to death called for 10 milligrams of midazolam. The new policy calls for a massive dose of 500 milligrams, far more than the 20 milligrams sometimes used to put cardiac surgery patients into deep unconsciousness. The state argues that 500 milligrams will ensure inmates are properly sedated. Opponents say that because midazolam is not a traditional sedative, it’s unclear what a much bigger dose would achieve, an argument called the “ceiling effect.” In Alabama, for example, condemned inmate Thomas Arthur is seeking to stop his November execution on the grounds that midazolam is unreliable as a sedative.
SOURCE OF DRUG
An Ohio law meant to help jump start executions shields the source of lethal injection drugs, meaning the state doesn’t have to say where it got its supply of midazolam or the other two drugs: rocuronium bromide and potassium chloride. Drug makers have by and large put their drugs off limits for executions. Earlier this year, Pfizer put seven drugs off limits, including the three drugs to be used by Ohio. But drugs like midazolam are widespread, found everywhere from dental offices to veterinary clinics, making it difficult to trace the origin.