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Nevada Department of Corrections is turning to fentanyl for an upcoming execution

One expert says Nevada's approach doesn't surprise him, another was "flabbergasted"

CNN  — 

At a time when the United States is grappling with an epidemic of opioid-related overdose deaths, one state is turning to a very high-potency opioid for criminal executions.

Opioids are a class of drugs that include some prescription painkillers as well as illicit drugs such as heroin and street fentanyl. The majority of drug overdose deaths nationwide involve an opioid, and about 91 Americans die every day from an opioid overdose, according to the US Centers for Disease Control and Prevention.

Now, the Nevada Department of Corrections is preparing to use fentanyl in a three-part drug combination for an upcoming execution, it said in a statement August 17.

The combination includes the sedative diazepam, which is often sold under the brand name Valium; the muscle relaxant cisatracurium; and fentanyl, according to the statement.

Nevada turned to fentanyl for an execution because the state had no other drugs to carry out a lethal injection after “pharmaceutical industry opposition to the use of their products in executions,” The Marshall Project reported Wednesday.

The Marshall Project, a nonpartisan nonprofit news organization covering the criminal justice system, originally published news of this execution approach.

“I have one word that summarizes all of it, and it’s ‘irony,’ ” said Josh Bloom, senior director of chemical and pharmaceutical sciences for the American Council on Science and Health, adding that Nevada’s decision left him “flabbergasted.”

“You got something that’s killing hundreds of people a day across the United States, and you got prisons who can’t get death penalty drugs, so they’re turning to the drug that’s killing hundreds of people across the United States. This sounds like an article from the Onion,” a news satire site, Bloom said.

On the other hand, Nevada’s decision didn’t seem to shock Dr. Edward W. Boyer, a medical toxicologist who also teaches at Harvard Medical School.

“Fentanyl itself is lethal. If you haven’t heard about fentanyl-laced heroin and its impact on death rates in opioid users over the past several months, you might have been living under a rock,” Boyer said.

“Fentanyl is a drug that you can inject intramuscularly, dermally and a wide number of routes,” he said. “The main problem with them from a clinical perspective is that they wipe out your ability to breathe. You simply stop breathing. It causes profound respiratory depression.”

‘This specific chemical cocktail … has never been used in this way before’

This fentanyl drug combination is to be used in the execution of 46-year-old Scott Raymond Dozier on November 14 at Ely State Prison in Ely, Nevada, according to the Department of Corrections’ statement.

“Dozier was sentenced to death after a first-degree murder conviction for the 2002 killing and dismemberment of Jeremiah Miller, 22,” the statement said. “Miller’s dismembered torso was found in a suitcase that had been dumped in a trash bin.

“During the course of their investigation, police uncovered another victim of Dozier who was dismembered and buried in the Arizona desert. Dozier was found guilty of second-degree murder in that case,” the statement said.

The Marshall Project reported that “Nearly a year ago, Nevada death row inmate Scott Dozier asked to be executed, telling a state court judge he would forego his appeals.”

In an emailed statement to CNN, Nevada’s chief medical officer Dr. John DiMuro said, “I can confirm that I am consulting with the NDOC as required by Nevada statute. This consultation process is ongoing and not complete at this time. Our expectation is that any final decision is likely to be reviewed by the Court.”

The American Civil Liberties Union of Nevada opposes the plans to use the new drug combination, said Tod Story, executive director of the ACLU of Nevada.

“The concern is that this specific chemical cocktail that they have proposed has never been used in this way before. It’s not like they can point to some success or result. This will be the first time,” Story said.

“Using Mr. Dozier as a guinea pig is not an option, despite his stated desire to want to give up all of his rights to appeal,” he said. “The use of the drugs that they have proposed are paralytics and an overdose of an opioid. So you’re essentially trying to kill this person by paralyzing them to death, which sounds horrific, and it’s certainly not in our perspective compliant with the Eighth Amendment of the Constitution, which is no cruel or unusual punishment.”

Last week, the ACLU of Nevada announced that it filed a public records request with the Department of Corrections in order to obtain additional details about Dozier’s upcoming execution.

The Marshall Project cited experts who said they saw no obvious reason why Nevada selected this drug combination.

The fentanyl and diazepam “may be trying to block the experience of suffocation,” Joel B. Zivot, an Emory University anesthesiologist who has served as an expert witness in legal challenges to execution protocols, told The Marshall Project.

“The fentanyl takes away pain, and the Valium takes away anxiety. Both drugs are limited in their ability to do that, and of course neither is designed to block the pain or anxiety of death. So that’s just a show,” Zivot said.

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    However, as a former organic chemist who takes no position on the death penalty, Bloom said that he thinks Nevada’s new execution cocktail is humane.

    The diazepam will put people to sleep, “so they won’t feel the fentanyl hitting them, and then the muscle relaxant stops them from breathing,” he said. “This would legitimately be a humane lethal injection. Absolutely, no question, it would work, assuming they give enough fentanyl – and it doesn’t take much.”