For Nevada’s first execution in more than a decade, state officials are turning to a never-before-tried combination of drugs, including a powerful painkiller that is fueling much of the nation’s opioid epidemic and a paralyzing drug that could mask any signs of trouble.
If the state’s highest court approves the plan and it works without complications, the system could offer an alternative execution method to other states seeking hard-to-obtain drugs for lethal injections. But the drugs also carry serious risks, and their use in an execution could invite new shortages of medication used for surgery and pain relief.
“It’s an experiment,” said Deborah Denno, a law professor and lethal injection expert at Fordham University in New York. “It sounds like a high-risk venture. Even trained people can’t claim to know what’s going to happen.”
None of the drugs — the sedative diazepam, the painkiller fentanyl and the paralytic cisatracurium — has been used in executions before.
Fentanyl has been at the center of the opioid crisis, with thousands of overdose deaths blamed on heroin laced with the synthetic opioid that often enters the U.S. from China and other countries. A fentanyl overdose killed Prince in 2016.
An execution using diazepam, commonly known as Valium, along with high doses of fentanyl, could risk complications such as vomiting, which is common in people experiencing fentanyl overdoses.
“It could be ugly,” said Jonathan Groner, a Columbus, Ohio, surgeon and lethal injection expert.
Using fentanyl for an execution could also spur drugmakers in the U.S. and abroad to pull the legal version of the drug from the market in protest, Groner said, which could cut the supply for other legitimate purposes.
A similar scenario occurred several years ago after Missouri announced a plan to become the first state to put an inmate to death using propofol, the powerful anesthetic blamed for the 2009 death of Michael Jackson. An outcry from the medical community helped scrap that approach.
Using a paralytic as a third drug could prevent body movements and disguise any suffering the condemned inmate might experience, Groner said.
The paralytic agent “pretty much ensures that if an execution is botched, we won’t know it,” he said.
The Nevada judge who delayed the execution of Scott Raymond Dozier cited concerns about “masking” pain and suffering when she balked at letting Nevada prison officials use cisatracurium.
Clark County District Court Judge…