{"id":796420,"date":"2026-10-08T23:12:13","date_gmt":"2026-10-08T23:12:13","guid":{"rendered":"https:\/\/www.newsbeep.com\/uk\/796420\/"},"modified":"2026-10-08T23:12:13","modified_gmt":"2026-10-08T23:12:13","slug":"what-we-know-about-pentobarbital-the-drug-of-choice-in-tennessees-execution-protocol","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/uk\/796420\/","title":{"rendered":"What we know about pentobarbital, the drug of choice in Tennessee’s execution protocol"},"content":{"rendered":"

On paper, Tennessee’s death penalty protocol looks neat.<\/p>\n

At 10am on the day of the execution, four syringes are prepared inside the lethal injection room.<\/p>\n

Second Pike execution attempt ‘uncharted territory’<\/a><\/p>\n

As Christa Pike wakes in hospital following two doses of lethal injection drug, experts say Tennessee could still try to execute her.<\/p>\n

Two of them contain saline solution. The other two contain pentobarbital, a lethal sedative most commonly used to euthanase animals.<\/p>\n

The inmate is restrained on a gurney, and a team of at least two physicians establishes intravenous lines and a catheter.<\/p>\n

The camera turns on, the curtain goes up. By 10:10am the drug has been administered and a five-minute wait begins.<\/p>\n

If the inmate is still alive, the process repeats.<\/p>\n

There is no protocol for what happens if the inmate does not die.<\/p>\n

There is also no mention of what death by pentobarbital overdose can look like.<\/p>\n

The ‘humane’ method of execution<\/p>\n

By the time Christa Pike entered the execution chamber on September 30, pentobarbital had been the drug of choice for multiple death penalty states for more than a decade.<\/p>\n

It is a type of barbiturate, or depressant, that slows brain activity and sedates the receiver.<\/p>\n

To many Australians it’s better known as Nembutal, a euthanasia drug, referred to by advocates as the “peaceful pill”<\/a>.<\/p>\n

But its effects on the central nervous system are severe, according to Andrew Crowe, an associate professor in pharmacology at Curtin University.<\/p>\n

“In the central nervous system, there are \u2026 neurons that are excited, [and] then we have inhibitory neurons,” he told the ABC.<\/p>\n

How one man’s method became the death penalty standard<\/a><\/p>\n

On this day in history, the US carried out its first execution by lethal injection \u2014 a method thought up by one doctor.\u00a0<\/p>\n

“They try to tell the other neurons: ‘I’ve had enough of that, let’s just suppress and go to sleep.’<\/p>\n

“What the barbiturates do is tell the inhibitory neurons they can work a lot better, they can work longer.”\u00a0<\/p>\n

The drug inhibits the respiratory sensors and cardiovascular sensors, according to Jonathan Brett, a clinical toxicologist at the NSW Poisons Centre and professor at UNSW.<\/p>\n

“You essentially gradually stop breathing and then your blood pressure drops, your heart rate drops and eventually your heart stops as well,” he said.<\/p>\n

Many states began using lethal injection as a “more humane” alternative to other execution methods, according to the Death Penalty Information Center.<\/p>\n

In a medical scenario, the safe dose to sedate a human being is a blood concentration of 1\u20135 micrograms per millilitre, with a recommended intravenous dose of 100 milligrams for an adult.<\/p>\n

A toxic dose is about 1 gram of the drug, or 1,000 milligrams, according to the US Food and Drug Administration.<\/p>\n

Tennessee’s execution protocol calls for two syringes containing a total of 5 grams of pentobarbital.<\/p>\n

But the drug will only dissolve in an extremely strong solution, according to Dr Crowe.<\/p>\n

“As soon as we start moving to the execution level \u2026 it has to be injected, and therefore it must be in a solution,” he said.<\/p>\n

“The issue with the pain, it’s not the drug itself, it’s what it’s in.”Tissues ‘annihilated’, risk of ‘drowning’ while alive<\/p>\n

The human body works in a very narrow pH range, close to neutral, or water.<\/p>\n

Pentobarbital, on the other hand, is a highly alkaline substance with a pH closer to household detergents or cleaners, according to a federal review of lethal injection protocol.<\/p>\n

The US Justice Department review found that the drug would only dissolve in either a highly acidic or a highly basic (alkaline) solution.<\/p>\n

That same review found using pentobarbital ran the risk of “extreme pain upon the initial injection”, and something called “flash pulmonary oedema”.<\/p>\n

“In essence, the drug’s pH level is so high [basic] that it damages the blood vessels in the lungs and causes them to fill with fluid, leading to the feeling of drowning,” the review said.<\/p>\n

In Christa Pike’s case, experts have speculated that the drug did not enter the vein, but the tissue surrounding it.<\/p>\n

\"a<\/p>\n

Death row inmate Christa Pike. (Reuters: J Miles Cary\/Knoxville News Sentinel\/USA Today Network)<\/p>\n

If that happened, Dr Crowe told the ABC, it would mean the pentobarbital and the solution it was mixed into did not have the chance to dilute into the bloodstream.<\/p>\n

“And so it stays there, and unfortunately your body tends to be quite soluble in pH 11, and so it starts dissolving your tissues and dissolving your blood vessels,” he said.<\/p>\n

“Any pain receptors that are there before they get annihilated are going to be sending some very strong signals to the brain.<\/p>\n

“And so those pain receptors are triggering like crazy and causing excruciating pain, while the tissue itself is going to end up dying where that base has been injected.”<\/p>\n

Pike believed to be brain dead before waking, lawyers say<\/p>\n

Pike, 50, had been waiting on death row since 1996 after being convicted of the murder of a classmate, Colleen Slemmer, when she was 18.<\/p>\n

She received two doses of pentobarbital on September 30 before being rushed to a nearby hospital from a maximum security prison in Nashville.<\/p>\n

Pike is the only person on record to receive the lethal injection drug and survive, according to the Death Penalty Information Center.<\/p>\n

Overnight her legal representatives told the media they had believed her to be brain dead and on life support on Monday.<\/p>\n

\"two<\/p>\n

Christa Pike’s attorney’s Luke Ihnen, center, and Randy Spivey, left, held a news conference outside court on Wednesday, local time.\u00a0 (AP Photo: George Walker IV)<\/p>\n

By Tuesday, she was awake and talking, lawyer Randy Spivey said.<\/p>\n

“What we do know is that Christa has a long road to recovery,” he said.<\/p>\n

“She has a blood clot in one of her arms, she has pneumonia, she is not able to swallow yet, so she has not eaten.<\/p>\n

“She cannot move either of her arms, both of her arms are tremendously swollen, and we do not know what, if any, function she will regain in her arms.”<\/p>\n

The lawyers did not give details about Pike’s long-term recovery prospects. A photo of her arm was reportedly leaked to media outlets following her hospitalisation, but deemed too graphic to be published.<\/p>\n

Teenage killer survives execution attempt<\/a><\/p>\n

Christa Pike was set to become the first woman executed in the US state of Tennessee in more than 200 years. Instead, she is fighting for life.<\/p>\n

The lethal injection method relies on a large concentration of the drug “very rapidly” entering the system, “so that the person isn’t necessarily aware and suffering”, Dr Brett said.<\/p>\n

“Obviously when the drug’s not in the vein, and it’s in the tissues \u2026 you get more gradual onset effects.<\/p>\n

“If it isn’t successful, you’ve had a period [of] decreased level of oxygen to the brain [and] it’s basically like having a big stroke \u2026 that can leave people very significantly disabled and requiring long-term care.”<\/p>\n

The state of Tennessee has not confirmed whether it will attempt to execute Pike again.<\/p>\n","protected":false},"excerpt":{"rendered":"On paper, Tennessee’s death penalty protocol looks neat. At 10am on the day of the execution, four syringes…\n","protected":false},"author":2,"featured_media":796421,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[42],"tags":[261852,261848,261849,176380,102,261850,6591,20032,261851,24960,56,54,55],"class_list":["post-796420","post","type-post","status-publish","format-standard","has-post-thumbnail","category-medication","tag-barbiturate","tag-christa-pike","tag-colleen-slemmer","tag-death-penalty","tag-health","tag-lethal-injection","tag-medication","tag-nashville","tag-pentobarbital","tag-tennessee","tag-uk","tag-united-kingdom","tag-unitedkingdom"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/796420","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/comments?post=796420"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/796420\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media\/796421"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media?parent=796420"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/categories?post=796420"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/tags?post=796420"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}