Missouri Execution Could Kill Americans’ Access to Key Anesthetic

Pharmaceutical companies in the European Union are blocking off-label drugs for executions.

Next month the state of Missouri is scheduled to execute convicted murderer Allen Nicklasson by overdosing him with propofol, a German anesthetic. Late last week, the European Union announced that the Missouri execution could trigger export controls on the drug. European Union law prohibits export of products that can be used for capital punishment. If export controls kick in, they could block American hospitals’ ability to purchase propofol, which is used in as many as 80 percent of American medical procedures requiring general anethesia.

The drug’s producer, the pharmaceutical company Fresenius Kabi, announced that it has unilaterally blocked distribution of the drug to American correctional systems. However, the E.U. regulations would go further than the private company’s decision.

The company hasn’t taken a public position on capital punishment. But it has an enormous interest in avoiding a block on exports of its products to the U.S. medical system. American anesthesiologists use propofol in four out of every five procedures; here’s a useful summary from Medical Daily.

The Missouri Society of Anesthesiologists, which opposes the drug’s use in Missouri executions, claims 50 million procedures across the U.S. could be affected if the execution triggers export controls. From the organization’s statement, which reads a bit panicked:

If Missouri uses this anesthetic in a single lethal injection, over 15,000 hospitals, clinics, and health care facilities across the country are in risk of losing their supply of propofol in the operating room.

The European Union (EU) has strict regulations to require immediate export restrictions of any drug used for lethal injection. Missouri is scheduled to become the first ever state to use propofol for lethal injection in our country on October 23.

The case is the latest in an ungoing tug of war between American prisons and the European drugmakers they have come to depend on. The usual drug for executions had been pentobarbital, a sedative also produced in the E.U. The Guardian‘s Ed Pilkington noted a few days ago that pentobarbital supplies for executions had all but run out after that drug’s Danish producer stopped selling it to American prison systems. The Guardian report termed the shortage the result of a “de facto boycott” of U.S. correctional systems by European pharmaceutical companies. The propofol case moves that de facto threat in a more de jure direction. Fear of E.U. trade law sanctions could now prohibit European drugmakers from exporting some substances to the U.S. at all.

As famous chemicals go, propofol may ring a bell as one of the drugs that killed singer Michael Jackson. Should the Nicklasson execution go forward at the end of the month, a second propofol execution is scheduled for Missouri in November. It would be Joseph Paul Franklin, a neo Nazi, convicted of a shooting at a synagogue. He is also famous for shooting Urban League president Vernon Jordan and skin magazine editor Larry Flynt, who had published sexually explicit photos of an interracial couple.

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