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The Peaceful Pill eHandbook Evolution of the Mixtures - DDMP to D-DMA
As clinicians in the US gained more experience in the use of the DDMP protocol, it became clear that further improvements could be made. The particular issue of concern was the small, but sig- nificant, number of people who took much longer than usual to die. The time to death from the ingestion of the DDMP mixture was documented as more than four hours. Yet the objective was a drug mix that would reliably cause death within 2 hours.
Several new strategies were tried. Initially, the morphine dose was increased from 10gm to 15gm. This mix was described as DDMP2. The number of outliers (those taking more than two hours to die) fell 66 percent. A more significant improvement was made by separating out the digoxin. This new development saw digoxin given as a separate dose some 30 minutes before the other three drugs (morphine, diazepam and propranolol) were taken. Thirty minutes was considered long enough for significant ab- sorption of the (physically-small) digitalis dose, before the much larger three-drug mix was consumed. Thirty minutes is also too short for the (unpleasant) symptoms of digitalis toxicity to de- velop. This strategy, referred to as D-DMP2, further reduced the number so-called outliers. The new mean time to death became 1.3 hours.
The relative effectiveness of DDMP@, D-DMP2 & D-DMA (courtesy of Dr Lonny Shavelson)