While morphine is one of the most common analgesics used in medicine, other prescribed opioid drugs include hydromorphone, oxycodone and fentanyl. There is also a number of illegal opioids such as heroin and carfentanil. For use as a DIY end of life strategy, the easy administration of a single dose of the drug should reliably bring about a peaceful death. Yet the opiates each have properties that make them difficult drugs to use for this purpose.
Greek god Morpheus (god of dreams) with Iris
The Dual Problems of Sensitivity & Tolerance
The biggest problem associated with taking opioids to end life is predicting the effect of a particular dose. There is remarkable individual variability in sensitivity to these drugs within the normal population. People who are similar physically (eg. same height, weight, sex etc.) can have a vastly different response to the administration of the same dose of an opioid.
A small opioid dose may have almost no effect on one person, while that same dose could kill another person. Predicting the effect of the drug on an individual is difficult. When these drugs are used clinically to control pain and where an accidental death would be disastrous, the rule of thumb has always been to ‘start low and go slow’ until the individual’s sensitivity to the particular opioid has been established.