Pre-medication is a term used to describe the step(s) taken prior to the final act in order to ensure the efficacy of the process. Ending one’s life is an immensely significant act that is, invariably, associated with a highly-accentuated emotional state. Unchecked levels of anxiety can lead to confusion and significant errors in the carrying out of the final steps. To minimise this risk, and to make the process easier, pre-medication - in the form of drugs taken to calm, alleviate anxiety, and even sedate to the point of loss of consciousness - can be employed. For oral drugs, the risk of vomiting must be addressed. An effective anti-emetic becomes an essential pre-medication.
Potentiation is a term used to describe additional steps, measures, or drugs taken to enhance the efficacy of a proposed lethal act. In the case of the ingestion of drugs of uncertain purity, potentiation may be in the form of an additional drug that enhances the main drug’s lethality. For example, a drug that ends life by depressing respiration by causing cerebral hypoxia, can be enhanced with the inclusion of an additional sedative that further depresses respiration. Potentiation is also achieved by the addition of ‘cardiac-switch’ drugs that stop the heart will even if the depressed respiration has not lead to cerebral death.
There is some overlap in the two actions: this is to say that drugs that pre-medicate can also potentiate and vice versa. Potentiation also refers to the behaviour or action that enhances a drug’s efficacy, and not simply the ingestion of additional drugs. Examples might include fasting (prior to taking lethal drugs), or hyperventilating (as a way of increasing the nitrogen hypoxia from the use of an Exit bag).
When planning to use pre-medication or potentiating drugs, it is wise to experiment prior to their use. This will allow the determination of dose and uncover any unexpected sensitivity or adverse reactions.