Sodium Nitrite

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“All-meat regimen cured my depression.”

― Canadian psychologist and professor of psychology Jordan Bernt Peterson

Simple step-by-step instructions[edit]

1. Take 30 mg metoclopramide (another editor suggested 800 mg of Tagamet, as well)

2. Wait 1 hour

3. Dissolve 15 – 25 g sodium nitrite in 50 – 100 ml water

4. Drink the solution and lay down

How it works[edit]

Sodium nitrite, NaNO2, is a catalyst that converts the hemoglobin in blood into methemoglobin (MetHB), a molecule with a much higher affinity with oxygen. This conversion occurs when the ferrous ions in the regular hemoglobin are converted into ferric ones. Since its affinity is so high, methemoglobin does not let the oxygen flow into other tissues that need it thus depriving them of oxygen—even while you're breathing. Death, then, occurs due to hypoxia. (Bailey, Feelisch, Horowitz, Frenneaux & Madhani, 2014) illustrated the nitrite-derived NO signalling[1|2]. Sodium nitrite poisoning symptoms include nausea, vertigo, vomiting, headaches.

As for the physical symptoms, the color of blood, skin, fingertips, and lips will change. The blood will take a bluish chocolate brown color, and the tips of fingers, toes, and nose will turn slightly blue from cyanosis. [[1]]

Sodium nitrite[edit]

The main compound for this method, sodium nitrite is easy enough to find; some generous members shared their success in doing so [2] [3] [4] [5]. Currently, sodium nitrite is sold without regulation and can be bought from Amazon, eBay, or any local lab supplier. Please make sure that its purity is >95% and you're purchasing sodium nitrite (NaNO2)—not sodium nitrate (NaNO3). Should you not find it by looking up "sodium nitrite", look for "NaNO2", "NNaO2", or "Filmerine". 100 grams cost €8 – 10. This chemical is completely legal to own and is used during curation of meats to preserve their color. About 5% of our nitrite intake comes from cured meats such as bacon, hot dogs, hams, pastrami, corned beef, cured sausages, and cured fish. Sodium nitrite is described as white to yellowish powder/crystals and very soluble in water, with a slightly salty taste.

As long as it's possible to purchase sodium nitrite with >95% purity, avoid curing salts(for example, Pink curing salt #1 [1|2] or Pink curing salt #2 [1|2]) because they mostly contain table salt. While Prague powder #1 or #2 is only composed of 6.75% sodium nitrite, it's possible to peacefully commit suicide using 250 grams Prague powder. There will be 15.625 grams sodium nitrite in Prague powder #1 and and, in Prague powder #2, an additional 10 grams sodium nitrate, which will reduce to nitrite in human body. The unpleasant symptoms of sodium chloride toxicity develope within hours after the ingestion, while the unconsciousness due to sodium nitrite happens only within minutes after the ingestion.

The recommended dose from the PPH is 25 grams; however, the dose was increased on different issues, from only 5, to 12, to 15. The PPH has increased the dose to 25 grams in 14 September 2019 revision. The dose has remained 25 grams up to 14 November 2019 revision.

• 15 – 25 g

Sodium nitrite density is 2.168 g/cm3. Assuming that one standard teaspoon holds about 5 cm3, the required dose is eqivalant to 2 teaspoons of sodium nitrite.

Antiemetics[edit]

In order to prevent vomiting in suicide attempts, dopamine blockers are used [[6]]. The reasons for doing so is that the mechanism by which sodium nitrite induce nausea and vomiting are iron overload as well as NO interaction with dopaminergic neurotransmitters (Liu, Liang & Soong, 2019). One of the well-used dopamine blocker antiemetics is metoclopramide. Metoclopramide goes by many commercial names—namely, Reglan, Plasil, and Primperan. The disadvantages of metoclopramide are (1) having gastro-prokinetic properties, which empties the acidic stomach form sodium nitrite; and (2) extrapyramidal symptoms, which are extremely rare in low doses.

Purchasing antiemetic will also be the bulk of the money spent during this method. It's possible to successfully commit suicide without antiemetics (Hideyuki Nushida, 2014); nevertheless, it's possible to vomit hence fail (Joosen, Stolk & Henry, 2014).

Stat dose (60 minutes before SN intake)

• 3 * 10 mg metoclopramide

or

Ahead regimen (48 hours before SN intake)

• 10 mg metoclopramide every 8 hours (i.e., 3 times per day) starting 48 hours in advance

Because the peak plasma concentration happens at about 1 – 2 hours after a single oral dose of metoclopramide, there's no significant advantage of going through the ahead regimen.

Another choice of antiemetic is domperidone. Domperidone too goes by many commercial names—namely, Motilium. Considering the affinity values (Ki) at the D2 receptor (Tonini et al., 2004), the interchangeable dose of domperidone is 10 – 15 mg, reaches at peak plasma level 30 minutes following oral administration (Heykants et al., 1981).

Stat dose (30 minutes before SN intake)

• 2 * 10 mg domperidone

If you lost hope in finding metoclopramide or domperidone, there're still other choices—including D2-receptor antagonist antiemetic (e.g., prochlorperazine, droperidol, bromopride, promethazine), D2-receptor antagonist antipsychotics (e.g., olanzapine, clozapine, haloperidol), or even D2-receptor antagonist antidepressant (e.g. amitriptyline).

Acid Regulators[edit]

The PPH recommends decreasing your stomach's fluid volume to make the sodium nitrite absorbed more quickly. This can be accomplished with drugs like Zantac or Tagamet. The recommended dose in the PPH is 800mg Tagamet, which is equivalent to 3 – 4 * 75 mg Zantac.

Stat dose (30 - 45 minutes before SN intake)

• 800 mg of Tagamet (cimetidine)

or

• 3 * 75 mg Zantac (ranitidine)

The PPH previously recommended sodium bicarbonate as absorption accelerator. The PPH argued that sodium bicarbonate would raise the stomach's fluid pH. The raise in stomach's fluid pH hindered loss of consciousness in some patients—although it was expected, given that the blood pressure—lowering effect of orally ingested nitrite was abolished when test persons were pretreated with a proton pump inhibitor (PPI) to raise gastric pH (Montenegro et al., 2016). Similar to sodium bicarbonate, the blood pressure-lowering effect of orally ingested nitrite is abolished by a proton pump inhibitor (Piknova & Schechter, 2017). Since the release of the October 2018 revision, the PPH suggests Tagamet (instead of sodium bicarbonate) and has misguidedly argued "this effect is not related to gastric pH, but rather to the production rate of acid." While the PPH still incorrectly recommends using H2 receptor antagonists, such as cimetidine and ranitidine, not using them will result in a more peaceful death, owing to formation of nitric oxide gas in acidic (Malko, Kucernak & Lopes, 2016) gastric environment, as shown in pathway A[1|2].

Required time[edit]

The PPH claims that, during a monitored suicide with SN, the patient was unconscious at 12 minutes and dead by 42. A further case—Shawn Shatto, a member of the site—according to her mother, Jackie Bieber, died within ~5 hours[1|2|3|4], given that she took it at 11:47 a.m. However, the Biebers had implied before on a radio program at the Messick's perfomace studio, A Parent’s Story-Shawn Shatto, that Jackie had found Shawn within ~3 hours. Jackie, working down the hall, had not heard any noises coming from Shawn's room. Nor did the Biebers find any vomits. Moreoever, (Workum, Bisschops & van den Berg, 2019) reported two case reports: a 27-year-old man who was passed away 2 hours after the ingestion, despite rescue attempt—and a 31-year-old man who survived due to being found 15 minutes after the ingestion. Under the compulsion of anti-choicers, the authors added, "because of the unbearable symptoms associated with suffocation, sodium nitrite is an extremely inappropriate suicide agent," omitting the fact that the loss of consciousness occurs in a couple of minutes. It's worth mentioning that the mechanism of death is suffocation in many suicide methods—pentobarbitals, phenobarbitals, opioids, cyanide, chlorine, inert gases, carbon monoxide, and hanging, to name but a few. In any case, a 6-hour time window is more than enough to complete the task.

Consequences of failure[edit]

The effects of this poisoning are completely reversible, and having any permanent damages is highly unlikely, should you be "saved" during your attempt. Because methemoglobin creation is a natural process in human body, G6PD enzyme works to transform it back into hemoglobin again. This process can be facilitated by using the antidote for sodium nitrite, methylene blue. There have been cases of people recovering from sodium nitrite poisoning without any side effects (Katabami, Hayakawa & Gando, 2016). Even in those cases that the ambulance was called soon enough, surviving was not certain (Harvey, Cave & Chanwai, 2010) The reason for such low chance of injury is the fact that the brain is protected during low O2 conditions by nitric oxide (Kolluru, Prasai, Kaskas, Letchuman & Pattillo, 2016). Release of NO locally results in a proportional increase in cerebral blood flow that compensates for the reduction in blood oxygen carrying capacity (Hare, Tsui, Crawford & Patel, 2013).

Success stories on the news[edit]

A fifty-year-old woman took 20 grams sodium nitrite diluted in 200 ml water. [[7]] Anothers cases [[8]] [[9]] [[10]]

Where to find[edit]

APC Pure took a pro-life stance and wished their link to be removed. The rest of retailers that have been listed on Suicide Wiki have been threatened or intimidated by anti-choicers to stop supplying the resources. In an attempt to suppress the freedom of choice, the UK government regulated sodium nitrite, putting it under the category of reportable substances: the purchaser is not required to hold any licence to acquire it, but the supplier has the duty to report to police any transaction they consider to be in any way suspicious. Given the ongoing restrictions on choices and unlimited shelf-life of supplies, it's wise to acquire the supplies—lest they become scarce.

Sodium Nitrite (Europe)

https://apcpure.com/product/sodium_nitrite_99_5

Antiemetic (Europe)

Primperan (metoclopramide)

https://www.ebay.co.uk/usr/lepou88https://www.ebay.co.uk/str/fredasstore

Acid Regulators (Europe)

Zantac (ranitidine)

https://www.ebay.com/usr/24hourchemist


Sodium Nitrite (North America)

https://www.ebay.com/str/manofohmchemicals

Antiemetic (North America)

Primperan (metoclopramide)

https://www.ebay.com/usr/ahsil0

Acid Regulators (North America)

Tagamet (cimetidine)

https://www.ebay.com/str/mrmedical

Zantac (ranitidine)

https://www.ebay.com/str/todatalahttps://www.ebay.co.uk/str/first4health


Sodium Nitrite (Oceania)

https://www.ebay.com.au/str/thehomechemistryshophttps://www.ebay.com.au/usr/leanne1906

Antiemetic (Oceania)

Anagraine (metoclopramide)

https://www.ebay.com.au/usr/mydiscountchemist

Acid Regulators (Oceania)

Zantac (ranitidine)

https://www.ebay.com.au/usr/mydiscountchemisthttps://www.ebay.com.au/usr/ravenswoodpharmacy

References[edit]

  • Bailey, J., Feelisch, M., Horowitz, J., Frenneaux, M., & Madhani, M. (2014). Pharmacology and therapeutic role of inorganic nitrite and nitrate in vasodilatation. Pharmacology & Therapeutics, 144(3), 303-320. doi: 10.1016/j.pharmthera.2014.06.009 [PubMed: 24992304] [Full Text]
  • Liu, C., Liang, M., & Soong, T. (2019). Nitric Oxide, Iron and Neurodegeneration. Frontiers In Neuroscience, 13. doi: 10.3389/fnins.2019.00114 [PMC: 6388708]
  • Hideyuki Nushida, M. (2014). An Autopsy Case of Fatal Methemoglobinemia due to Ingestion of Sodium Nitrite. Journal Of Forensic Research, 06(01). doi: 10.4172/2157-7145.1000262 [Full Text]
  • Joosen, D., Stolk, L., & Henry, R. (2014). A non-fatal intoxication with a high-dose sodium nitrate. Case Reports, 2014(may30 2), bcr2014204825-bcr2014204825. doi: 10.1136/bcr-2014-204825 [PMC: 4039755]
  • Tonini, M., Cipollina, L., Poluzzi, E., Crema, F., Corazza, G., & De Ponti, F. (2004). Clinical implications of enteric and central D2 receptor blockade by antidopaminergic gastrointestinal prokinetics. Alimentary Pharmacology And Therapeutics, 19(4), 379-390. doi: 10.1111/j.1365-2036.2004.01867.x [PubMed: 14871277]
  • Heykants, J., Hendriks, R., Meuldermans, W., Michiels, M., Scheygrond, H., & Reyntjens, H. (1981). On the pharmacokinetics of domperidone in animals and man IV. The pharmacokinetics of intravenous domperidone and its bioavailability in man following intramuscular, oral and rectal administration. European Journal Of Drug Metabolism And Pharmacokinetics, 6(1), 61-70. doi: 10.1007/bf03189516 [PubMed: 7250152]
  • Montenegro, M., Sundqvist, M., Larsen, F., Zhuge, Z., Carlström, M., Weitzberg, E., & Lundberg, J. (2016). The Blood Pressure-Lowering Effect of Orally Ingested Nitrite Is Abolished by a Proton Pump Inhibitor. Free Radical Biology And Medicine, 100, S146. doi: 10.1016/j.freeradbiomed.2016.10.385 [PubMed: 27802417]
  • Piknova, B., & Schechter, A. (2017). Acid Test for Nitrite Pharmacology. Hypertension, 69(1), 13-14. doi: 10.1161/hypertensionaha.116.08222 [PMC: 5145751]
  • Malko, D., Kucernak, A., & Lopes, T. (2016). Performance of Fe–N/C Oxygen Reduction Electrocatalysts toward NO2–, NO, and NH2OH Electroreduction: From Fundamental Insights into the Active Center to a New Method for Environmental Nitrite Destruction. Journal Of The American Chemical Society, 138(49), 16056-16068. doi: 10.1021/jacs.6b09622 [Full Text]
  • Workum, J., Bisschops, L., & van den Berg, M. (2019). [Autointoxication with ’suicide powder’]. Ned Tijdschr Geneeskd, 163 pii: D3369 [PubMed: 30875162] [Full Text: 1|2|3|4]
  • Katabami, K., Hayakawa, M., & Gando, S. (2016). Severe Methemoglobinemia due to Sodium Nitrite Poisoning. Case Reports In Emergency Medicine, 2016, 1-3. doi: 10.1155/2016/9013816 [PMC: 4987464]
  • Harvey, M., Cave, G., & Chanwai, G. (2010). Fatal methaemoglobinaemia induced by self-poisoning with sodium nitrite. Emergency Medicine Australasia, 22(5), 463-465. doi: 10.1111/j.1742-6723.2010.01335.x [PubMed: 21040485] [Full Text: 1|2|3|4]
  • Kolluru, G., Prasai, P., Kaskas, A., Letchuman, V., & Pattillo, C. (2016). Oxygen tension, H2S, and NO bioavailability: is there an interaction?. Journal Of Applied Physiology, 120(2), 263-270. doi: 10.1152/japplphysiol.00365.2015 [Full Text]
  • Hare, G., Tsui, A., Crawford, J., & Patel, R. (2013). Is methemoglobin an inert bystander, biomarker or a mediator of oxidative stress—The example of anemia?. Redox Biology, 1(1), 65-69. doi: 10.1016/j.redox.2012.12.003 [PMC: 3757671]