Increased prevalence of sodium nitrite suicides in South Australia

Abstract

Sodium nitrite (NaNO2) is a water-soluble, white-yellow coloured crystalline powder with broad industrial applications.1 In Australia, it has also been used to humanely control growth of feral pig populations.2 While several cases of accidental consumption have been reported in the literature, sodium nitrite has recently emerged as an increasingly popular method of pharmacological suicide. This method has been recommended in The Peaceful Pill Handbook3 with additional information and ‘suicide kits’ available online. Between 2000 and 2019, 10 cases of intentional sodium nitrite ingestion were identified from records at Forensic Science South Australia and the National Coronial Information System. All 10 cases occurred in the latter 3 years of the study period. All decedents had a history of depression or chronic illness and demonstrated characteristic post-mortem signs of methemoglobinaemia (blue-grey post-mortem hypostasis and dark brown discolouration of blood and internal organs). This study highlights a significant emerging public health issue. Awareness of emerging fatal substance abuse trends, clinical symptoms and post-mortem signs by health professionals and forensic pathologists is critical to effectively identifying these cases at presentation and autopsy. 1.Benowitz N. Nitrates and nitrites. In: Olsen K, editor. Poisoning and Drug Overdose. 7th ed. New York: McGraw Hill, 2018; 339–40.2.Shapiro L, Eason C, Bunt C, et al. Efficacy of encapsulated sodium nitrite as a new tool for feral pig management. J Pest Sci 2016; 89: 489–95.3.Nitschke P, Stewart F. The Peaceful Pill eHandbook. Blaine, WA: Exit International, 2018.