This piece first appeared on newstatesman.com.

Pentobarbital and sodium thiopental are anaesthetics, used around the world by doctors and vets on all kinds of patients in a variety of cases. They are also used to render prisoners unconscious in the ten U.S. states that use lethal injection to execute their condemned.

That is, as long as they can obtain the drug. Since pharmaceutical company Hospira stopped manufacturing sodium thiopental in early 2011, there hasn’t been a domestic producer of either drug within the U.S. American prisons rely on either one of the drugs as the first of the three used in the standard cocktail given to those due to be executed—the others being pancuronium bromide, which paralyses all of the muscles in the body, and potassium chloride, which stops the heart.

A couple of years later, and prisons have started to use up the stockpiles, bought from before production ceased. The result is the rise of new, untested drugs in execution cocktails. Here’s the Guardian from yesterday:

On Thursday, the state of Ohio is scheduled to inject Dennis McGuire, 53, with two drugs: first, the sedative midazolam; then, the painkiller hydromorphone. When it is over, McGuire, who was convicted of the 1989 rape and murder of Joy Stewart, will be dead—which is Ohio’s goal. But the procedure is untried and untested; the drugs that the state will employ have never been used in a death chamber. And experts have warned in legal proceedings that if the process goes wrong, McGuire will not just peacefully drift away, but will be awake, struggling and failing to pull enough air into his lungs, until the drug overdose that will kill him takes hold. "McGuire will experience the agony and terror of air hunger as he struggles to breathe for five minutes after defendants intravenously inject him with the execution drugs," his lawyers have said in court documents. But on Monday a federal judge in Columbus, Ohio, ruled that McGuire's execution could go ahead. Judge Gregory Frost found that there was insufficient evidence to show a substantial risk of severe pain for the condemned man and said that “Ohio is free to innovate and to evolve its procedures for administering capital punishment.” An Ohio state prosecutor, addressing the court, said: "You're not entitled to a pain-free execution.”

That last point is contentious—much of the motivation for making sure that executions are calm and painless is to avoid accusations that they might constitute a “cruel and unusual punishment,” as prohibited by the Eighth Amendment. Lethal injection is used specifically because it is seen as less painful than historical forms of execution, such as beheading, electrocution, or firing squad.

Yet the pretense of kindness relies on there being no struggle from the condemned prisoner. While there is no sure way of knowing the pain that someone experiences when getting the sodium thiopental/pancurium bromide/potassium chloride cocktail, there are several cases of prisoners appearing to be in severe pain. A typical lethal injection death should be completed within seven minutes. Often that time is exceeded, sometimes by one or two hours, and throughout the execution the prisoner can be twitching, shaking, blinking, or appearing to try to speak.