Lawmakers target chemical promoted online as ‘suicide kit’

If you are experiencing mental health-related distress or are worried about a loved one who may need crisis support, call or text 988 for the Suicide and Crisis Lifeline.

NEW BEDFORD — A chemical compound that has been promoted as a “suicide kit” on internet blogs and chat rooms was used in three Massachusetts suicides this year. Since 2016, the deadly chemical has been the method for 18 suicides in Massachusetts and more than 173 documented exposures nationwide. Niche corners of online persuasion have accelerated the trend that has largely been facilitated by the world’s largest marketplace: Amazon.

A prominent and beloved young artist in New Bedford died at St. Luke’s Hospital in April. The antidote she was administered, methylene blue, could not save her by the time she arrived at the emergency room. In Worcester, the February death of a young mother who worked as a teacher’s aide and cosmetologist came as a shock to friends and family, including her 3-year-old son. In Charlton, a family mourned the January passing of their 19-year-old son, who was enrolled at Worcester State University.

A New Bedford Light review of death certificates found that among the 18 deaths in Massachusetts due to the compound since 2016, the average age of those who died was 29 years and the youngest was 17. Two of these were residents of New Bedford, the artist and a librarian who immigrated from the Azores. Across the state, the deaths included a high school student, an attorney, a school custodian, two undergraduates, and more.

In significantly diluted form, the chemical substance can be found in fertilizers or as an anti-bacterial food preservative. But there are no household uses, especially for the 98% pure concentrated powder that was available on Amazon without any health labels attached — including from the manufacturers, sellers, or even the Food and Drug Administration.

In comments and reviews on Amazon’s webpage, cited in a lawsuit against the online retailer, grieving loved ones had begged to remove the product. For years, nothing happened. 

In April 2022, America’s Poison Centers put out an alert citing a 253% increase in self-poisoning related to the compound. In October of that year, Amazon announced it would only sell the chemical product to accounts registered as businesses. 

This did have a noticeable effect on reducing deaths. Still, in 2023, there have been at least 17 exposures to the deadly substance across the country so far.

Now as the online suicide blogs and the substances they're pushing have increased in notoriety, they've received the attention of lawmakers, including U.S. Rep. Lori Trahan of Massachusetts.

Trahan introduced legislation in June, with bipartisan sponsors in the Senate and House of Representatives, called the Youth Poisoning Protection Act. It would add the chemical to a list of banned substances which have an “unreasonable risk of injury” and cannot be sold to consumers. Only business-to-business sales would be legal.

“In high concentrations, sodium nitrite is as lethal as some of the most widely regulated poisons on the market. There’s simply no reason it should be available to the public, particularly with its promotion on online suicide forums,” said Trahan in a press release. 

The bipartisan cosponsors in both chambers include Republicans Mike Carey and Chris Stewart in the House and J.D. Vance in the Senate, as well as Democrats Katie Porter in the House and U.S. Sen. Tammy Duckworth. “I will continue working with my colleagues on both sides of the aisle to get it signed into law," said Trahan in a statement to The Light.

Carrie Goldberg and Naomi Leeds, attorneys at the New York City firm C.A. Goldberg, have brought three separate lawsuits against Amazon in California and Washington. They said that “a ton more” lawsuits could be coming from among their more than 50 clients, each representing a death related to an Amazon sale. There are other vendors, but Goldberg said the online retail giant has been responsible for the overwhelming majority of the 60 clients she represents connected to the substance.

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"In every state we have laws that you can’t aid or assist in suicide," Goldberg said. "But a chemical that is more lethal than cyanide has become popular and convenient and cheap for people to use for suicide." Continuing to sell this product, Goldberg added, "is homicidal behavior." 

Trahan said she may also try to regulate the blogs themselves: "My team and I have been working for the past year and a half to advance legislation that will give the Department of Justice the power necessary to target these forums that operate in the shadows of the internet."

A review by The Light found these blogs remain an active, but secretive forum. Even first-time visitors can sometimes find specific instructions on chemical dosages for suicides. Others come looking for relief or encouragement.

“I don’t want to die feeling sad and like a failure,” said one user recently. Another wrote a detailed list of preparations — like preparing a goodbye letter — and asked a forum to “Kindly advise on the dosage” of lethal chemicals. 

According to Goldberg, it will be more difficult to limit these websites' ability to share information than to limit the sale of the known, harmful substances.

Dr. Anita Mudan was one of the first doctors to publish in a medical journal about the compound in 2020 and also to make the connection to online blogs. While working as a medical toxicology fellow in San Francisco, Mudan noticed a spate of suicides. From two survivors she interviewed, Mudan learned about suicide kits and their prevalence in online forums. 

Mudan, who now works at New York-Presbyterian Hospital and teaches at Columbia University, said that part of the chemical’s increasing popularity in online forums was that an antidote exists: methylene blue. This supposedly offered a back door out, perhaps for the unsure blog-reader. But, in Mudan's experience and research, even small amounts of the compound are often too much for doctors to reverse. 

"Yes there is an antidote, but sometimes it isn't enough," Mudan said. "Even with all the interventions that we have in medicine, the damage has been done and we can’t reverse everything."

Once ingested, the compound changes the structure of blood cells, prohibiting the cardiovascular system from absorbing oxygen and delivering it to the body. Patients drown with heads above water as their skin becomes blue and blood turns a chocolatey brown. 

How much money has Amazon gained by selling these kits? According to one of the lawsuits Goldberg has filed, each purchase yielded Amazon $2.67 in revenue. The profit was likely pennies after shipping costs and overhead, she said.

The first client reached out to Goldberg in April 2021. "We were very naive about this issue," the attorney said. On behalf of this client, she says she contacted Amazon, and "the only goal was to notify them … we just wanted it off the shelf."

But within a month, Amazon had sent an official response through a lawyer, which Goldberg described as "a longer letter basically saying that Amazon is not liable for deaths from this." 

Within weeks of Goldberg receiving the letter from Amazon's lawyers, two more deaths occurred. Both of the grieving families have found their way to Goldberg and will be represented in lawsuits, she said.

A spokesperson for Amazon on Monday declined an email request for comment from The Light.

Email Colin Hogan at chogan@newbedfordlight.org

Roxanne Hepburn contributed reporting to this story. Email Roxanne at rhepburn@newbedfordlight.org 

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