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Suicide attempt using sodium nitrite ordered on the internet: Two case reports.

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Sodium nitrite is easily accessible online and causes methemoglobinemia, a dangerous condition impairing oxygen transport. Increased awareness and regulation are crucial to prevent rising suicide attempts via this chemical.

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Area of Science:

  • Toxicology
  • Emergency Medicine
  • Psychiatry

Background:

  • Sodium nitrite is a strong oxidizing agent causing methemoglobinemia, which impairs oxygen delivery.
  • Clinical effects include dysrhythmia, hypotension, and potential fatality.
  • Accidental sodium nitrite poisonings are known, but recent years show a rise in intentional self-poisoning.

Observation:

  • Two patients presented to the emergency department after ingesting sodium nitrite purchased online for suicide attempts.
  • Symptoms included dyspnea, cyanosis, and nausea.
  • Initial diagnosis of methemoglobinemia was confirmed by blood tests.

Findings:

  • Patients received methylene blue for methemoglobinemia.
  • Discharged after psychiatric evaluation and treatment for suicidal ideation.
  • Patients reported ease of access to sodium nitrite for self-harm purposes.

Implications:

  • Easy online access and shared information on sodium nitrite for suicide increase poisoning risks.
  • Physicians must maintain clinical suspicion for unexplained cyanosis and methemoglobinemia.
  • Urgent need for regulation of online sales of sodium nitrite to prevent further poisonings.