The United States is among many countries that allow the chemical compound to be sold as a food preservative, and the federal Food and Drug Administration regulates its use for that purpose.
There is no systematic tracking of suicides involving the compound, but The Times identified dozens of people who had used it since 2018 in the United States, the United Kingdom, Italy, Canada and Australia. More than 300 members of the suicide website had announced intentions to use the compound to kill themselves.
A study of 47 cases of poisoning by the preservative reported to the National Poison Data System over a five-year period found that suicide attempts with it had been increasing since 2017. A 2020 article in The Journal of Emergency Medicine warned that because the compound “is readily accessible through online vendors, and is being circulated through various suicide forums,” emergency rooms might see more patients who have used it.
Dr. Kyle Pires, a resident emergency room physician at Yale University Hospital who treated a 28-year-old woman who had bought the compound on Amazon, wrote in the journal Clinical Toxicology about her death and the recent rise in suicides by this method. The article, published last May, said policymakers should be aware of the preservative’s use in suicides, and encouraged emergency rooms to stock doses of an antidote, methylene blue, that can prevent death if administered early.
In an interview, Dr. Pires said that businesses should be able to buy the preservative, but sales to individuals should be banned.
“There’s an argument that it’s a slippery slope to restrict sales of something that is legal just because some people are using it to kill themselves,” Dr. Pires said. But, he added, “this is a cost-benefit analysis of a small number of hobbyists using this chemical to cure meat at home versus these growing numbers of young people, including teenagers, using it to kill themselves. For me, it’s an easy calculation.”
In the United Kingdom, coroners for nearly two years have been highlighting suicides involving online purchases of the preservative and asking the government to take action. A cross-government group is working with businesses — including manufacturers and online suppliers of the preservative — to reduce access and end some sales to individuals, according to a spokeswoman for the government’s Department of Health and Social Care. The United Kingdom already requires sellers to inform law enforcement officials of any suspicious purchases of the compound, though it’s unclear how often such reports are made.