Deadly Consequences: Police-Midazolam Cocktail Claims Lives in California

At least 16 individuals lost their lives in California over a period of ten years following encounters with law enforcement that involved physical force and subsequent sedation by emergency personnel administering midazolam, according to an investigation spearheaded by The Associated Press (AP). In two recent cases, this occurred during restraint procedures carried out by the Richmond Police Department. Other locations where such incidents were documented include Los Angeles, San Diego, Orange County, and San Bernardino County.
While ketamine has drawn criticism in other states regarding its use as a sedative, AP’s investigation found that California paramedics almost always employed midazolam (Versed) during these encounters outside of hospitals. The deaths were part of more than 1,000 documented by the AP across the United States between 2012 and 2021 involving individuals who died following interactions with police where force was applied or Tasers were employed; roughly half of all fatalities had medical officials attributing their demise to law enforcement’s use-of-force.
The investigation revealed that it is challenging for the AP to determine whether sedation played a role in many of the 94 deaths associated with these drugs, as few instances saw authorities examining the suitability and necessity of such treatments during police encounters; instead, attention often centered around policing procedures utilized by law enforcement officials while reviewing other substances consumed by victims.
Supporters maintain that sedatives like midazolam are employed to calm individuals who exhibit combative behavior as a result of drug use or psychotic episodes in order for them to receive medical treatment without putting front-line responders at risk; critics, however, argue that these medications’ administration during police encounters is too hazardous given the possibility they might be injected involuntarily.
California was among several states with a high number of sedation cases identified as part of the AP probe collaboratively done with PBS documentary producer FRONTLINE and The Howard Centers for Investigative Journalism, indicating that these drugs’ use is not confined to California alone. Two emergency room doctors in San Diego told the AP they had considered switching from midazolam to ketamine given its reported efficacy over their current drug of choice; however, negative media coverage concerning this medication and misuse incidents in Colorado stalled such efforts.
Eric Jaeger – an expert on EMS (emergency medical services) education in New Hampshire who has studied the issue at length and advocates for additional safety measures and training – stated that sedation’s risks during behavioral emergencies transcend any specific drug, given its potential to cause respiratory depression when combined with police restraint tactics or alcohol/certain drugs. As more data on these matters become available, we recognize that they can pose a significant danger regardless of the type of medication used,” he added.
Sedatives were frequently administered as treatments for “excited delirium” – an agitated condition linked to drug use and mental illness; medical bodies have lately abandoned this diagnosis due to its disputable validity, including in postmortem evaluations (PMs). In 2023, California became the first state ever to prohibit excited delirium as a legitimate cause of death or explanation for fatalities during PM examinations.