Midazolam is a sedative that is often used during colonoscopies and cardiac catheterizations, however; it has become an issue and debate surrounding executions in the United States. The sedative was invented by Armin Walser and is more powerful than Valium.

According to New York Times, Walser formulated midazolam in order to make people's lives easier and not to contribute to the death of the accused. The said drug was not created for the purpose of killing as stated by Walser who is not in favor of death penalty and execution.

Midazolam was used in at least six of United States execution chambers and has created secrecy, medical disputes, court challenges and political pressure. The latest issue involves the plan in Arkansas to execute eight inmates in 10 days next month. The execution plan is in a rush because Arkansas' stocks of the sedative drug will expire at the end of April. One considering factor on the rush plan is the hesitation of pharmaceutical companies to manufacture the said drug for execution purposes.

In Arkansas, midazolam is the first of the three drugs in state's lethal injection. The sedative was presented in United States Supreme Court claiming that it is a safe and effective substitute for execution drugs that was difficult to purchase. However, death penalty critics argue that the drug puts prisoners on unconstitutionally painful punishment because of its mechanism of execution.

As reported by Drugs, midazolam is a relatively short-acting benzodiazepine central nervous system (CNS) depressant. It has anxiolytic, hypnotic, anticonvulsant, muscle relaxant, and anterograde amnestic effects. Although the mechanism of action of the drug is not thoroughly established, it is believed that it mediates through the inhibitory neurotransmitter gamma-amino butyric acid (GABA). GABA is one of the major inhibitory neurotransmitters in the brain.

Midazolam was also used in an execution case in Oklahoma however, the issue has doomed state officials because of an improper installation of the intravenous line. Critics have created a fuss regarding the ineffectiveness of the drug's use during lethal injections.

Proponents acknowledge midazolam as the drug of choice for executions because abolitionists create limited options for the states. The opponents of the death execution put the states into a crisis situation wherein the choice of the sedative which is not optimal is "the only choice".