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February 14, 2012
Theft of deadly medicine prompts 'catastrophe' concerns
Published: 24 Feb 10 12:06 CET | Double click on a word to get a translation
Online: http://www.thelocal.se/25180/20100224/
The theft of an extremely strong sedative from a Lund hospital has caused alarm. On the street the drugs could have catastrophic consequences, according to the doctor who discovered the theft, local newspaper Sydsvenska Dagbladet reports.
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"We could not imagine that anyone outside of the hospital could be interested in the substance which was stolen," Doctor Bengt Roth at the intensive care clinic told the newspaper.
Roth, who discovered the missing bottles and informed the police, warned that the drug is very dangerous and said that it would be a "catastrophe" if the bottles found their way to the street, as even the smallest inhalation can cause a cessation of lung function.
The drug is used during surgery and normally only when the patient is connected to a respirator in the event of breathing problems.
The bottles of Ultiva branded remifentanil were stolen from a locked room requiring three pass card checks to enter.
Bengt Roth is at a loss to explain how somebody could have gained access and stated that the hospital logs shed no light on where the drugs have gone.
Malmö police confirmed to the newspaper that they were not aware of the drug being commonly in use among drug addicts.
"We urge those that have taken this not to use it, either themselves or on somebody else. One ampoule is enough to to stop the breathing of 50 men weighing 100 kilogrammes a piece - it is that strong," said Mikael Persson at Skåne police.
Peter Vinthagen Simpson
news@thelocal.se
+46 8 656 6518
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Yes because people are never interested in things which kill others, right?
In our hospital to remove narcotics requires a computer PIN so that every narcotic distribution can be traced to a particular doctor or nurse.
The strange thing about this theft is that Remi is not a great drug to abuse. The ideal drug to abuse would create a light plane of narcosis that lasted a long time. Remi is very potent but disappears within minutes. Makes no sense to me.
Remifentanil has to be injected intravenously. not practical for terrorism. Most drug thefts in hospital are done by drug users/abusers. The only thing that makes this event interesting is that Remi is not a drug that it commonly abused.
As for narcotic drugs as terror weapons, they already exist. Fentanyl, another very potent narcotic, can be aerosolized. It was originally designed for crowd control. The plan was to aerosolize fentanyl to sedate large crowds of people. Unfortunately, some in the crowd will die a narcotic death, so it is not a practical sedative agent.
If you recall, several years ago in Russia, Chechians held hostages in a theater. The Russians tried to sedate everyone with aerosolized Fentanyl. Unfortunately, some of the Chechians were undersedated and were able to fight back, while many hostages died from narcotic overdose. In large enough doses aerosolized fentanyl could be used as a terror weapon.
Seems like your question should be easy to answer but it is not. I will assume that the thief stole the largest vial of Remifentanyl(5mg). And, to make things easier I will assume that the person taking the Remi weighs 100kg.
Here is where things get difficult. The actions of Remi are related to many factors including the speed of administration and coincident use of other sedatives or central nervous system depressants. And, even in large doses, the actions of Remi will disappear in a few minutes, so it might be possible to survive a large overdose.
All of that said, 5 mcg/kg as a rapid intravenous bolus should be enough to kill a person. In our 100kg victim 5mcg/kg equals 0.5mg. A single vial of Remi would then be able to kill 10 people.