In a previous post I looked at the use of poison for state-sponsored assassination in the recent past. In the period since the assassination attempt on Khalid Mishal by Israeli agents in 1997 I have not found any other reports of the use of fentanyl for murder. While its lethal effect on people who have used it as a heroin substitute has been notorious, I discovered another even more disturbing application of the drug.
Fentanyl (N-phenyl-N-(1-(2-phenylethyl)4-piperidinyl)propanamide) is a potent synthetic opioid agent widely used for surgical analgesia and sedation. It is 200 times more potent than morphine. In therapeutic use fentanyl is quickly absorbed through the skin and is frequently applied as a skin patch. There has been research into the use of this drug in spray format.
Although prodigiously useful in the operating room, fentanyl has toxic cousins that deliver a lot more than freedom from pain. Nonpharmaceutical fentanyl use can be deadly. According to a 2008 MMWR report 1,013 deaths in six jurisdictions were attributed to fentanyl abuse in a two-year period, making this the largest such epidemic ever reported. Recent data on illicit fentanyl and its analogues indicate that these compounds are becoming increasingly popular on the drug market. The street will sell you a pocketful of sweet dreams with many aliases: China White, Synthetic Heroin, Mexican Brown, Persian White, Apache, China Girl, Dance Fever, Friend, Goodfella, Jackpot, Murder 8, TNT, and Tango & Cash. All of these potentially lethal hits make morphine look like child’s play.
But beyond its common use as a street drug, fentanyl — or, more accurately, powerful variants of the drug — is being studied by a number of governments for official use as a biochemical weapon. For example, a fentanyl derivative was used to end the Moscow theatre hostage crisis in 2002, in which many hostages died from accidental overdoses of the narcotic. [1,2]
It was this act of terrorism that first brought the issue of incapacitating biochemical weapons to widespread public attention. On October 23, 2002, a group of Chechen terrorists raided the Dubrovka theatre during a performance and took 800 people hostage. The 50-odd hostage takers were well armed and the women among them were wired with high explosives. They demanded the withdrawal of Russian troops from Chechnya and threatened to kill the hostages if their demand was not met. On the morning of October 26, Russian Special Forces troops disseminated a biochemical agent through the ventilation system, putting everyone who remained in the auditorium into a deep sleep. Approximately 30 minutes later, the troops stormed the building, killing the hostage takers and ending the crisis. 125 hostages died from the effects of the gas, and many more were severely injured. Several days later, the Russian Health Minister let it be known that the gas contained a derivative of fentanyl, but he did not reveal the specific nature of the agent used. According to Russian media reports the drug used was the formidable incapacitating agent Kolokol-1, whose active ingredient is secret but could possibly be the extraordinarily potent carfentanil or 3-Methylfentanyl. Sprayed into the air as an anesthetic gas, it takes effect very quickly, within one to three seconds, reportedly rendering its victims unconscious for two to six hours.

Since 1992 proponents of so-called “non-lethal weapons” have been attempting to loosen the constraints imposed by the Chemical Weapons Convention (CWC) on the weaponization of other forms of toxicity, such as riot control agents (RCAs). In a process of creeping legitimization, several countries now appear to be pursuing more lethal forms of incapacitating biochemical weapons.
The process has been one of not only “public diplomacy” and other more hidden pressures for exemption, but also one of national legislation. In the United States the “Ensign Amendment” of the 2006 National Defense Authorization Act asserts that “riot control agents are not chemical weapons.” No other state that is party to the CWC has adopted such a position, nor even commented publicly on what the United States has done. At the same time, the failure to amend the the 1993 Chemical Weapons Convention to prohibit the growing acceptance of RCAs demonstrates the varying levels of ignorance, incompetence, heedlessness, short-termism and conflicting political interests among the world’s governments. A situation in which some types of toxic weapon are tolerated but others are not is certain to be unstable.
Let us hope that saner views will prevail now that the Bush years are over. Otherwise a toxic chemical attack could be coming to a theatre near you.
References
1. Geoghegan J, Tong JL. Chemical warfare agents. Continuing Education in Anaesthesia, Critical Care and Pain. 2006 1 Dec ;6(6):230-234
2. Pearson A. Incapacitating biochemical weapons: science, technology, and policy for the 21st century. Nonproliferation review. 2006 July;13(2):151-188.
3. Perry Robinson JP. Difficulties facing the Chemical Weapons Convention. International affairs. 2008;84(2):223-239.
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