The Russian government may claim its use of fentanyl, a heroin-like chemical 100 times more potent than morphine, was unavoidable in the circumstances of the Moscow hostage crisis.
But that does not excuse the authorities’ failure to prepare the emergency services for what their advisers must have warned them would be the hideous consequences.
Fentanyl, a painkiller rather than an anaesthetic, is widely used for cancer sufferers and during childbirth. It is so dangerous that those who make it at companies such as McFarlan Smith, a subsidiary of Johnson Matthey, in Edinburgh, wear full body protective clothing during the manufacturing process. A nurse is always on standby with a syringe of anti-opiate drugs in case of accidents. Even a tiny drop on the skin can cause unconsciousness.
It has a notoriously variable effect on patients. The dosage is difficult to judge because some people react much more violently than others: 100 milligrams is often enough to cause dizziness, sweating, nausea, vomiting and unconsciousness.
In larger quantities — doses that some people would inevitably receive if the drug was pumped into a large room in aerosol form — it would cause rapid death from respiratory failure.
Proper emergency treatment of the hostages would have involved putting them in the correct recovery position — not laid out flat or in seats — and washing them down to remove all traces of the drug from their skin.
In 1994, after a series of patient deaths from respiratory problems, the US food and drug administration issued a warning about a painkilling fentanyl skin patch, Duragesic, saying that it should not be used by under-12s or by under-18s weighing less than 110 pounds. The starting dose should not be higher than 25 micrograms per hour, they added, saying: ”The patch should be used only by patients who are … tolerant of opioid therapy.”
Fentanyl is relatively easy to make and adapts well to being distributed by aerosol. It is understood the UK chemical warfare establishment at Porton Down has carried out research into fentanyl aerosols.
Indeed, the substance is so easy for a chemistry student who has done a little research to make that some experts fear it could become a weapon to be used by, rather than against, terrorists. – Guardian Unlimited (c) Guardian Newspapers Limited 2001