May 20th, 2010 by David Kroll, Ph.D. in Better Health Network, Book Reviews, Opinion, Research
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This is going to be a quick welcome to Deborah Blum who has just moved her blog, Speakeasy Science, to ScienceBlogs.
Why quick?
Because I am only 22 pages away from finishing her latest book, The Poisoner’s Handbook: Murder and the Birth of Forensic Medicine in Jazz Age New York.
This engaging tale of the race of science and medicine against chemical poisonings for profit and punishment features the true story of NYC chief medical examiner Charles Norris and toxicologist Alexander Gettler.
Of course, the other actors are arsenic, methanol, chloroform, thallium, and radium, among others. In the teens through the mid-1930s, long before benchtop atomic absorption spectrophotometry and LC/MS instruments, Norris and Gettler devised methods to detect poisons in human tissues with high sensitivity. These advances led to the prosecution of some, the absolution of the wrongly-accused, and revealed that our own government poisoned citizens who dared to challenge Prohibition. Read more »
*This blog post was originally published at Terra Sigillata*
March 1st, 2010 by David Kroll, Ph.D. in Better Health Network, News
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A year ago we wrote about a death of a San Jose teenager from poisoning by hydrogen sulfide gas, or H2S. At the time, I had hypothesized that the death might have been from an attempt at synthesizing methamphetamine gone awry.
But while one can mistakenly generate hydrogen sulfide gas from improper meth synthesis, I soon learned that intentional suicides with H2S is an increasing US trend imported from Japan. One can easily mix commonly-available consumer products to generate the gas and high enough concentrations can cause death. The gas acts in a manner similar to cyanide by binding to the heme in cytochrome c oxidase and inhibiting electron transport and ATP production by oxidative phosphorylation in the mitochondria. (Interestingly, small amounts of H2S are made in the body and is being investigated as a neurotransmitter and biological modulator.) Read more »
*This blog post was originally published at Terra Sigillata*
December 1st, 2009 by Dr. Val Jones in Audio, Expert Interviews
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There has been a lot of media attention surrounding the safety of polycarbonate plastic products containing bisphenol A (BPA). BPA is found in polycarbonate, hard clear plastic products like eye glasses, bicycle helmets, and food containers, and also in epoxy resins that act as protective coatings on everything from food and beverage cans to steel pipes and car engines.
In the next week or so, the FDA is expected to provide a new analysis of the science behind BPA safety. To gain some insight into what the fuss is all about, Dr. Steve Novella and I interviewed Dr. Steven Hentges (Executive Director of the Polycarbonate/BPA Global Group of the American Chemistry Council) on a blogger briefing call.
You may listen to the entire conversation here (and please read on for my summary of the issues):
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September 5th, 2009 by David Kroll, Ph.D. in News
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The Boulder County coroner announced today that the July death of a Boulder teen was indeed due to opioid intoxication from preparation of a poppy pod tea.
Jeffrey Joseph Bohan, 19, of Boulder, was found dead in his friend’s Boulder home about 6 p.m. July 21 after drinking poppy-pod tea the night before with his brother, according to Boulder police.
Investigators suspected the Fairview High graduate, who was going to Colorado State University, died from the psychoactive tea, which is brewed from the plant that produces opium. But they couldn’t be sure until the Coroner’s Office confirmed Monday that Bohan’s cause of death was morphine overdose, and his manner of death was accident.
Here is also coverage from The Boulder Daily Camera.
This marks the second death in Boulder from young adults mixing up decoctions of seeds or pods from the poppy, Papaver somniferum. We reported in March on the death of CU-Boulder student, Alex McGuiggan, in March.
In a subsequent post, we expanded on a commenter’s story of his own efforts to raise awareness of the dangers of poppy seed tea following the death of his own son. Commenter Tom’s site can be viewed at Poppy Seed Tea Can Kill You (http://poppyseedtea.com).
Extracts from poppy pods can contain up to 10% morphine and 1-5% codeine together with several other benzomorphan compounds. Seeds themselves are intrinsically devoid of morphine but the drug can remain on the seeds in reasonable quantities simply from their processing. The Santa Clara County crime laboratory investigating the death of Tom’s son determined that a tea made with the same seeds he used contained 259 µg/mL of morphine.
Depending on the starting material, however, the extract may also contain thebaine, a natural intermediate used for semi-synthetic opioid synthesis that causes intense nausea, vomiting, and even convulsions.
*This blog post was originally published at Terra Sigillata*
July 9th, 2009 by DrRob in Better Health Network, True Stories
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My worst night as a doctor was during my residency. I was working the pediatric ICU and admitted a young teenager who had tried to kill herself. Well, she didn’t really try to kill herself; she took a handful of Tylenol (acetaminophen) because some other girls had teased her.
On that night I watched as she went from a frightened girl who carried on a conversation, through agitation and into coma, and finally to death by morning. We did everything we could to keep her alive, but without a liver there is no chance of survival.
Over ten years later, I was called to the emergency room for a girl who was nauseated and a little confused, with elevated liver tests. I told the ER doctor to check an acetaminophen level and, sadly, it was elevated. She too had taken a handful of acetaminophen at an earlier time. She too was lucid and scared at the start of the evening. The last I saw of her was on the next day before she was sent to a specialty hospital for a liver transplant. I got the call later that next day with the bad news: she died.
The saddest thing about both of these kids is that they both thought they were safe. The handful of pills was a gesture, not meant to harm themselves. They were like most people; they didn’t know that this medication that is ubiquitous and reportedly safe can be so deadly. But when they finally learned this, it was too late. They are both dead. Suicides? Technically, but not in reality.
For these children the problem was that symptoms of toxicity may not show up until it is too late. People often get nausea and vomiting with acute overdose, but if the treatment isn’t initiated within 8-10 hours, the risk of going to liver failure is high. Once enough time passes, it is rare that the person can be cured without liver transplant.
Acetaminophen overdose is the #1 cause of liver failure in the US. According to a Reuters article, there are 1600 cases of liver failure from this drug per year (2007). This is a huge number. In comparison consider that the cholesterol drug Cerivastatin (Baycol) was withdrawn from the market when there were 31 deaths from rhabdomyalysis (severe muscle break-down, which is far more common than liver failure in these drugs). These happened mainly when the drug was used in combination with another cholesterol drug.
Should the drug be pulled from the market? No, it is safe when used properly. The toxic dose is generally 10 times the therapeutic dose. My complaint is not that they have dangerous drugs available; ALL drugs should be considered dangerous. Aspirin, decongestants, anti-inflammatories, and even antacids can be toxic if taken in high dose. The problems with acetaminophen stem from several factors:
- Most people don’t realize the danger.
- There has been very little public education and no significant warning labels on the packages.
- The drug is often hidden in combination with other drugs, including prescription narcotics and over-the-counter cold medications. This means that a person can take excess medication without knowing it.
I would advocate putting warning labels on medications containing this drug. I am sure this doesn’t thrill the drug manufacturers, but the goal is not to make them happy. I have thought this since that terrible night during residency. If there was such a warning, perhaps she wouldn’t have died.
It seems a bit silly that this action by the FDA is coming after their pulling of children’s cough/cold medications. Those drugs have very small numbers of true harmful overdoses. The reason they were pulled was probably more that they didn’t do anything over the fact that they were dangerous. Acetaminophen, on the other hand, can be deadly.
Just ask the parents of my two patients.
*This blog post was originally published at Musings of a Distractible Mind*
