Moscow hostage crisis chemical agent

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The chemical agent used in the Moscow theatre hostage crisis of 26 October 2002 has never been definitively revealed by the Russian authorities, though many possible identities have been speculated. An undisclosed incapacitating agent was used by the Russian authorities in order to subdue the Chechen terrorists who had taken control of a crowded theater.

Contents

Suspected agent

At the time, the agent was surmised to be some sort of surgical anesthetic or chemical weapon. Afterwards, there were numerous speculations about the identity of the substance that was used to end the siege. Several chemicals were proposed, such as the tranquilizer diazepam (Valium), the anticholinergic BZ, the highly potent oripavine-derived Bentley-series opioid etorphine, another highly potent opioid, such as a fentanyl or an analogue thereof, such as 3-methylfentanil, and the anaesthetic halothane. Foreign embassies in Moscow issued official requests for more information on the gas to aid in treatment, but were publicly ignored. While still refusing to identify the gas, on October 28, 2002, the Russian government informed the U.S. Embassy of some of the gas' effects. Based on this information and examinations of victims, doctors suggested that the compound might be a morphine derivative.

The Russian media reported the drug was Kolokol-1, either mefentanyl or α-methylfentanil dissolved in a halothane base.

It was reported that efforts to treat victims were complicated because the Russian government refused to inform doctors what type of gas had been used. In the records of the official investigation of the act, the agent is referred to as a certain "gaseous substance", in other cases it is referred to as an "unidentified chemical substance". [1]

Opioid version

Two days after the incident, on October 30, 2002, Russia responded to increasing domestic and international pressure with a statement on the unknown gas by Health Minister Yuri Shevchenko. [2] He said that the gas was a fentanyl derivative, [3] an extremely powerful opioid. Boris Grebenyuk, the All-Russia Disaster Relief Service chief, said the services used trimethyl phentanylum (3-methylfentanyl, a fentanyl analog that is about 1000 times more potent than morphine, which was manufactured and abused in the former Soviet Union); New Scientist pointed out that 3-methylfentanyl is not a gas but an aerosol. [4]

Clothing samples from British survivors of the attack showed the presence of the narcotics remifentanil and carfentanil. The same study detected norcarfentanil in another survivor's urine. [5] A German toxicology professor who examined several German hostages said that their blood and urine contained halothane, a once-common inhalation anaesthetic which is now seldom used in Western countries, and that it was likely the gas had additional components. [6] However, halothane has a strong odor (although often defined as "pleasant" by comparison with other anesthetic gases). Thus, by the time the whole theatre area would be filled with halothane to a concentration compatible with loss of consciousness (0.5–3%), it is likely that Chechens inside would have realized they were being attacked. Additionally, recovery of consciousness is rapid after the flow of gas is interrupted, unlike with high-dose fentanyl administration. Therefore, although halothane might have been a component in the aerosol, it was probably not a major component, [6] or perhaps it was a metabolite of another drug. Some of the later publications in medical journals assumed that Russian special forces used aerosol of a fentanyl derivative, such as carfentanil, and an inhalational anesthetic, such as halothane " [7]

Other theories

Newspapers

Writing in the Moscow daily Komsomolskaya Pravda, Viktor Baranets, a former Russian Defense Ministry official, stated that the Ministry of the Interior knew that any normal riot control agent, such as pepper spray or tear gas, would allow the Chechens time to harm the hostages. They decided to use the strongest agent available. The paper identified the material as a KGB-developed "psycho-chemical gas" known as Kolokol-1, and reported that "the gas had such an influence on [Chechen siege leader Movsar] Barayev that he couldn't get up from [his] desk". [8] Russian doctors who helped hostages in the first minutes after the siege used a common antidote to fentanyl, naloxone, by injection. [9] [ unreliable source? ] But the effects of the fentanyl derivative's application, which can exacerbate chronic diseases, [ citation needed ] grew acute for the hostages, who had stayed in a closed space without water and food for several days. [9]

Although the exact nature of the active chemical has not been verified, the Russian language newspaper Gazeta.ru claimed that the chemical used had been 3-methylfentanyl, attributing this information to "experts from the Moscow State University chemistry department."

Zilker and Wheelis

Prof. Thomas Zilker and Dr. Mark Wheelis, interviewed for the BBC's Horizon documentary series, dispute that the gas could have been based on fentanyl. [10]

Thomas Zilker: It seems to be different from fentanyl, carfentanil and sufentanil, but it has to be, it has to have the potency of carfentanil at least because otherwise it wouldn’t work in this circumstance. So the Russians obviously have designed a new fentanyl which we cannot detect in the west.

Mark Wheelis: The fact that the Russians did it and got away with a lethality of less than twenty percent suggests to me that very likely there may have been a novel agent with a higher safety margin than normal fentanyl.

Riches et al.

In 2012, Riches et al. [11] found evidence from liquid chromatography-tandem mass spectrometry analysis of extracts of clothing from two British survivors, and urine from a third survivor, that the aerosol was a mixture carfentanil and remifentanil the exact proportions of which they could not determine. Assuming that these were the only active constituents (which has not been verified by the Russian military), the primary acute toxic effect to the theatre victims would have been opioid-induced apnea; in this case mechanical ventilation and/or treatment with naloxone, the specific antidote for poisoning with carfentanil in humans, would have been life-saving for many or all victims. If fentanyl or a fentanyl derivative was used, the hostage liberators had only minutes to inject naloxone into the hostages before death by asphyxiation occurred.

Related Research Articles

Incapacitating agent is a chemical or biological agent which renders a person unable to harm themselves or others, regardless of consciousness.

<span class="mw-page-title-main">Fentanyl</span> Opioid medication

Fentanyl is a potent synthetic piperidine opioid primarily used as an analgesic. It is 20 to 40 times more potent than heroin and 100 times more potent than morphine; its primary clinical utility is in pain management for cancer patients and those recovering from painful surgeries. Fentanyl is also used as a sedative. Depending on the method of delivery, fentanyl can be very fast acting and ingesting a relatively small quantity can cause overdose. Fentanyl works by activating μ-opioid receptors. Fentanyl is sold under the brand names Actiq, Duragesic and Sublimaze, among others.

<span class="mw-page-title-main">Moscow theater hostage crisis</span> Terrorist attack and Hostage Crisis in Moscow

The Moscow theater hostage crisis was the seizure of the crowded Dubrovka Theater by Chechen terrorists on 23 October 2002, which involved 850 hostages and ended with Russian security services killing or causing the death of 172 people. The attackers, led by Movsar Barayev, claimed allegiance to the Islamist separatist movement in Chechnya. They demanded the withdrawal of Russian forces from Chechnya and an end to the Second Chechen War.

<span class="mw-page-title-main">Anesthetic</span> Drug that causes anesthesia

An anesthetic or anaesthetic is a drug used to induce anesthesia ⁠— ⁠in other words, to result in a temporary loss of sensation or awareness. They may be divided into two broad classes: general anesthetics, which result in a reversible loss of consciousness, and local anesthetics, which cause a reversible loss of sensation for a limited region of the body without necessarily affecting consciousness.

<span class="mw-page-title-main">Carfentanil</span> Synthetic opioid analgesic

Carfentanil or carfentanyl, sold under the brand name Wildnil, is an extremely potent opioid analgesic used in veterinary medicine to anesthetize large animals such as elephants and rhinoceroses. It is typically administered in this context by tranquilizer dart. Carfentanil has also been used in humans to image opioid receptors. It has additionally been used as a recreational drug, typically by injection, insufflation, or inhalation. Deaths have been reported in association with carfentanil.

<span class="mw-page-title-main">Sufentanil</span> Synthetic opioid analgesic drug

Sufentanil, sold under the brand names Dsuvia and Sufenta, is a synthetic opioid analgesic drug approximately 5 to 10 times as potent as its parent drug, fentanyl, and 500 times as potent as morphine. Structurally, sufentanil differs from fentanyl through the addition of a methoxymethyl group on the piperidine ring, and the replacement of the phenyl ring by thiophene. Sufentanil first was synthesized at Janssen Pharmaceutica in 1974.

Gray death is a slang term which refers to a potent mixture of synthetic opioids, for example benzimidazole opioids or fentanyl analogues, often sold on the street misleadingly as "heroin". However, other substances such as cocaine have also been laced with opioids that resulted in illness and death.

Kolokol-1 is a synthetic opioid developed for use as an aerosolizable incapacitating agent. The exact chemical structure has not yet been revealed by the Russian government. It was originally thought by some sources to be a derivative of the potent opioid fentanyl, most probably 3-methylfentanyl dissolved in an inhalational anaesthetic as an organic solvent. However, independent analysis of residues on the Moscow theater hostage crisis hostages' clothing or in one hostage's urine found no fentanyl or 3-methylfentanyl. Two much more potent and shorter-acting agents, carfentanil and remifentanil, were found in the samples. They concluded that the agent used in the Moscow theater hostage crisis contained two fentanyl derivatives much stronger than fentanyl itself, sprayed in an aerosol mist.

<span class="mw-page-title-main">Ohmefentanyl</span> Chemical compound

Ohmefentanyl is an extremely potent opioid analgesic drug which selectively binds to the µ-opioid receptor.

<span class="mw-page-title-main">3-Methylfentanyl</span> Opioid analgesic

3-Methylfentanyl is an opioid analgesic that is an analog of fentanyl. 3-Methylfentanyl is one of the most potent opioids, estimated to be between 400 and 6000 times stronger than morphine, depending on which isomer is used.

<span class="mw-page-title-main">Diprenorphine</span> Chemical compound

Diprenorphine, also known as diprenorfin, is a non-selective, high-affinity, weak partial agonist of the μ- (MOR), κ- (KOR), and δ-opioid receptor (DOR) which is used in veterinary medicine as an opioid antagonist. It is used to reverse the effects of super-potent opioid analgesics such as etorphine and carfentanil that are used for tranquilizing large animals. The drug is not approved for use in humans.

<span class="mw-page-title-main">Lofentanil</span> Opioid analgesic

Lofentanil or lofentanyl is one of the most potent opioid analgesics known and is an analogue of fentanyl, which was developed in 1960. It is most similar to the highly potent opioid carfentanil (4-carbomethoxyfentanyl), only slightly more potent. Lofentanil can be described as 3-methylcarfentanil, or 3-methyl-4-carbomethoxyfentanyl. While 3-methylfentanyl is considerably more potent than fentanyl itself, lofentanil is only slightly stronger than carfentanil. This suggests that substitution at both the 3 and 4 positions of the piperidine ring introduces steric hindrance which prevents μ-opioid affinity from increasing much further. As with other 3-substituted fentanyl derivatives such as ohmefentanyl, the stereoisomerism of lofentanil is very important, with some stereoisomers being much more potent than others.

<span class="mw-page-title-main">Mirfentanil</span> Chemical compound

Mirfentanil is a fentanyl derivative with strong selectivity for the μ opioid receptor. At lower doses, it antagonizes the analgesic effects of alfentanil and substitutes for naloxone in morphine-treated monkeys; however, it also reverses naloxone-precipitated withdrawal in pigeons trained to discriminate morphine from naloxone.

<span class="mw-page-title-main">4-Phenylfentanyl</span> Opioid analgesic

4-Phenylfentanyl is an opioid analgesic that is a derivative of fentanyl. It was developed during the course of research that ultimately resulted in super-potent opioid derivatives such as carfentanil, though it is a substantially less potent analogue. 4-Phenylfentanyl is around eight times the potency of fentanyl in analgesic tests on animals, but more complex 4-heteroaryl derivatives such as substituted thiophenes and thiazoles are more potent still, as they are closer bioisosteres to the 4-carbomethoxy group of carfentanil.

<span class="mw-page-title-main">Butyrfentanyl</span> Synthetic opioid analgesic

Butyrfentanyl or butyrylfentanyl is a potent short-acting synthetic opioid analgesic drug. It is an analog of fentanyl with around one quarter of its potency. One of the first mentions of this drug can be found in document written by The College on Problem of Drug Dependence, where it is mentioned as N-butyramide fentanyl analog. This document also states that the article describing its clinical effects was published in 1987. It is an agonist for the μ-opioid receptors.

<span class="mw-page-title-main">Acetylfentanyl</span> Opioid analgesic

Acetylfentanyl is an opioid analgesic drug that is an analog of fentanyl. Studies have estimated acetylfentanyl to be 15 times more potent than morphine, which would mean that despite being somewhat weaker than fentanyl, it is nevertheless still several times stronger than pure heroin. It has never been licensed for medical use and instead has only been sold as a designer drug. Acetylfentanyl was discovered at the same time as fentanyl itself and had only rarely been encountered on the illicit market in the late 1980s. However, in 2013, Canadian police seized 3 kilograms of acetylfentanyl. As a μ-opioid receptor agonist, acetylfentanyl may serve as a direct substitute for heroin or other opioids. Common side effects of fentanyl analogs are similar to those of fentanyl itself, which include itching, nausea and potentially serious respiratory depression, which can be life-threatening. Fentanyl analogs have killed hundreds of people throughout Europe and the former Soviet republics since the most recent resurgence in use began in Estonia in the early 2000s, and novel derivatives continue to appear.

<span class="mw-page-title-main">Furanylfentanyl</span> Opioid analgesic

Furanylfentanyl (Fu-F) is an opioid analgesic that is an analog of fentanyl and has been sold as a designer drug. It has an ED50 value of 0.02 mg/kg in mice. This makes it approximately one fifth as potent as fentanyl.

<span class="mw-page-title-main">Acrylfentanyl</span> Opioid analgesic

Acrylfentanyl (also known as acryloylfentanyl) is a highly potent opioid analgesic that is an analog of fentanyl and has been sold online as a designer drug. In animal studies the IC50 (the half maximal inhibitory concentration for acrylfentanyl to displace naloxone) is 1.4 nM, being slightly more potent than fentanyl itself (1.6 nM) as well as having a longer duration of action.

<span class="mw-page-title-main">Remifentanilic acid</span> Inactive metabolite of remifentanil

Remifentanilic acid is a metabolite of the potent short-acting synthetic opioid analgesic drug remifentanil. It is an analog of fentanyl and remifentanil, but is not active as an opioid in its own right.

References

  1. ↑ Conclusions of forensic examination commission, Volumes 30-33 of the criminal case.
  2. ↑ "News Chronology (August through October 2002)". THE CBW CONVENTIONS BULLETIN (Issue 58). 2002. pp. 27–46.
  3. ↑ Russia Confirms Suspicions About Gas Used in Raid Archived 2012-09-24 at the Wayback Machine - Potent Anesthetic Pumped Into Theater - 2 More Hostages Die From Drug's Effects, Susan B. Glasser and Peter Baker, Washington Post, 2002-10-31 A.15
  4. ↑ Mystery of Russian gas deepens NewScientist.com news service, Debora MacKenzie, 2002-10-29
  5. ↑ "Analysis of Clothing and Urine from Moscow Theatre Siege Casualties Reveals Carfentanil and Remifentanil Use" . Retrieved 23 May 2017.
  6. 1 2 "Unexpected "Gas" Casualties in Moscow: A Medical Toxicology Perspective" (PDF). Retrieved 23 June 2016.
  7. ↑ Wax, Paul; et al. (May 2003). ""Unexpected "gas" casualties in Moscow: A medical toxicology perspective"". Annals of Emergency Medicine. Elsevier Science Direct. 41 (5): 700–705. doi:10.1067/mem.2003.148. PMID   12712038. S2CID   44761840.
  8. ↑ Peterson, Scott. (October 29, 2002). Gas enters counterterror arsenal - The unprecedented use of a secret toxic gas leaves 400 still hospitalized, and starts a debate about Russian tactics. The Christian Science Monitor , WORLD; p. 1.
  9. 1 2 CHECHEN-NORTH-OST SPECIAL FORCE OF RUSSIA N 11 (74) NOVEMBER 2002 in Russian, last three paragraphs
  10. ↑ "BBC - Science & Nature - Horizon - The Moscow Theatre Siege" . Retrieved 23 June 2016.
  11. ↑ Riches, J. R.; Read, R. W.; Black, R. M.; Cooper, N. J.; Timperley, C. M. (2012). "Analysis of Clothing and Urine from Moscow Theatre Siege Casualties Reveals Carfentanil and Remifentanil Use". Journal of Analytical Toxicology. 36 (9): 647–656. doi: 10.1093/jat/bks078 . PMID   23002178..
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