20.9.08

Suicide do's and dont's: Seven drugs, poisons, and other chemicals that are great to kill yourself with, provided you are into that sort of thing

Obligatory Disclaimer: The intention of this post is not to provide instructions on how to end your life. If you are seeking such information, there are plenty of places to find it on the Internet.

My personal view (since you obviously want to know) on suicide is that sometimes it's okay, particularly as a means of relieving terminal pain and suffering. However, it does bum me out when someone with a potentially treatable mental illness takes their life. I'm not saying that drugs can fix everyone, or even really 'fix' people at all, but they do have the potential to increase an individual's quality of life.

Anyway, if you're thinking about kicking your own bucket, perhaps I could humbly suggest two things? First, do some research. The Wikipedia article on sucide isn't a bad place to start. Or maybe it is, I'm not an expert. Second, there's this thing called the National Suicide Prevention Lifeline. It's capitalized because it's important! If you want to give them a call, their number is 1-800-273-TALK. Just saying.

Okay, back to drugs. To complement my previous post, here are the "do's" of chemical-based suicide. I've kept it to single chemicals, so effective synergistic combos like ethanol and Valium have been excluded.

7. Old school tricyclic antidepressants
As far as prescription drugs go, these suckers are pretty darn toxic. They are associated with a higher rate of death in the event of an overdose relative to the newer nontricyclic antidepressants (e.g. SSRIs such as Zoloft or Prozac) [1]. In this regard, of all the tricyclics, desipramine (aka Norpramin or Pertofrane) is apparently the most 'effective'.

6. General anaesthetics
Ever been put under? They tell you to start counting down from 10, and you're out cold at 8. If your anesthesiologist is actually a highly deceptive, remarkably agile, incredibly intelligent, and yet stunningly incompetent grizzly bear, then it's likely that your heart stops around 2. Acquisition may be a challenge, but otherwise it's probably just a matter of making sure you push enough to shut your brain (and heart, and lungs) down permanently.

5. Any narcotic solvent (diethyl ether, chloroform, benzene, etc.)
The American government just had to go and make it confusing, but from a pharmacological standpoint, a narcotic is essentially any substance that in appreciably large quantities produces euphoria, stupor, and/or coma. Up the dose a little bit more, and add death to that list.

4. gamma-Hydroxybutyrate (GHB)
A big ol' bolus will cause rapid unconsciousness, respiratory depression, and heart failure. Vomiting and convulsions may occur but generally only while you're unconscious, so no biggie. In short, a big mess for whoever cleans you up but a built-in fail-safe (aspirating on your vomit) as far as ending things goes.

3. Opioids (heroin, morphine, fentanyl, etc.)
The primary purpose of these drugs are to numb pain, which is a good place to start when you're looking to meet the reaper.

2. Barbiturates
The number one choice of doctors who end their lives [2].

1. Carbon monoxide
Puts you to sleep before it knocks you off, is readily available (see: gas ovens, running vehicles in the garage, etc.), and you don't even have to swallow or inject something. There's a reason they make detectors for it.

[1] Kapur S, Mieczkowski T, Mann JJ. (1992). Antidepressant medications and the relative risk of suicide attempt and suicide. JAMA 268(24): 3441-3445.
[2] Hawton K, Clements A, Simkin S, Malmberg A. (2000). Doctors who kill themselves: a study of the methods used for suicide. QJM 93(6): 351-357. (link)

2.9.08

Suicide do's and dont's: Eight drugs, poisons, and other chemicals that you shouldn't use to kill yourself

I did a post on this topic when I first started this blog, but it needed improvement. Behold, improvement!

8. Sodium chloride (table salt)
Yeah, you read me right. Pretty much anything will kill you, if you get enough of it into you. This includes good ol' NaCl. You're probably looking at drinking a couple of gallons of salt water, and you'll puke long before you get most of that into you.

7. Methanol (wood alcohol)
It might work, and you get to get drunk while you're at it. But if it doesn't work, you'll end up blind and with holes in your brain.

6. Any radioactive substance
Even if you somehow manage to get your hands on something that is sufficiently radioactive to dose yourself with thousands of rems, dying is still going to take you at the very minimum a couple of days chock full of intense nausea and diarrhea.

5. Strychnine
As I discussed previously, a painful and terrifying way to die. You remain fully conscious and coherent as you experience repeated bouts of violent convulsions until finally your lungs stop working and you asphyxiate. Woo.

4. Any carcinogen with low acute toxicity
You'll need to a get a lot of it into you, which is a pain, and if you don't finish the job, you end up with cancer a couple of years (or more) down the road. I suppose the cancer might kill you, but that's an awfully roundabout and terribly painful and potentially very slow and agonizing way of ending things, don't you think?

3. Corrosive substances
These include common household chemicals like bleach, oven cleaner (sodium hydroxide), chlorine for the pool, and of course, that muriatic acid you have stockpiled in the garage. Some people seem to think that drinking one of these chemicals would be a good way to meet the reaper. Those people are wrong. Being strongly acidic or strongly alkaline, these chemicals will corrode anything organic, including your mouth, esophagus, and stomach. Then, I theorize, all of your stomach acid will escape into the trunk of your body, dissolving your internal organs. That doesn't sound terrible at all.

2. Paraquat
Paraquat is a herbicide found in many weed control products (e.g. Gramoxone). If you drink enough of it, you'll experience the joys of multisystem organ failure with death occurring within hours to a few days. However, should you fail to drink enough of it, it will selectively accumulate and persist in your lungs and slowly eat away at them while you spend several weeks gasping for breath in terrible pain before you expire. There is currently no antidote, and even people who manage to get lung transplants find that their new lungs are eventually destroyed as well, since the poison also hangs out in the fat surrounding them. Sadly, it is widely used as a means of suicide in many parts of the world.

1. Acetaminophen
Also known as paracetamol and Tylenol, acetaminophen is the most common cause of intentional self-poisoning in adults in many countries on account of it being widely available and cheap as hell. What doesn't appear to be widely available is the knowledge that this analgesic is highly toxic to pretty much just the liver and kidneys. Even if you take enough to destroy these organs, it can take up to two weeks to actually die. The pain is apparently excruciating.

22.8.08

Listeriolysin O - Basically why listeriosis sucks so bad

Every so often, the narcissistic tendencies of Listeria monocytogenes get to be too much for this annoying Gram-positive bacterium to bear, and it decides to make the news by causing a listeriosis outbreak. Typically this involves a major food manufacturer having to recall a product that has become contaminated with the bug. The media loves bacterial narcissism.

Based on what I've read (Wikipedia, obviously), listeriosis is fairly uncommon and largely associated with infants, old people, and those with compromised immune systems. It's actually more common in animals, particularly cows and stuff. Wikipedia also points out that although L. monocytogenes was first described in 1926, it wasn't identified as a cause of foodborne disease until 1981 (in Halifax, Nova Scotia, of all places). Listeriosis often presents as a flu-like illness (fever, puking, feeling like you're gonna puke, and getting the runs) that eventually subsides or else worsens into such fun things as septicemia (blood poisoning), encephalitis/meningitis (brain/brain membrane inflammation), corneal (eye) ulcer (Google Image or bust!), or pneumonia.

Listeriolysin O (LLO) is a protein toxin secreted by L. monocytogenes that helps the bacterium get inside cells, where it can reproduce like crazy while remaining hidden from the the immune system [1]. The entire process starts with the bacterium tricking white blood cells into engulfing it into a container called a phagosome. At this point, LLO creates a hole in the phagosome, permitting the bacteria to escape its container into the cytoplasm of the cell, where it can start dividing like a mofo.

Here's the really cool part. LLO is activated only under the more acidic conditions it encounters within a phagosome, so once it forms a pore and spills out along with the bacterium into the more basic cytoplasm, it's activity is reduced [1]. This means that LLO won't form pores in the plasma (outer) membrane of the cell, which would likely kill it, thus ensuring the maintenance of a nice little cell incubator for Listeria to multiply in.

[1] Schnupf P, Portnoy DA. Listeriolysin O: a phagosome-specific lysin. (2007). Microbes Infect. 9(10):1176-1187.

15.8.08

Diisopropyl fluorophosphate (DFP) - Sarin's little brother

Organophosphates are a class of chemical compounds that possess a phosphate atom bound to a couple of oxygen atoms. They include among their ranks such essential-for-life biochemicals as nucleic acids and ATP, as well as life-ending insecticides, herbicides, and nerve agents.

Nerve agents kill you by inhibiting an enzyme called acetylcholinesterase, which hangs out wherever nerves from your brain/spinal cord connect with your muscles in order to tell them what to do. When the nervous system wishes a muscle to bend to its will (lol), a neurotransmitter (chemical facilitator of communication between nerve and muscle) called acetylcholine is released from nerves and binds to sites on muscle to cause them to contract. Normally, acetylcholinesterase then breaks down the acetylcholine so that the muscle can relax. Organophosphates bind to a special site on acetylcholinesterase and prevent it from breaking down acetylcholine, resulting in prolonged muscle contraction (i.e. being paralyzed). Since you need muscles to breathe, organophosphates are somewhat problematic, causing asphyxiation and death death death.

Diisopropyl fluorophosphate (DFP) is an organosphate nerve gas; an insecticide gone wrong, if you will. It was originally developed by a British dude named Bernard Charles Saunders, who was trying to break into the exciting world of chemical warfare products (aren't we all). In a major setback for Mr. Saunders, DFP was found to be less toxic than similar compounds like tabun or sarin. However, he stuck with his little toxic friend, and eventually figured out that it could be mixed with mustard gas to produce a mixture with a sufficiently low enough melting point to be used in cold weather, which was apparently a big deal at the time. Mustard gas: Now able to blister you to hell all year round.

Since DFP resembles much more toxic chemical agents (taurin, sarin, soman, cyclosarin, etc.), it has been used by military forces as a substitute for such agents in training drills and top-secret experiments and stuff. DFP is actually a structural analog of sarin, meaning that it contains the same atoms but they are arranged differently.

DFP has been used by eye doctors and vets to produce miosis (constriction of the pupil of the eye), which is beneficial to the treatment of chronic glaucoma and some other stuff. Neuroscience researchers have been known to play around with it since it inhibits acetylcholinesterase and so can be used to induce delayed peripheral neuropathy, permitting this condition to be studied.