Talk:Moscow hostage crisis chemical agent

Old talk

I could not find any sources claiming that it was "Kolokol-1". Most important, what is "Kolokol-1" chemically?Biophys 04:12, 5 June 2007 (UTC)

What it was?

I looked some scientific publications on this topic (there are surprisingly few of them!) and found only the following. The only detected substance in blood was halothane, and nothing else was found. This is the only fact, and everything else is speculation or possibly deliberate disinformation. From my perspective, I can only tell that (a) there is any evidence at all about a fentanyl derivative (could be any poison gas); and (b) this agent binds to its protein target irreversibly (hence long-term effects and the compound was not detected since it was completely bound to its target).Biophys 14:41, 5 June 2007 (UTC) This is not to criticize the article. It is actually very good. Side note. For a gas agent, one can hardly tell about a calculated dose of the drug. ; the dose can be usually calculated for a drug that is given orally or injected.Biophys 14:57, 5 June 2007 (UTC)

Another question. It follows from the hostage testimonies that most of them actually felt the smell of the gas and remained conscious for a certain period of time (for how long?), and some of them were smart enough to start breathing through a tissue (cloths, etc.). Then they remained conscious longer. Is that correct? If this is correct, then (a) the gas was completely useless against terrorists since they realized to be under attack and could blow out the building (but they could not because their devices have been disconnected by the puzzling Abu Bakar); and (b) they felt the smell of this compound, which may provide a clue to finding out what it really was. What it smells like?Biophys 14:57, 5 June 2007 (UTC)

Let's separate scientific findings and pure speculations

So far, I found only two clear scientific facts and one reliable conclusion about this gas. The facts were: (1) analyses of blood/urine samples detected traces of halothane, but no any opiate derivatives and "no evidence of nerve agents"; (2) according to hostage testimonies, this gas did not act immediaately, people remained conscious for a few minutes or longer if they were smart enough to start breathing through a tissue (cloths, etc.). A reliable conclusion was about a mixture of several components, since halothane alone could not cause such effect. Everything else (claims about fentanyl, etc.) is pure speculation. Moreover, fentanyl dereivatives were not found during the expertise. This should be reflected in the article.Biophys 21:40, 16 July 2007 (UTC)

P.S. No evidence that breathing through tissue actually helped.Biophys 22:21, 16 July 2007 (UTC)

So, I am going to clean this article a little and remove some completely unsourced statements in the process.Biophys 21:52, 16 July 2007 (UTC)

Another important fact is that any fentanyl derivative is a liquid, not gas. Thus, it could only be applied as aerosol spray, something like pepper spray. That would requre using a device like Pepper-spray projectile and would only be effective at a short distance, unless those projectiles launch frangible balls which break upon impact (which was not the case). Biophys 22:16, 16 July 2007 (UTC) Halothane, which was indeed found, is a gas.Biophys 22:18, 16 July 2007 (UTC)

The above paragraph is simply not true. Pepper spray is a surface irritant, not meant to be inhaled as fine droplets into the lungs; a "knockout gas" is a systemic sedative, which, in order to act before those targeted realise what is happening, needs to be inhaled, not swallowed or absorbed through the skin. Pepper spray is dispensed as a tight stream at high pressure for a number of reasons... so that it can be aimed at the eyes, , so that it can be used at a distance, so that it can be aimed at a specific person with as little effect as possible on others in the vicinity, so that wind cannot easily blow it back at the person spraying, or disperse it into a larger crowd, and also so that it cannot easily be inhaled as droplets deep into the respiratory system. In the case of the agent used in the theatre, none of these requirements applied. In fact the requirements were the opposite; it was required to be as evenly dispersed as possible so that all persons were affected as equally as possible (unfortunately it seems that some were overdosed, while others were still conscious), it was required to be breathed deeply into the respiratory system to ensure rapid effects, and those "spraying" it were not in the theatre and thus were not at risk of being affected. At least I try (talk) 08:27, 28 February 2016 (UTC)

The gas supposedly looked like a fine white mist which fell from the top area to the larger seating area below, just like gaseous dry ice does. The gas was potent and supposedly took effect very quickly upon being inhaled. The reason it took so long for people to go out was that they saw the gas and avoided it (there was some outcry from hostages, interviews say they franticly told each other that it was tear gas, the gov't abandoned them, ect). A woman walked out of the building 20 minutes after the gas started pumping in and it was decided to pump it in for another 40 minutes to ensure people would be unconscious. The terrorist leaders were in the control room at the time and unaffected. They would be shot shortly during the raid. The 60 minutes of exposure to the gas undoubtedly killed many people. During the evacuation, the victims were laid out on their backs and according to on-site doctors, the majority most likely died from suffocation (when unconscious on the back you choke on your limp tongue). Antidote was ordered before the raid and administered, but it did nothing. No one knows what the antidote was. All this information is obviously unsourced and useless, I just picked it up while watching a documentary. I'm going to research this more as I noticed this seemingly relevant information is not included in the articles here. Sabar^Cont 03:13, 26 September 2007 (UTC)

Thank you very much. I appreciate your contribution here. So, it was not gas but aerosol after all.Biophys 04:19, 26 September 2007 (UTC)

"Gaseous dry ice" is not just a gas; what we see when we see that white vapour from dry ice falling and flowing along the ground is condensed water vapour (which is not a gas), heavier than air, mixed with CO2, also heavier than air, all somewhat cold (from the dry ice) which makes it heavier still. That is a highly specific situation, pretty much unique to cryogenic agents (dry ice, liquid nitrogen etc.) and also occurring when an upright freezer is opened, especially when the ambient humidity is high. That phenomenon seems to be being used here to show that the substance used could have been a gas, but hairspray and insecticide and indeed any aerosol, are also fine white mists that will fall, and they are not gases. Very few gases are visible white mists (sulphur dioxide is one but they certainly didn't use that). On the other hand, almost all aerosols are visible white mists that are heavier than air. This suggests that it was an aerosol of some kind. If halothane was also used, perhaps it was a solution of a solid drug in halothane, atomised into a fine spray, resulting in the evaporation of the halothane, leaving a fine, suspended powdered drug that would be deliverable through air conditioning ducts with far less tendency to stick to the ducts the way a liquid spray would. — Preceding unsigned comment added by At least I try (talk • contribs) 07:25, 28 February 2016 (UTC)

More recent studies show a mixture of Carfentanil and Remfentanil. Riches et. al., J. Anal Tox (November/December 2012) 36 (9): 647-656. doi: 10.1093/jat/bks078 First published online: September 20, 2012. Same article cited on the Carfentanil page. I have minimal skills at editing Wikipedia, but this seems relevant. — Preceding unsigned comment added by 64.128.48.50 (talk) 14:08, 18 April 2014 (UTC)

Riches et al Analysis of Clothing and Urine from Moscow Theatre Siege Casualties Reveals Carfentanil and Remifentanil Use are definitely on point, showing that while fentanyl or 3-methyl fentanyl were absent from the urine of one survivor or residues of the agent in clothing of two other British survivors, the veterinary large animal sedative drug carfentanil and anesthetic agent remifentanil were discovered by liquid chromatographic tandem mass spectrometry (compared to standards which comprised fentanyl hydrochloride, cis-3-methylfentanyl free base, carfentanil oxalate, sufentanil citrate, lofentanil oxalate, remifentanil hydrochloride, norcarfentanil and remifentanil acid).

I would say that these are enough hard data to allow us to conclude that the Russian Health Minister Yuri Shevchenko either willingly lied or was misled by his own government's sources in announcing the active agent of the gas used in the hostage rescue at the Barricade Theatre in Moscow was fentanyl, and that speculation that the agent was the more toxic and potent analogue 3-methyl fentanyl was premature. Analysis of actual agent residues, compared to known standards of both fentanyl and 3-methyl fentanyl, showed presence of neither drug, while showing the presence (otherwise unaccountable-for in a moviegoer's clothing or urine) of carfentanil and remifentanil.

That's the last analytical word, friends. I added it to the article, along with Wax, et al a review article in The Annals of Emergency Medicine which places the whole issue into four valuable perspectives:

- the toxicology in HUMANS of the veterinary drug carfentanil and the perioperative anesthetic drug remifentanil when used as aerosolized agents ("gases" within the military sense of the word) weren't studied closely enough and the lipophilicity of all the fentanyl derivatives may have caused a "re-narcosis" syndrome requiring repeated doses of the appropriate antidote (these authors state that would have been the standard opiate antidote naloxone ("Narcan"), while the Porton Down team correctly state that naltrexone is the preferred and much more highly effective antidote to human overdosage with carfentanil) promptly to save affected persons' lives;

- withholding of the identity of these drugs or even the general class to which they belonged probably cost many lives after the rescue, but hypoxic brain damage might have been unavoidable in some cases;

- these points notwithstanding, it's hard to see what other options the Spetsnaz team in charge of the rescue had but using these agents to subdue the Chechen terrorists (with their fingers on the detonators of enough high explosives to kill everyone there) and, unavoidably, their hostages. The secrecy which prevented Russian officials from IMMEDIATELY informing their own physicians what they were treating WAS avoidable, however; and

- future use of these or similar agents to subdue hostage takers or other violent individuals while trying to avoid unnecessary fatalities should only be attempted after more extensive study of their effects, how they are deposited after being introduced into building air vents or other ways, how the human body absorbs them and which metabolic and physiological pathways the drugs take after inhalation or ingestion, and - most importantly - making appropriate antidotes for these agents available to be administered promptly to incident survivors after their use. loupgarous 02:47, 20 September 2015 (UTC)

Nord-Ost Organization on the agent/antidote (via Kasparov)

"The gas that they applied at storming the 'Nord-Ost' has no antipoison at all," Ms Karpova has stated. "Therefore, Patrushev's words cannot be true. He said that special services had prepared the required amount of antipoison, even more, but people who were under stress 'sometimes were not able to explain whether the antipoison had been injected into them or not'." In the opinion of Tatiana Karpova, Patrushev's confession "is just senseless." She said that the preparation named nalaxon, which had helped to save a certain number of hostages, was not a real antipoison. It was selected experimentally, without any participation of FSB employees, the Kasparov.Ru reports.

http://eng.kavkaz-uzel.ru/newstext/engnews/id/1204290.html --HanzoHattori (talk) 16:08, 24 December 2007 (UTC)

Naltrexone is the specific, preferred antidote for carfentanil poisoning in humans (which to date has only occurred during accidental needle sticks or other accidental ingestion of the drug by veterinary personnel sedating large animals such as hippos or elephants). Since Riches et al at Porton Down have identified carfentanil and remifentanil on residue of the agent on British hostages' clothing and in the urine of a British hostage, the context in which that remark may have been made becomes a little clearer. It's possible that "Ms Karpova" was ignorant that carfentanil has a specific antidote, or other reasons for what she said may exist. loupgarous 02:59, 20 September 2015 (UTC)

Page should have a section on long term effect

Just as radiation victims get monitored, the >700 Moscow survivors/exposure victims should be monitored for effects. This page should have a section for the long term. This could over time be important. 143.232.210.150 (talk) 18:03, 12 June 2012 (UTC)

The active ingredients in the agent used to subdue the Chechens and their hostages, carfentanil and remifentanil, have extremely short biological half-lives (which is why the Russians probably honestly believed they could be used in enclosed spaces without a high fatality rate). Sixteen percent, or one in every six hostages died after this incident, and available information is that the Russians never saw this in prior use of this or similar incapacitating agents - they've been playing around with nonlethal incapacitants since the early 1980s in Afghanistan.

You do have a great point, however. A review article in The Annals of Emergency Medicine touches on the fact that most of the fentanyl derivative drugs are lipophilic (in other words, taken up rapidly into the fatty tissues), so that a "renarcosis" syndrome can occur - it's possible to treat a patient for exposure to these drugs, get a good response, then have the patient re-experience toxic symptoms from the drug as it is released from the patient's body fat back into the patient's circulation, often at an unpredictable interval (at least until more data are available on uptake of these agents into body fat and the rate at which it is released back into the central circulation).

But while within the context of the intended use of these very short-acting opiate drugs, a span of hours to several days after exposure may be "long-term effects," I don't know if we ought to call them that in a separate section heading. Generally, "long-term effects" (from my experience as a medical writer and clinical data analyst for a few Big Pharma firms) are "months to years" in scope.

The article I cited does call for more research into ALL the effects of these drugs when used as military incapacitants. However, I'm reluctant to single out what may or may not be considered a "long-term effect" in normal medical contexts, because I don't think the articles I've read supply that information solidly enough for it to appear in this article (it'd be a real case of WP:Undue Weight, I think).

I am glad you brought this up, however, because we need someone with experience in industrial or toxicological epidemiology or just plain experience with these sorts of opiate drugs to lend us their experience with what is or is not a "long-term effect" stemming from exposure to these drugs. I'd be willing to venture that brain hypoxia would cause such effects, and it's been mentioned as a sequel to exposure to these drugs in a setting such as the Barricade Theatre hostage rescue, but we need a greater consensus than just you and me before putting that in the article.

Anyone? loupgarous 03:00, 20 September 2015 (UTC)

@Loupgarous:

"I'd be willing to venture that brain hypoxia would cause such effects, and it's been mentioned as a sequel to exposure to these drugs in a setting such as the Barricade Theatre hostage rescue, but we need a greater consensus than just you and me before putting that in the article."

I agree with the OP, and agree to adding above as it's better than nothing. Ken K. Smith (a.k.a. User:Thin Smek) (talk) 03:26, 6 February 2019 (UTC)

This substance killed "up to 204 hostages", but there was almost no mention of any deaths in the article content!

In a reference for the main Moscow theater hostage crisis article, a contemporary BBC report [1], it is clear that the rescue raid killed "[a]t least 90 hostages".

The above "204 hostages" quote is from the lead section of the Moscow theater hostage crisis article, expanded below. In that article; the Nord-Ost musical article; the references for this article; and the talk page for this article; it is clearly stated that the substance killed hostages.

"All 40 of the terrorists were killed,[2] and up to 204 hostages died during the siege, including nine foreigners, due to poisoning by the gas.[3] All but two of the hostages who died during the siege were killed by the toxic substance pumped into the theater to subdue the terrorists.[4][5] ..."

So it is imperative that there is substantial mention of deaths in the article, particularly at the start with an approximate death toll. All I could find in the article content today was this, and it was in the "Zilker and Wheelis" section of the "Criticism" section:

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.

Remember, even though the Russian government's agencies were involved in the crisis, Wikipedia is not to be censored by governments or anyone else (per WP:NOTCENSORED). Ken K. Smith (a.k.a. User:Thin Smek) (talk) 14:52, 6 February 2019 (UTC)