RSS

Category Archives: Poisons & Drugs

Wax, Or Is It Wane?: A New Form Of Marijuana Is On The Scene

Wax

Wax, Butter, Honeycomb. Sounds so innocent. But regardless of what it’s called, this is a new and powerful Mary Jane that makes smoking a joint seem almost pedestrian. Easily hidden, easily used, and its effects can last all day.

It looks like lip balm—-or wax—-thus the moniker—but contains very high levels of tetrahydrocannabinol (THC). Oh yeah, an instructions for making it can be found on the internet.

What will the think of next?

 
2 Comments

Posted by on December 17, 2014 in Poisons & Drugs

 

Q and A: Will Ingestion of Bee Venom Kill Someone Who Is Allergic to Bees?

Q: If a person is allergic to bee venom and the venom is ingested, would the person be likely to die? Would the venom show up on a tox screen at autopsy?

Bee-apis

A: Bee venom is a protein toxin and would be digested by the acids in the stomach if swallowed. And once digested it would not likely cause an allergic reaction. However, an allergic reaction would happen once the venom contacted the buccal mucosa—big word for the lining of the mouth. This could cause an anaphylactic reaction and kill the victim.

Anaphylaxis is a rapid allergic reaction to some antigen. These antigens are typically foods, drugs, or insect venoms. Common foods are peanuts and shellfish; common drugs are penicillin and iodine, which is found in many radiographic dyes; and common insects are bees as in your story. There a myriad other foods, drugs, and bugs that can cause anaphylaxis in the allergic person.

This rapid immune (or allergic) reaction involves antigens (the food, drug, the bee venom, etc.) and antibodies, which are manufactured by the body and react to the specific antigen that they are directed against. This reaction is a critical part of our defense against bacteria and viruses. The body recognizes the antigen (virus, let’s say) as foreign and builds antibodies that will recognize and attach to the virus. This reaction attracts white blood cells (WBCs), which release chemicals that kill or harm the virus, which is then consumed by the WBCs and destroyed.  This process is essential for each of us to survive in our bacteria and virus-filled world.

But, in allergic individuals, this reaction is rapid and massive and causes a release of large amounts of the chemicals from the WBCs and it is these chemicals that cause the problems. They cause dilatation (opening up) of the blood vessels, which leads to a drop in blood pressure (BP) and shock. They cause the bronchial tubes (airways) to constrict (narrow severely), which leads to shortness of breath, wheezing, and cough. This is basically a severe asthmatic attack and prevents adequate air intake and the oxygen level in the blood drops rapidly. The chemicals also cause what is known as capillary leak. This means that the tiny microscopic blood vessels in the tissues begin to leak fluids into the tissues. This leads to swelling and various skin lesions such as a red rash, hives (actually these are called bullae and are fluid-filled, blister-like areas), and what are called wheel-and-flare lesions (pale areas surrounded by a reddish ring). These are also called Target Lesions because they look like targets with a pale center and red ring.

In the lungs this capillary leaking causes swelling of the airways, which along with the constriction of the airways, prevents air intake. In the tissues it causes swelling of the hands, face, eyes, and lips. The net result of an anaphylactic reaction is a dramatic fall in BP, severe wheezing, swelling and hives, shock (basically respiratory and cardiac failure), and death.

Usually anaphylaxis onsets within minutes (10 to 20) after contact with the chemical, but sometimes, particularly with ingested foods, it may be delayed for hours—even up to 24 hours. With a bee sting it would begin in a matter of minutes. Bee venom in the mouth might take only a few minutes to instigate the reaction.

Your victim would suffer swelling of the tongue and face—particularly of the lips and around the eyes—as well as swelling of his hands. Hives and wheel-and-flare lesions would pop out over the skin. He would begin to gasp for breath and develop progressively louder wheezing. As the oxygen content of his blood began to drop he would appear bluish around his lips, ears, fingers, and toes. This would progress until his skin was dusky blue. He would sweat, weaken, and finally when his BP dropped far enough would lose consciousness, lapse into a coma and die. Unless treatment was swift and effect that is.

Untreated anaphylaxis leads to shock and death in anywhere from a very few minutes to an hour or more, depending upon the severity of the reaction and the overall health of the victim. Treatment consists of blood pressure (BP) and respiratory support, while giving drugs that counter the allergic reaction. BP support may come from intravenous (IV) drips of drugs called vasopressors. The most common would be Dopamine, Dobutamine, epinephrine, and neosynephrine. Respiratory support may require the placement of an endotracheal (ET) tube and artificial ventilation. The victim would then be given epinephrine IV or subcutaneously (SubQ) and IV Benadryl and steroids. Common steroids would be Medrol, Solumedrol, and Decadron. These drugs work at different areas of the overall allergic reaction and reverse many of its consequences. The victim could survive with these interventions. Or not. Your call.

If you decide that your victim will die, then at autopsy, the findings are non-specific. That is, they are not absolutely diagnostic that an anaphylactic reaction occurred. The ME would expect to find swelling of the throat and airways and perhaps fluid in the lungs (pulmonary edema) and maybe some bleeding in the lungs. He may also find some congestion of the internal organs such as the liver. He must however couple these findings with a history of the individual having eaten a certain food, having ingested or being given a certain drug, or having receives an insect bite or sting and then developing symptoms and signs consistent with anaphylaxis. And in the case of insects, such as the bee you are using, he may be able to find antibodies to the insect’s venom in the victim’s blood. Maybe not. So you can have it either way—yes he finds the antibodies or no he doesn’t.

Originally published in the October, 2014 issue of Suspense Magazine

 
6 Comments

Posted by on December 14, 2014 in Medical Issues, Poisons & Drugs, Q&A

 

Snake Handling and Jesus: What Could Possibly Go Wrong?

Mark 16:17-18 (King James Version):

17: And these signs shall follow them that believe; In my name shall they cast out devils; they shall speak with new tongues;

18: They shall take up serpents; and if they drink any deadly thing, it shall not hurt them; they shall lay hands on the sick, and they shall recover.

Many snake handlers refer to this, and other, Biblical quotes to justify the taking up of snakes. Rattlesnakes and copperheads seem to be the creatures of choice and these deadly serpents are an integral part of their church services. As is ranting non-sense syllables—-the speaking in tongues part. Not to mention that they typically avoid medical help when such help is needed. Sometimes taking strychnine in the belief that this will add another layer of protection against the venom. After all . . . any deadly thing . . . shall not hurt them . . .

Don’t think that snake handling is a thing of the past or is relegated to the backwoods of the South. Though most still thrive in Appalachia, there are over a hundred such churches and they stretch from coast to coast.

What could possibly go wrong?

Well, actually, a lot. Snake handlers have died from bites, when a visit to the ER could have saved them. But religion is a powerful motivator and often over-rides common sense.

For example:

Jamie Coots, the pastor of the Full Gospel Tabernacle in Jesus Name in Middlesboro, Ky: http://abcnews.go.com/US/snake-handling-pentecostal-pastor-dies-snake-bite/story?id=22551754

Punkin Brown: http://www.hiddenmysteries.org/religion/pentecostal/snakeskill-fool.shtml

And one Glen Summerford, pastor of the Church of Jesus with Signs Following, attempted to murder his wife with a rattlesnake. The story in chronicled in the wonderful American Book Award winning and National Book Award nominated book SALVATION ON SAND MOUNTAIN by Dennis Covington.

Glen Summerford: https://www.newoxfordreview.org/reviews.jsp?did=1095-hartman

My third Samantha Cody thriller ORIGINAL SIN deals with such preachers. Sam visits her old friend Tennessee CV Surgeon Lucy Wagner and both find themselves entangled with the patriarch of a snake-handling church. And everything goes wrong.

 

OS 200X300

 

ORIGINAL SIN:

Dr. Lucy Wagner was on top of her game. The only cardiac surgeon on staff, a new pediatric cardiac unit dedicated to her, and an impeccable reputation not only put her at the apex of the local medical pyramid but also garnered a few powerful enemies. Such is the nature of jealousy and greed. Turf wars can get ugly. Still all was good until the day old John Scully, the spiritual founder and leader of a local snake-handling church, died on her operating table. Fainting spells, nightmarish dreams, and patient after patient succumbing to some violent psychosis followed, putting her career, and her life, in jeopardy. Aided by long time friend and ex-boxer, ex-cop Samantha Cody, Lucy must reach deeply into her family’s past and into her own soul to find the strength to confront old and very powerful forces she never knew existed.

More Info on ORIGINAL SIN: http://www.dplylemd.com/DPLyleMD/Books-SCody.html

 

Visine and Munchausen Syndrome By Proxy

visine-1

 

Visine is a useful medication. I use it all the time. When the Santa Ana’s blow in SoCal and the temperature rises, the humidity falls, and eyes dry out, Visine works very well. When used properly it is very safe and effective—-but, if used improperly, it can be a deadly poison.

Actually, anything can be deadly. The difference between a drug and a poison is simply a matter of dose. What can cure, can harm; what can harm, can kill. It’s really that simple.

The active, and dangerous, ingredient in Visine is tetrahydrozoline hydrochloride. If ingested in sufficient amounts, it can cause an elevation in blood pressure, a drop in heart rate, a reduction in body temperature, nausea, vomiting, shortness of breath, blurred vision, seizures, coma, and death, to name a few effects.

The case of Samantha Elizabeth Unger underlines this danger. Seems she poisoned her two children by adding the medication to their juice. And may have done so multiple times—-which could indicate that this is a case of Munchausen Syndrome By Proxy—a psychiatric disorder in which parents harm children in order to garner attention and sympathy. Odd, but not rare.

Recently on Crime and Science Radio, Jan Burke and I interviewed Beatrice Yorker, the Dean of the College of Health and Human Services at California State University, Los Angeles and a renowned expert in Munchausen Syndrome By Proxy. Take a listen and check out some of the links for more info on the fascinating topic.

 

 

Snake Venom For Treating Seizures? On Second Thought

rattlesnake

 

In the dark ages of medicine, meaning anything before 50 to 100 years ago, those afflicted with epilepsy were treated, how shall we say, less than compassionately. They were often thought to be infected by some evil miasma, or possessed by a lurking devil or witch or warlock, or were afflicted with some contagious process. They were isolated from society, feared and shunned by all, and often subjected to horrific treatments – everything from freezing water to cutting holes in the skull to let out the evil spirits (trepanning).

 

trepan

 

This is not an uncommon reaction when people are faced with things that they don’t understand. And 100 years ago the medical profession actually understood very little.

A case in point would be Philadelphia physician Dr. Ralph Spangler who suggested that rattlesnake venom, which interestingly he had been using to treat tuberculosis (go figure), might be useful in treating epilepsy. He published an article about a Texas man who had been bitten by a rattlesnake and subsequently the epileptic seizures that had plagued him suddenly ceased. In this empirical observation of a single case he jumped to the profound conclusion that snake venom cures seizures. Thankfully cooler heads prevailed and other physicians pointed out that snake venom not only didn’t, and couldn’t, help epilepsy but rather frequently caused allergic reactions as well as hemolytic destruction of the blood. Not pretty.

The history of medicine is replete with such examples.

 

Crime and Science Radio: Deadly Doctors, Killer Nurses and other Medical Miscreants

photo 2012 cas

 

Join Jan Burke and I for a lively interview with Bea Yorker. We will delve into the very odd and not all that rare Munchausen by Proxy Syndrome as well as healthcare professionals who commit serial murders.

 

BIO: Beatrice Crofts Yorker is the Dean of the College of Health and Human Services at California State University, Los Angeles where CSULA’s forensic science program is located. She is renowned for her own research into Munchausen By Proxy, her landmark study of medical serial killers, and her publications on other topics that bring law, psychology, medicine, and ethics together.

 

LISTEN: http://www.blogtalkradio.com/suspensemagazine/2014/03/09/crime-and-science-radio-with-special-guest-bea-yorker

 

LINKS:

Medicine Net: Munchausen Syndrome: http://www.medicinenet.com/munchausen_syndrome/article.htm

Munchausen Syndrome, Cleveland Clinic: http://my.clevelandclinic.org/disorders/factitious_disorders/hic_munchausen_syndrome.aspx

Munchausen By Proxy: Cleveland Clinic: http://my.clevelandclinic.org/disorders/factitious_disorders/hic_munchausen_syndrome_by_proxy.aspx

Kid’s Health: Munchausen By Proxy Syndrome: http://kidshealth.org/parent/general/sick/munchausen.html

Medicine Net: Munchausen By Proxy: http://www.medicinenet.com/munchausen_syndrome_by_proxy/article.htm

Angels of Death: The Doctors: Crime Library: http://www.crimelibrary.com/serial_killers/weird/doctors/index_1.html

Angels of Death: The Female Nurses: Crime Library: http://www.crimelibrary.com/notorious_murders/angels/female_nurses/index.html

Angels of Death: The Male Nurses: Crime Library: http://www.crimelibrary.com/notorious_murders/angels/male_nurses/index.html

Serial Murder By Healthcare Professionals by BC Yorker, et al: http://www.ncbi.nlm.nih.gov/pubmed/17199622

Serial Murder By Healthcare Professionals by BC Yorker, et al: As PDF File: http://www.chem.sc.edu/analytical/chem107/tox/chem107_toxarticle.pdf

Psychology Today: The Medical Murder Club: http://www.psychologytoday.com/blog/the-human-equation/201206/the-medical-murder-club

 

 

Nip, Tuck, Jump: An Anesthetic Death?

nip_tuck

 

 

Beverly Hills is famous for plastic surgery. And famous plastic surgeons. Like Dr. Brian Novak, one the surgeons to the stars. But recently, things didn’t go so well with one of his patients. Like something from the TV series Nip/Tuck, where odd happenings were common, the recent suicide of a 53 year old woman was bizarre and unexpected. Seems she and undergone a face lift, after which she recuperated at the North Camden Drive clinic. At some point she became agitated, confused, ripped off her gown, and now naked climbed to the 10th floor roof where she threatened to jump. Ultimately she did, despite the efforts of a crisis negotiation team.

 

BH Clinic

 

How and why did this happen? I would suspect her tragic behavior had to do with drugs. Not those kind. The medical kind. Anesthetics and pain meds, drugs that work on the brain, the former to induce deep sleep and the latter to reduce the perception of pain. But these drugs can also cause confusion, disorientation, and bizarre behavior. Even delusions and hallucinations. These reactions can be part of the drug’s effects or a reaction to withdrawal or “coming down” from the drugs’ effects. These reactions are often unpredictable and come on quickly, as seems to be the case here. Sad.

 

 
 
Follow

Get every new post delivered to your Inbox.

Join 2,564 other followers