Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide Slide 18 Chemical Agents of Opportunity for Terrorism: TICs & TIMs Positive Purpose “The use of pharmacological agents to produce calm behavioral state , particularly as relevant to management of individuals and/or groups that are agitated, aggressive and/or violent, is a topic with high relevance to achieving the mission of law enforcement and military communities ” (nldt2.arl.psu.edu/documents/calamative_report.pdf ) October 3, 2000 Module Two - The Clinical Neurotoxicology of Chemical Terrorism 18 Sedatives can be put to positive use to overcome an aggressive person or group, the difference being the route of delivery. In the emergency department (ED) we frequently sedate people in order to produce a calm behavioral state. To sedate a group, the chemical sedative must be delivered in a different fashion, such as by inhalation. This has been studied, along with other techniques such as sticky foam and netting, as a non-lethal technique to replace bullets for law enforcement. December 2008 Version 2.0 Page 86
Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide Slide 19 Chemical Agents of Opportunity for Terrorism: TICs & TIMs Inhaled Calmatives/Sedatives • Aerosolized drugs – GABAergic agents • Benzodiazepine (e.g. diazepam) • Barbiturate (e.g. pentobarbital) – Opioids • Volatile agents – Hydrocarbons Module Two - The Clinical Neurotoxicology of Chemical Terrorism 19 This slide describes some other examples of agents that would be useful as calmatives. They are all used in clinical medicine given their relative effectiveness and safety. Effective delivery is the challenge. Some hydrocarbons can be readily converted to gaseous form (such as inhalational anesthetics (halothane)) while most drugs are solids that, once dissolved in water or another solvent, can be aerosolized (misted). However, even creating a respirable aerosol is quite difficult and requires sophisticated technology. Not all substances that are inhaled are true gases. Some chemicals are liquid particles that can be suspended in air. This appears as a fine mist. The process of producing this mist is known as aerosolization. This mist preparation may also be known as an aerosol. Some liquid chemicals that are calmatives or sedatives have been aerosolized for use. These include agents that act through the GABA neurotransmitters discussed previously. These agents cause sedation. Examples are two drug classes known as benzodiazepines and barbiturates. While one would not necessarily use aerosolized versions of these drugs to treat patients, such aerosolized versions might have other uses such as to sedate large crowds of people, hence their potential use by law enforcement and the military. Volatility generally refers to the ability of a liquid to convert to a gas form (vapor) at relatively low temperatures. Unlike aerosols, vapors are not suspended liquid particles. Hydrocarbons refer to liquids which give off vapors at a high enough temperature. For instance, gasoline is a liquid hydrocarbon. An open can of gasoline emits a vapor which has a distinctive odor. Hydrocarbon vapors may also cause sedation. Drugs used in anesthesia that put patients to sleep in the operating room are hydrocarbons such as halothane (and in the past, ether and chloroform). December 2008 Version 2.0 Page 87
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Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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