Inert Gases Can Lead To Murder!

Some time ago, I watched an interesting TV murder mystery program. It had a most intriguing plot. The scenario involved a wealthy man who had his home office designed such that it was similar to an impenetrable vault—both for security and privacy purposes. The room was so secure that it had its own air supply and other essential life-sustaining amenities for extended periods of seclusion.

However, this well-designed, perfectly secure room became a murder weapon in itself because someone who was displeased with the man added a halon gas canister to the ventilation system. The man was murdered by asphyxiation when the gas canister was remotely activated and halon gas pumped into the room. This action temporarily replaced the room’s normal atmosphere, thus depriving the man of life-sustaining oxygen.

As you can imagine, it took considerable time and a complicated investigation to determine the cause of death since the room was locked from the inside and there was no evidence of foul play.

Of course, I made some notes and researched halon gas! I found that, for a long time, halon gas was the gold standard of fire-suppressant systems for enclosed areas such as bank vaults, museums and other secure areas that contained high-value assets that could be damaged by traditional water-based sprinkler systems. Although, the halon in the television plot was not part of a fire suppression system for that man’s office, it was attached to the fresh air supply used specifically for his isolated office space.

I also learned that halon gas production was banned in many countries between 1989 and 1994 when it was discovered that halocarbon agents depleted the ozone layer. Existing halon-based fire suppression systems are still permitted, and recycled halon gas is allowed for maintenance and to refill these systems as needed, but no new halon systems can be constructed.

So, my idea of a storyline involving halon gas in one of my future stories became less feasible, since halon is not as available as it used to be. I decided that the TV show writers were possibly working from older research data.

That’s when I dug deeper and searched for halon replacement products. I discovered that, after halon was banned, other “clean agent” systems were developed that reportedly have no known ozone-depleting capacity. And these systems are installed now in place of, or as replacements for, halon-based systems.

These mainly include various inert gas fire suppression systems that utilize mostly nitrogen, argon or carbon dioxide—plus a few other inert elements that appear to be more difficult to use.

Nitrogen, argon and carbon dioxide naturally occur in the atmosphere, they do not harm the environment and are not toxic to humans (at least to the extent regarding residues on surfaces after their use).

Therefore, it’s perfectly feasible that any of these three gases could be used in a murder plot in much the same way as halon gas was used in that TV program. Flood a secure, sealed area with one of these gases and any human within that environment would die from oxygen depletion since the gases replace the regular room air to suppress fire without damaging valuables. This effect requires an airtight environment, of course, and that is termed “enclosure integrity.”

An interesting advantage to these inert gases is that the gas canisters that contain them can be located much further away from the protected enclosure than halon canisters. These inert gases flow much better inside suppression system piping and can be located up to 400 feet away from the area to be protected against fire.

This fact makes it easier for the villain in your murder plot to have access to the equipment that supplies air to the secure area to add an inert gas canister, or to activate an inert gas fire suppression system even without starting a fire. Of course, all this can be activated remotely.

So, the next time you need a character killed in one of your stories, you might consider placing that character in a room or vault that can be sealed off rapidly before the character can escape and then remotely activate the fire suppression system or attach a gas canister to flood that area with one of these inert gases.

The cause of death will be asphyxiation (suffocation/oxygen-depletion) but without an obvious source and with no external evidence of trauma or foul play.

Thoughts? Comments? I’d like to hear them!

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Smart Pills Simplify Medication Compliance Issues

Experts estimate that patients who do not take their medications as ordered cost this nation approximately $100 billion a year in additional medical expenses. Much of that additional cost is due to patients getting sicker and needing additional treatments or even hospitalizations.

Several years ago, I wrote a blog about the mind-boggling statistics regarding the number of patients who go to the doctor for a specific ailment but then ignore the doctor’s prescribed treatments. At that time, an estimated one-third of patients did not fill the prescription(s) that the doctor ordered to cure or alleviate the ailment.

The elderly population appears to be the worst about taking medications as prescribed. study by the US Office of Inspector General (OIG) indicated that 55% of elderly patients do not take their medications as prescribed. That percentage increases to an estimated 75% when elderly patients are prescribed three or more medications.

Earlier this month, the US Food and Drug Administration (FDA) approved the very first “digital pill” and this is a significant advance toward addressing the longstanding issues of drug therapy non-compliance.

A digital pill is an oral medication embedded with a sensor that emits a signal when a patient takes their medication. The sensor—containing safe ingredients normally found in food, like copper, magnesium and silicon—generates an electrical signal when touched by stomach acid.

After several minutes, the signal is detected by a patch worn on the patient’s skin—looks like a Band-Aid. The patch should be located on the skin over the left rib cage and needs to be replaced after seven days.

The patch, after receiving the signal from the ingested sensor material, sends the date and time of the medication’s ingestion to a cellphone app via Bluetooth technology. That information is then transmitted to a database that physicians and others, who have the patient’s permission to do so, can access.

Since 2016, the use of this technology has been tested outside of the clinical trials with specific pharmacies, but commercial use was very limited. Until this recent FDA approval, the sensors and medication were added to a digestible capsule by the dispensing pharmacies. Nine health systems in six states tested the technology with success for conditions that included hypertension and Hepatitis C.

The first digital medication approved this month by the FDA for the embedded sensor technology is Abilify, a medication prescribed to patients with schizophrenia and/or bipolar disorder. Patients with these conditions often do not take their medication regularly, and non-compliance can have severe relapse consequences. This new version of Abilify is called Afilify MyCite.

Additional regulatory clearance is being sought for medications used by heart patients, stroke victims, those with H.I.V., diabetic patients, and post-surgical patients to monitor for taking too much opioid pain medications.

Experts believe that regular compliance to medication therapy by a wide variety of patients, especially the elderly, could lead to reduced costs from non-compliance.

Variations of this initial sensor technology are already in the works with sensors made from magnesium and silver chloride that do not use the patch technology to pick up the signal of therapy ingestion.

Medication embedded with these chemicals generate a low power radio signal that can be picked up by a receiver worn around the neck of the patient. This presents an acceptable alternative for those patients who might be sensitive/allergic to the patch receiver option. There is also receiver technology being developed in the form of watch bands and cellphone cases for additional convenience.

The issue of privacy, as well as the overall argument by some that this is simply another “Big Brother Watching” scheme, is a concern with many patients. At least for the foreseeable future, such technology is merely an interesting option to conventional oral medications, and this new technology can be rejected by patients with privacy concerns.

Thoughts? Comments? I’d love to hear them!

Posted in About James J. Murray, About Medications/Pharmacy, Advances in Medication Therapy Compliance, Blog Writers, Blogging, Controlling Drug Costs, Cost of Ignoring Doctor Orders, Cutting Edge Drug Therapy Research, Deaths Related to Therapy Non-Compliance, Developing Technologies, Digital Oral Medication Compliance, Digital Pill Technology, Drug Error Prevention, Drug Errors in The Elderly, Drug Misadventures, Economic Impact of Therapy Non-Compliance, Future Drug Manufacturing Practices, Future of Drug Manufacturing, Innovative Drug Manufacturing Practices, James J. Murray Blog, Making Medications Affordable, Medication Cost Increases, Medication Non-Compliance, Medication Safety Issues, Misuse of Drugs, Murder Mayhem and Medicine, New Blog, New Drug Discoveries, New Drug Manufacturing Methods, New Drug Research, New Research Technology, New Ways to Manufacture Painkillers, Non-Compliance in Medication Therapies, Non-Compliance to Physician Orders, Non-Compliance to Prescription Therapies, Non-Compliance with Medication Therapies, Patient Non-Compliance, Patient Therapy Compliance Issues, Patient Therapy Outcomes, Pharmacy/Pharmaceuticals, Prescription Drug Safety, Prescription Fill Rates, Prescription Fill Statistics in the US, Prescription For Murder Blog, Prescription Prescribing Practices, Prescription Therapy Non-Compliance in the Elderly, Prescription Trends, Reasons for Medication Therapy Non-Compliance, The Pharmacy Profession, The Practice of Pharmacy, Types of Medication Non-Compliance | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | 2 Comments

A Thankful Writer!

Here in the United States it’s Thanksgiving time—Thursday, November 23rd to be exact—and it’s a day of fantastic food feasts, with the bonus of a long holiday weekend ahead.

More importantly, it’s a time to reflect on what makes our lives so special and rewarding and what makes us thankful when we think back on the current year and the events that have shaped our lives in the recent past.

This has been an interesting year for me, a challenge in many ways, but one in which I feel healthier and more energetic than ever.

Regarding my involvement in the world of long distance running, I have a couple of new certifications—a next level coaching certification for adults that has afforded me an opportunity to coach a group of fantastic coaches. More recently, I earned an advanced certification to develop and coach youth programs.

I will finish the year with a certification to become a CPR and First Aid instructor, a golden opportunity to teach others how to save lives should the need arise.

In my world of being an author, I published a new Jon Masters novel mid-year called Imperfect Murder (order HERE) and am now in the process of writing another novel in my detective series with a storyline that continues to excite me each time I think about it.

In past years, I have written a blog about why I’m so thankful for being an author. The “perks” to being an author range from being able to fanaticize as much as I want and not be considered crazy to the fact that (according to the reviews of my books) my work entertains people.

Every day, I am most thankful to my readers for supporting and encouraging my work as an author. You continue to inspire me and I THANK YOU from the bottom of my heart.

Happy Thanksgiving! And I wish you success at being thankful on a daily basis.

Thoughts? Comments? I’d love to hear them!

Posted in A Holiday Wish, A Writer's Thanksgiving Blog, About James J. Murray, About Running, About Writing, Being Thankful Every Day, Being Thankful For Your Life, Blog Trends, Blog Writers, Blogging, Developing Writing Skills, Growing As A Writer, Happy Thanksgiving Blog, Holiday Cheer, James J. Murray Blog, Life Skills, Life-Altering Goals, Murder Mayhem and Medicine, New Blog, Prescription For Murder Blog, Special Perks of Being A Writer, Thankful For Being A Writer, Why A Writer Should Be Thankful!, Writing As A Special and Rewarding Career | Tagged , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

A Safer Way to Control Pain

Several years ago, I wrote a blog about the DEADLIEST DRUGS in the US. It resulted from a question one of my readers had asked. This reader, an author, was contemplating what lethal chemical or sinister designer drug to use in one of his upcoming murder mysteries.

My initial thoughts were that the deadliest drugs in this country included the popular illegal ones—heroin, cocaine or methamphetamine—or some combination of those addictive drugs. It seemed an easy answer; but, as my readers know, I never make statements about drugs without first doing the research.

What I found astonished me! The deadliest drugs in the US—even several years ago—were prescription narcotic painkillers. In fact, I discovered that there was a three-fold increase in deaths from narcotic (opioid) prescription drugs in the past decade, even surpassing the psycho-pharmaceuticals often obtained illegally on the street.

More recently, studies have shown that opioid medications are prescribed by physicians far too often when other less addictive, and potentially less lethal, drugs might relieve a patient’s pain as effectively. In the decade between 2001 and 2010, emergency room-generated prescriptions for opioids rose nearly 50%.

The current epidemic of opiate addiction has left millions of Americans addicted to narcotic painkillers. It should be noted that not everyone who is prescribed narcotic pain medication will become addicted.

However, a report released in July by the National Academies of Sciences, Engineering and Medicine found that about eight to ten percent of patients will develop an addiction to a prescribed opiate, a so-called “opiate use disorder” and approximately 15% to 25% engage in problematic behaviors that suggest a dependence on the prescribed opiate drug. These patients often are still taking narcotic pain relievers a year later than expected.

This past July, the President’s Commission on Combating Drug Addiction and the Opioid Crisis published their findings and more recently declared opiate addiction as a “national emergency” with statistics that indicate almost 150 people die each day from a prescription opiate overdose.

An interesting study caught my eye the other day as I scanned my online news reports. It was conducted at the Montefiore Medical Center’s Emergency Department in the Bronx, New York. The study subjects were ER patients with bone fractures, sprained ankles, dislocated shoulders, traumas to the knee, and the like. From personal experience, I know that bone pain can be some of the worst to endure.

In this study, patients with bone injuries were evenly assigned into one of four groups: those receiving a non-narcotic combination of acetaminophen and ibuprofen (Tylenol and Advil or Motrin, respectively, are brand names), those receiving Percocet (a drug containing the narcotic oxycodone), others receiving Vicodin (the narcotic hydrocodone), and some receiving Tylenol #3 (a codeine/acetaminophen combination).

The results indicated that the over-the-counter pain cocktail of Tylenol (acetaminophen) and Advil (ibuprofen) worked as well, if not better, than the narcotic alternatives. On a 10-point pain scale with 10 being the worst pain possible, patients receiving the non-narcotic combo rated their pain two hours after dosing as a 4.3 on the scale, while the other three groups of narcotic-dosed patients rated their pain reduction as 4.4, 3.5, and 3.9, respectively—a statistically insignificant difference.

This study suggests that there are much safer alternatives to narcotic prescription prescribing practices. This simple study comparison in a real-world setting could not only help shape pain relief practices profoundly, but also shape the future direction of narcotic addiction statistics and possibly reduce the overall lethal overdoses from narcotic pain relievers in the United States.

Thoughts? Comments? I’d love to hear them!

Posted in About James J. Murray, About Medications/Pharmacy, Alternatives to Opiate Painkillers, Blog Writers, Blogging, Deadliest Drugs in America, Deadliest Drugs in US, Deadly Drugs in America, Death From Prescription Painkillers, Drug Abuse, Drug Misadventures, Drug Poisoning, Epidemic of Narcotic Overdoses, Illegal Drug Trends, James J. Murray Blog, Murder Mayhem and Medicine, New Blog, Opiate Epidemic, Opioid Crisis, Opioid Therapy Alternatives, Pharmacy/Pharmaceuticals, Prescription Drug Safety, Prescription For Murder Blog, Prescription Narcotic Deaths, Prescription Narcotic Overdoses, Prescription Painkiller Overdose, Prescription Prescribing Practices, President's Commission of Combating Drug Addiction | Tagged , , , , , , , , , , , , , , | Leave a comment

Veterans Day in The USA and Around The World

In the United States, Veterans Day is the anniversary of the signing of the armistice that ended the World War I hostilities between the Allied nations and Germany in 1918.

Veterans Day is celebrated annually on November 11th to honor and thank all military personnel (soldiers, sailors and airmen) who served the United States in all wars.

Originally named Armistice Day, commemorating the signing of the agreement that ended World War I at 11:00AM on November 11, 1918, this federal holiday’s name was changed to Veterans Day in 1954.

Each year, special ceremonies are held at Arlington National Cemetery in Virginia, as well as various other celebrations and parades around the nation. My own city, San Antonio, will have a huge parade on Saturday along one of the main downtown streets.

The first Armistice Day was held on the grounds of Buckingham Palace, hosted by King George V, on the morning of November 11, 1919. Simultaneously in 1919, President Wilson proclaimed that the day should be filled with solemn pride and gratitude for the victory and there were parades, public meetings and a brief suspension of business activities at 11:00AM in honor of the signing of the accord on the 11th hour of the 11th day of the 11th month in 1918.

The US Congress officially recognized the day in 1926 as a national day of remembrance and made it a legal holiday known as Armistice Day in 1938. In 1954, at the urging of veterans service organizations, Congress changed the holiday’s name to Veterans Day.

Many allied nations around the world observe November 11th as a day of remembrance for their military veterans. In Canada, the day is known as Remembrance Day, honoring veterans who have died in service to their county. In England, France and Belgium the day remains known as Armistice Day, and in 2012 Serbia made the day an official holiday.

In many parts of the world, people observe a one-minute, and more often a two-minute, moment of silence at 11:00AM on November 11th as a sign of respect—the first minute for the roughly 20 million people who died in World War I and the second minute dedicated to the living (the wives, children and family left behind who were deeply affected by the conflict). In recent times, however, this ritual has evolved to include veterans and affected families of all wars.

On this day, take a moment at 11:00AM to remember those who have sacrificed to keep our respective nations free from tyranny. And if you see a veteran this week, take a moment to stop and shake his or her hand and say, “Thank You for your service!”

Thoughts? Comments? I’d love to hear them!

Posted in A Veterans Day Reflection, About James J. Murray, Armistice Day, Blog Writers, Blogging, Celebrating Freedom, James J. Murray Blog, New Blog, Prescription For Murder Blog, Remembering Our Veterans, Remembrance Day, The Meaning of Veterans Day, The Price of Freedom, US National Holiday, Veterans Day | Tagged , , , , , , , , , , , , , , | 1 Comment

An Adrenaline Rush To Death!

Adrenaline is our friend! It’s one of those hormones that floods our bodies when we severely injure ourselves, feel afraid, or do strenuous exercise. It’s known as “the fight or flight hormone” (along with some help from norepinephrine and dopamine). It’s interchangeably referred to as adrenaline or epinephrine. In some literature, you will see it spelled adrenalin, and both spellings are considered correct.

So, what happens when too much pours into our bloodstream? We DIE! And that makes for a very interesting method of murder that can become the basis of a dramatic murder scene in writing.

We’ve all experienced an adrenaline rush in some form or another. From whatever cause, when our adrenal glands pump adrenaline (epinephrine) into our bloodstream, we experience: 1) a noticeable increase in strength, 2) no feeling of pain, 3) heightened senses, 4) a sudden burst of energy, and 5) our breathing and heart rate increases.

Such symptoms of extra adrenaline in our bodies may be in response to extreme fear, a life-threatening trauma (either to ourselves or others), or as a result of competitive sports participation. It helps us think clearly, react rapidly and appropriately, and dulls pain when needed. This experience is known as an “adrenergic storm” and is the basis of the fight or flight reaction.

Adrenaline, as an epinephrine drug, also treats severe allergic reactions since the drug narrows blood vessels to raise falling blood pressure. It also opens airway passages that may be constricted with associated wheezing. And there are auto-injectors available for people who may experience such allergic reactions.

The drug is readily available in an intramuscular auto-injector mechanism as an adult dose of 0.3mg (the 1:1000 strength). Since I have asthma, I carry around an injector. I’ve not used it for an asthmatic episode, but I did use it once while experiencing a rather dramatic reaction to an antibiotic.

An overdose of adrenaline (epinephrine) flooding into our bodies can be LETHAL. At times, we’ve seen news reports of medical professionals mistakenly administering a wrong dose of epinephrine and killing the patient.

There are also reports of people using epinephrine as a weapon of murder! And the consequences of an epinephrine overdose can lead to complete cardiac arrest.

Initially, there’s a rapid onset of agitation, blood pressure spikes, the heart beats fast and irregular, slurred speech and confusion ensue, sometimes a severe headache is experienced—and then the person cascades into either a cerebral hemorrhage or cardiac arrhythmias prior to death.

Treatments to prevent the fatal outcome include administration of benzodiazepines and beta-blocker drugs, but administration should be timely since epinephrine acts rapidly, especially if it is given intravenously.

So, with a readily available source, rapid onset and a deadly outcome, adrenaline could easily transition from friend to foe and provide an interesting murder weapon. And it should create a rather dramatic murder scene involving either your protagonist or antagonist.

Thoughts? Comments? I’d love to hear them!

Posted in A How To Blog on Murder Plot Ideas, A How To Blog on Murder Weapons, About James J. Murray, About Medications/Pharmacy, Adrenaline Overdose, Adrenaline Rush, Adrenaline Used For Murder, Adrenoline and The Fight or Flight Response, All About Murder, Blog Writers, Blogging, Bloodless Death Scene Writing, Bloodless Death Scenes, Chemicals Used For Murder, Designer Drug Deaths, Designing Murder Plots, Developing Storyline Ideas, Dramatic Murder Weapons, Drug Misadventures, Drugs For Murder Plots, Drugs Used For Murder, Epinephrine and The Fight or Flight Response, Epinephrine Overdose, Epinephrine Used for Murder, How to Choose a Murder Weapon for a Plot Idea, How To Write A BloodLess Murder Scene, Ideas for Murder Scenes, Imperfect Murder The Novel, Interesting Murder Weapons, James J. Murray Blog, Killing a Villain in a Novel, Killing Off Characters in Your Novel, Lethal Agents and Murder, Misuse of Drugs, Murder Mayhem and Medicine, Murder With Drugs, New Blog, New Methods of Murder, New Methods To Kill Characters in Your Novel, Plotting Interesting Murder Scenes, Prescription For Murder Blog, Story Development, Tools of Murder, Unique Murder Plots, Unique Murder Weapons, Using Adrenaline in a Murder Scene, Using Epinephrine in a Murder Scene, Writing Death Scenes | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

FENTANYL – The Good and The Bad!

Fentanyl is a synthetic opioid that is utilized in medical practice as a powerful pain reliever. It’s most commonly used in clinical settings either prior to surgery to induce sedation before administering longer-lasting sedation or in the recovery room following surgery for immediate pain relief. Fentanyl is very potent and effective to relieve pain, but it has a short duration of action—one to two hours at most, and often less than one hour.

The drug is also used to relieve extreme pain outside of the clinical setting via a drug patch applied to the skin. This transdermal patch slowly releases fentanyl over a 72-hour period. When I practiced pharmacy in an out-patient setting, a significant number of patients came to my homecare services sporting fentanyl patches as part of their overall pain relief plan while our nursing support administered intravenous medications for a variety of ailments that caused the extreme pain.

As commonly as fentanyl is in both the clinical and non-clinical settings, its reputation has taken on a more ominous one as a “filler” to “cut” heroin as well as other opioid and some non-opioid drugs. Over the last few years, fentanyl has been found as a filler in the party drug cocaine, and this is considered by drug law enforcement as a “game-changer.”

Courtesy of the New Hampshire State Police Forensics Lab

The reason for this enhanced apprehensiveness is somewhat complex, but a central concern is why people abuse heroin vs cocaine and the type of users who abuse these drugs. Heroin, an opioid from the poppy flower plant, is a depressant drug. Heroin is the type of drug that gives a sustained “buzz” and a heroin abuser often has a greater tolerance to opioid drugs. Although fentanyl-laced heroin is an extremely dangerous combination, drug overdoses have not been as extreme as in cases of fentanyl being added to cocaine.

Cocaine is a stimulant drug, a non-opiate from the coca plant, that gives a short-term euphoric effect—thus, its popularity as a party drug. When fentanyl is mixed into cocaine, that becomes the “game-changer,” as law enforcement agencies suggest. Cocaine users are more casual drug abusers, with a lesser chance of long-term addiction. The addition of fentanyl changes those dynamics, and that becomes a lethal combination.

Now it appears that drug-using party animals who use cocaine casually and occasionally have become unsuspecting victims with the progression of fentanyl into street drug mixes.

A 2016 study of overdose deaths in New York City revealed that 44% of the 1,300 overdose deaths involved fentanyl and 37% of those OVERALL overdose deaths involved a fentanyl-cocaine mix—that’s 84% of the lethal overdoses that involved fentanyl and that represents an increase of 11% over the previous year.

Synthetic opioids, such as fentanyl, are cheap to make, are easily available on the dark web and become extraordinarily profitable for illicit drug distributers. Heroin-fentanyl on the street costs a fraction of what prescription painkillers cost on the street. Although much focus has been given recently in news broadcasts regarding prescription opiate abuse and overdoses, most of the deaths are seen with illicit opiate abuse—as with the synthetic opioid fentanyl and fentanyl-laced street drugs.

Fentanyl is an extremely potent and dangerous drug when not used properly. Although heroin is about three times more potent than morphine (the so-called “standard” used for pain-relieving drug potency), fentanyl is up to 100 times more potent than morphine.

The initial symptoms of an overdose include pinpoint pupils, muscle weakness, dizziness and confusion. The symptoms progress to a profound decrease in heart rate and very low blood pressure, with eventual loss of consciousness. Extreme respiratory depression and a dangerously slow heart beat lead to lack of oxygen to the brain (and potentially lethal hypoxia) that can exhibit as permanent brain damage.

If your next storyline involves a drug overdose, a fentanyl-laced drug might be an interesting and timely addition to consider.

Thoughts? Comments? I’d love to hear them!

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