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Doctor Discusses Drug That Killed Russian Hostages

Aired October 30, 2002 - 13:47   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


MARTIN SAVIDGE, CNN ANCHOR: Reports from Moscow say two more people involved in last week's hostage crisis have died. That brings the hostage death toll now to 119. All but two of those deaths are blamed on the gas that was used in the rescue. Today, Russia's top health official confessed as to what the compound was, fentanyl, a narcotic often used for anesthesia.
Dr. Sandy Fryhofer joins us now to talk more about this drug, this anesthesia.

Give us the primer. What exactly is this stuff?

DR. SANDY FRYHOFER, MEDICAL EXPERT: Marty, fentanyl has been around since the 1950s. It's a powerful narcotic that is opiate based, and it's used in anesthesia to relieve pain. It's about 100 times more potent than morphine. It usually comes in a lollipop form or it's a lozenge. So we don't usually see it in a gas. That's what's interesting, because it could be the top secret part of this is that the Russians have developed some sort of new system in which to suspend this in a gas, and that may be what they don't want everyone to know about. But usually this is in a lozenge form or as a skin patch.

Now, also we know that, as I said, it's used to relieve pain. It also can use euphoria, confusion. It can cause the pupils to become constricted and become pinpoint. It also can cause nausea. And in high doses, it depresses respiration and it can shut down breathing so the body can't get oxygen. So in very high doses, it could even cause death. And that might have been what happened in this case. These people just couldn't get the oxygen they needed because their respirations, they couldn't breathe basically.

SAVIDGE: So why is it that some people die and some people do not, though?

FRYHOFER: Well, you know, usually when we give medications like this, we control the dose, we temper the dose according to the person's size. Again, a lot of these patients, a lot of these people, were elderly. These were theatergoers. Also the effects of this fentanyl can be enhanced if people had been drinking or if they had any liver problems. Or if they were on something as simple as an antihistamine. So much we don't know. Also the skin patches are actually dangerous for children. So depending upon the size of the individual and other medical conditions, that could have an effect.

But it really does sound like the dose used in this instance was very high. It's more like an unconventional use of a conventional drug, because as I said, this fentanyl has been around since the 1950s.

SAVIDGE: And if doctors in Russia had known this was being used, is there an antidote they could have applied, say, directly at the scene that might have saved lives?

FRYHOFER: There is an antidote, and it's called Narcan. We did hear reports that some of the individuals who did recover, some of these hostages that recovered, did respond to the Narcan. What I've heard is the doctors weren't told that from the onset. They weren't told what was in that. Certainly, if the doctors had the knowledge as to what they were dealing with, they could have been better able to take care of these people. Probably more people could have lived.

But also you think about it, here there were about 700 hostages. They couldn't breathe. It's pretty hard to resuscitate that many individuals at one time. But certainly, if they'd had that knowledge and known OK, go ahead and give these people Narcan, that would have been a big help. It might have saved some more lives.

SAVIDGE: I believe there will be a lot of studying that will be done on this incident.

FRYHOFER: A lot of studying, you've got that -- Marty.

SAVIDGE:: Dr. Sandy Fryhofer, thank you very much for joining us today.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com







Aired October 30, 2002 - 13:47   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
MARTIN SAVIDGE, CNN ANCHOR: Reports from Moscow say two more people involved in last week's hostage crisis have died. That brings the hostage death toll now to 119. All but two of those deaths are blamed on the gas that was used in the rescue. Today, Russia's top health official confessed as to what the compound was, fentanyl, a narcotic often used for anesthesia.
Dr. Sandy Fryhofer joins us now to talk more about this drug, this anesthesia.

Give us the primer. What exactly is this stuff?

DR. SANDY FRYHOFER, MEDICAL EXPERT: Marty, fentanyl has been around since the 1950s. It's a powerful narcotic that is opiate based, and it's used in anesthesia to relieve pain. It's about 100 times more potent than morphine. It usually comes in a lollipop form or it's a lozenge. So we don't usually see it in a gas. That's what's interesting, because it could be the top secret part of this is that the Russians have developed some sort of new system in which to suspend this in a gas, and that may be what they don't want everyone to know about. But usually this is in a lozenge form or as a skin patch.

Now, also we know that, as I said, it's used to relieve pain. It also can use euphoria, confusion. It can cause the pupils to become constricted and become pinpoint. It also can cause nausea. And in high doses, it depresses respiration and it can shut down breathing so the body can't get oxygen. So in very high doses, it could even cause death. And that might have been what happened in this case. These people just couldn't get the oxygen they needed because their respirations, they couldn't breathe basically.

SAVIDGE: So why is it that some people die and some people do not, though?

FRYHOFER: Well, you know, usually when we give medications like this, we control the dose, we temper the dose according to the person's size. Again, a lot of these patients, a lot of these people, were elderly. These were theatergoers. Also the effects of this fentanyl can be enhanced if people had been drinking or if they had any liver problems. Or if they were on something as simple as an antihistamine. So much we don't know. Also the skin patches are actually dangerous for children. So depending upon the size of the individual and other medical conditions, that could have an effect.

But it really does sound like the dose used in this instance was very high. It's more like an unconventional use of a conventional drug, because as I said, this fentanyl has been around since the 1950s.

SAVIDGE: And if doctors in Russia had known this was being used, is there an antidote they could have applied, say, directly at the scene that might have saved lives?

FRYHOFER: There is an antidote, and it's called Narcan. We did hear reports that some of the individuals who did recover, some of these hostages that recovered, did respond to the Narcan. What I've heard is the doctors weren't told that from the onset. They weren't told what was in that. Certainly, if the doctors had the knowledge as to what they were dealing with, they could have been better able to take care of these people. Probably more people could have lived.

But also you think about it, here there were about 700 hostages. They couldn't breathe. It's pretty hard to resuscitate that many individuals at one time. But certainly, if they'd had that knowledge and known OK, go ahead and give these people Narcan, that would have been a big help. It might have saved some more lives.

SAVIDGE: I believe there will be a lot of studying that will be done on this incident.

FRYHOFER: A lot of studying, you've got that -- Marty.

SAVIDGE:: Dr. Sandy Fryhofer, thank you very much for joining us today.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com