Re: Ivins's "suicide": Questions: How much Tylenol with Codeine must one take to do the job?

Question 2: How long is such medicine effective if kept at optimal conditions?

Question 3: Would a knowledgeable person pick this method to commit suicide? (Remember, his a scientist of a kind who should how to find out about many chemical methods.)

Question 4: Is all we know that a former friend of Ivins told the press that this was the manner of his death (as he was told after visiting Ivins in the hospital).

will cream your liver.

that it destroys your liver & it takes about two horrible weeks to pass

in sufficient quantities. So I've read.

Prob. not, which points to the possibility that someone else . . . Hmmm.

There's suicide and there's suicided.

If someone wanted him dead for sure, why not kill him instantly, instead of leaving a faint chance that he would die in the hospital? For that matter, if he were murdered as part of a cover-up, where is the planted confession? Where is the evidence that would remove all doubt that he killed himself and that he was guilty?

There are holes in either theory.

Again, intelligent.

Why not "suicide him" in an everyday manner? You can't be sure a car accident will do it and so you pick a certain (as you showed, take too much Tylenol and it's over) but common manner (to not raise suspicions).

Of course, I see the holes here too.

so that part is not odd.

With a full grown adult once it destroys the liver, it takes anywhere from forty eight to seventy two hours to die from liver failure.

I'll add to this... it is not a nice way to go either

The whole thing has holes a plenty... but not in the method of death

for what killed him, so it's not considered a suspicious death. I think that's the law in many places. If someone dies in a hospital while being treated for what killed them, then the cause of death is not considered suspicious. They ran blood tests and treatments on him for two days while he died in exactly the way they'd expect from the cause. It's not that unusual, but of course, this wasn't a usual case, so everything is magnified.

puts you to sleep and supreses your respiratory functions. If you take enough, it puts you to sleep and you just don't wake up. If someone does get to you in time, the tylenol damage to your liver is irreversible, so they can't save you. It's the most common type of OD in emergency rooms, and a favorite form of suicide.

Also, he may have just used what he had available. No form of poison is going to cause a pleasant death, but one that puts him to sleep will be the least painful. And there's no telling what someone in that state of mind is thinking. Some are looking for the most effective way, some are looking for the way that gives them the greatest chance of survival (the "cry for help" suicides), some are trying to punish themselves and so are looking for a painful death. And some haven't even thought it through. They sit down, they realize there is a bottle sitting next to them that will kill them, they stare at it, and before they can change their minds they swallow the pills to end all their pain. Sometimes they trick themselves afterwards--they aren't really going to die, they didn't do anything, they are just going to go to sleep and face it all when they wake up. That's why some people choose pills over guns or tall buildings--no pain, and the decision doesn't require them to know for sure that they will be dead in an instant. It gives the mind room to trick itself. Suicide is rarely performed in a sane frame of mind. Sometimes, but rarely. Usually at least depression and stress are twisting thoughts.

Whether that's what happened, I'm not saying. Only that the method is not inconsistent. I have a lot of doubts here. But to me it's possible he killed himself, and that wouldn't even mean he's guilty.

guilt).

And maybe he could have thought of a better chemical method, but since time was short, etc.

But shouldn't an investigative reporter be asking these questions of the authorities (FBI, hospital, etc.)???

Had he had any attempts previously?

(I have had some experience in this field as an attendant in a mental hospital in the 1970s. Saw a young man who slit both wrists and his jugulars with the broken glass of a light bulb who then came to the nurses' station asking for a cigarette. Took 4 attendants to put pressure on the 4 cuttings and walk hims to the medical ward. I was one. Yikes.)

Seriously, these are good answers. Not definitive, of course, but good.

How long had he known he was under investigation? Couldn't he have planned a different method if he foresaw the possibility of having to do this?

We've heard rumors from one source that he was hospitalized before and that he had homicidal tendencies. There were a couple of sources who claimed he had suffered from depression. There was a quote from his brother that he believed he was omnipotent, but there was no context for that statement. The way it was quoted made it seem like his brother believed he was guilty, but I haven't heard more from his brother, and you'd think that would be news.

The questions aren't being asked, and the answers we have seen aren't convincing. I can completely believe that someone could do what he's accused of doing, but I haven't seen enough evidence to say he absolutely did do it. And the other thing that's being left out is the political side. There's a suggestion that he did it to test an Anthrax vaccine, but that makes no sense. He mailed letters from Florida to New York--too wide-spread to be a decent test, and too narrow a list of people. All the people were personal enemies of Bush, and that's not being discussed as a motive by anyone. Maybe the feds are being ordered by BushCo to keep that aspect silent, I don't know.

Too many holes. We don't know anything, and I don't know that the investigators know anything. The news is full of people being proven innocent despite investigators being absolutely certain they were guilty.

means a favored form of suicide among men.

the best method in minutes. So why not a better way????


Here's a major hole in everything I've been writing: If he was mentally disturbed, trying to make rational sense of his methodology might not be so rational.

It would be the way he was most familiar with. And if he was suffering from depression, he wouldn't be trying for rational perfection. He'd just be trying to get it done.

Look at it from both sides, not just one. What if he was going to kill himself, and he decided that that evening? What would he do? Of everything he had around him, the Tylenol was the most effective. He didn't want to go out to shop for other chemicals--he might lose his nerve, and he was depressed, not wanting to go out. All he wanted was an end to the pain and fear and feelings of depression. Take some pills, go to sleep... Perfectly consistent with a suicide.

Yeah, knowing the outside context it's easy to be suspicious. I'm suspicious, too, very. But nothing about the way he supposedly did it makes me more suspicious. It's perfectly believable, and there's no evidence in it to prove otherwise.

Our proofs lie elsewhere.

It's the fact that he couldn't have made the anthrax that lethal nor mailed the letters.

With planning and knowledge, i don't know what he could have done. But that's the point. I haven't seen evidence that he did any of it, or how he did it, or why he did it. So far we've seen good reasons to investigate him, but no good reasons to convict him. Do they really have no case, or are they protecting someone else, or what? I doubt we'll learn anything until Bush is out of office.

And the reason I commented on the suicide issue was because that's all you said in your post. I rarely go back to previous discussions when replying. Mostly because my memory is so bad I can't remember previous discussions. :)

Yes, too much codeine and you go to sleep permanently because it doesn't just knock you out it depresses your respiratory function, which reduces oxygen to the brain, which further weakens respiratory function, which...

But if they get to you before your breathing fails they can treat you for the tylenol overdose at the same time they use naloxone to neutralize the effect of the codeine. As long as they know about they tylenol.

What often happens is that somebody doesn't take enough for the codeine to kill them. But that's plenty of tylenol to deplete an enzyme needed by the liver. So they walk around happy they survived (if they're not happy they get hold of more of this stuff and take a bigger dose). The liver, without the enzyme, struggles along for a day or two without much complaint, then suddenly it dies. And that's when the pain kicks in. Agonizing pain. Which lasts two or three days, then you die (and you'll be very glad when death comes, because that's the only thing that will put an end to the intense pain).

Before the pain kicks in they can treat you with the special enzyme. Your liver will be damaged to some degree, depending on how long between the overdose and the treatment. But you'll live.

That enzyme could be added to tylenol which would prevent this form of suicide (too much tylenol would still kill you, but the dose is a lot higher, and the way it kills you is different). But it adds a few pennies to the cost, so a single company marketing it wouldn't make enough money on it. Only if all of the pharma companies were forced to do it would it be viable. But governments around the world won't do that because it would upset the pharma companies.

The difference between the recommended dose and the dose that causes liver damage is very small. The safe dose is safe only if you don't take it for more than three days because in some people there's a chance that even the safe dose is enough to deplete that enzyme faster than it can be replenished. Alcohol intensifies the effect of tylenol and some people have suffered serious liver damage after washing down a couple of tylenol with a glass of wine (it's rare, but it happens).

A smart guy like Ivins would know all this stuff (because he's smart enough to research it beforehand) and would either choose a different method or take enough to make damned sure it would be the codeine that killed him.

I think what a number of people have written here would give a good investigative journalist a real kick in the pants, good perspective on the entire, and lots of good questions to ask, trails to pursue.

Esp. Jobycom and you. It doesn't matter if you're at variance, what we all want in investigation.

I don't remember seeing that in any thread other than this one. But the turnover in posts on DU means I
have to speed-read through some of them and even then I can only hope to look at a fraction of them.

If he was two days in hospital then it wasn't codeine that got him but tylenol. And I just do not believe a guy that smart would use that particular method of suicide and botch it. He might not have known the exact dosages required, but he'd have known that too little would not take him out cleanly. So he'd either have researched it and taken the right dose, or chosen another method, or accumulated enough of the stuff to take a megadose that was far higher than could possibly be needed.

There are plenty of ways to kill yourself. Many of them are slow and/or painful. But few of them compare to the protracted agony of tylenol. If you make a botch of hanging yourself, instead of breaking your neck you strangle slowly for five minutes—nothing compared to tylenol. If you can acquire a hypodermic you can inject air into a vein and cause an embolism that gives you a fatal heart attack—no fun at all for a couple of minutes, but nothing compared to tylenol. If you yank the power cord from a desk lamp, dip your hands in salty water, then grab the bar ends you'll send enough current through your chest for a fatal heart attack. Even in a situation where you have to improvise (like a hospital ward) you can usually find a way to do it provided you're willing to put up with intense pain for up to 10 minutes—nothing compared to tylenol.

The one advantage the codeine/tylenol mix has is that you can take it without feeling pain and, if you're lucky, die in your sleep. It might superficially seem attractive to a more painful method. But only if you're completely unaware of what happens if you don't take enough.

But assume Ivins didn't know the correct dose, or thought he did but miscalculated. And assume he didn't have the courage for one of the other methods which guaranteed some relatively brief pain, or none of those were available to him. So he took the codeine/tylenol mix, but a low enough dose that he woke up the next day and realized that it hadn't worked. Realized that he now needed to get treatment for the tylenol or in a day or perhaps two he would then face two days of intense agonizing pain before death. Would he decide to just wait for the intense pain to kick in, or would he seek out immediate treatment, or would he cast around for some other means to finish himself off quickly before the two days of intense pain kicked in?

For him to have been two days in hospital before death, he must have had at least one day in which to either top himself a different way or to seek treatment. Yet he chose to just wait until the pain kicked in.

It does not compute.

Oh wait, not everyone knows about what an overdose of tylenol does. But he was a scientist at USAMRID. More to the point, some of his LTTEs show that he was widely-read outside of his own specialized field, including a reference to a research paper linking homosexuality to a gene complex that determines the direction of whorls on the head (or something very obscure like that). That's a man with a pack-rat brain. A man who always wins at Trivial Pursuit. A man who is a glutton for knowledge. A man who probably reads Scientific American and/or New Scientist as recreation. So even if he were not in a position to research the exact doses required, he'd almost certainly know what an overdose of tylenol can do.

OK, it's possible to come up with a complex explanation to account for it, requiring all sorts of ad hoc assumptions just to make it hang together—a prime target for Occam's Razor. But it's still something you might just about be able to swallow. Until you consider every other thing about the official explanation of every aspect of the case requires similar complex, implausible, unbelievable arguments to bolster them.

our SOP in the field was activated charcoal, plenty of it, and transport to the resus unit

If we caught it in time the liver may have survived the insult... aka most of the crap got caught in the AC

If we didn't... that person went into the liver transplant list or plainly died.

How about men with PHDs in biochemistry?

also it was in Mexico

I saw five kids who tried, two that succeeded

One that used rat poison and succeeded

We didn't see that many guns since they were not that widely available

So men used ropes and nooses, instead of guns.

Oh and on the really sad part... our suicide attemtps went thorugh the roof the month before christmas all the way to mid january and one christmas we saw a total of seven suicides, that is my crew and I... not the shift, that year was a bumper crop with over thirty in one day...

Yep, it still strikes me as an odd year

Oh and none of those had a college degree to their name either.

The closest I got to somebody with even a bachelors was the wife of a guy who used to beat her...

I once took the standard dosage of Tylenol w/Codeine after a tonsillectomy. I had trouble breathing.
If that's how he truly died, my question is suicide or accident?

I'm not a good one to know because I could only take a single tab once.

I do DOUBT that it was an accident as someone suggested. Ph.D. in bio chem or somesuch.

If the person is medication naive; maybe 10 tablets - although that would only add up to ~3 grams of Tylenol, which wouldn't be enough to cause liver failure; codeine at 300 mg might do it though. If he had been taking the medication regularly, then it's a different story. He would have a tolerance to the codeine since it's a narcotic (methylmorphine), so who knows. Some people take up to 1000 mg of codeine a day for pain management/because they're addicts with no problem. Liver failure doesn't occur until ~10 grams of tylenol. So that would be about 30 tablets.

Will cause respiratory arrest, convulsions, muscle twitching, gastrointestinal spasms; kidney and liver failure.

It's a very strange way to commit suicide - slow and painful.

If Mr. Ivins truly wanted to kill himself, I'd expect he would have used a gun or slit his wrists.

There's a lot about this story that doesn't add up.

It's difficult to defend yourself against criminal allegations when you're dead.

not put much beyond Cheney.

is that we start looking like the whacko conspiracy nuts who couldn't believe that Vince Foster killed himself. Aren't we doing the same thing when we engage in stuff like this?

If you administer Mucomyst, even a large tylenol OD is survivable. But treatment must be initiated within the first 10 -- perhaps even 24 -- hours.

I don't know how much codeine he took, or even which type of pill he took (Tylenol 1,2,3, or 4). But the immediate effects -- coma, respiratory depression, etc ) would have been from the codeine, not the tylenol.

It all depends on what dose he took. Enough to cause coma from the codeine? Or enough just to cause toxicity to the liver, but not knock him out from the opioid effects of the codeine?