Black Market Botox

Updated 3/2017-- photos and all links (except to my own posts) removed as many no longer active. and it was easier than checking each one.

Earlier today I listened to NPR’s broadcast of the Diane Rehm show:  Implications of a Global Black Market for Botox (link removed 3/2017 -- no longer active).  The guests were

Col. Randall Larsen, executive director of the bi-partisan, Commission on the Prevention of Weapons of Mass Destruction Proliferation and Terrorism and the founding director of The Institute for Homeland Security (2000-2003)

Marina Voronova-Abrams, biosecurity or biothreat reduction expert, formerly based in Central Asia and Russia, now works for the nonprofit environmental group Global Green

Dr. Tina Alster, clinical professor of dermatology at Georgetown University Medical Center and the Director of the Washington Institute of Dermatologic Laser Surgery.

Kenneth Coleman, a Senior Fellow, for the Chemical & Biological Weapons Nonproliferation Program (CBWNP) of the James Martin Center for Nonproliferation Studies at the Monterey Institute of International Studies

In full disclosure, Diane Rehm begin by mentioning the use of Botox for her own vocal spasmotic dystonia.  Very interesting show.  

The reason for the show was the Washington Post article by Joby Warrick  “Officials fear toxic ingredient in Botox could become terrorist tool” posted Monday, January 25, 2010.

….Obtaining the most lethal strain of the bacterium might have posed a significant hurdle for would-be terrorists in the recent past. But today, the prospect of tapping into the multibillion-dollar market for anti-wrinkle drugs has spawned an underground network of suppliers and distributors who do most of their transactions online, the researchers found. Customers don't need prescriptions or identification, other than a shipping address………..

So lethal is the undiluted toxin that at least three countries -- the United States, the then-intact Soviet Union and Iraq -- explored its possible use as a possible biological or chemical weapon. All three gave up on the idea, partly because botulinum toxin degrades quickly when exposed to heat, making it poorly suited for delivery by missile or bomb

Having taken a few courses on Disaster Preparedness, it is always pointed out botulinum toxin is not a great toxin for mass destruction as it would be difficult to weaponize the bacteria as noted above and here.

Botulinum toxin is the most poisonous substance known.  A single gram of crystalline toxin, evenly dispersed and inhaled, would kill more than 1 million people, although technical factors would make such dissemination difficult. The basis of the phenomenal potency of botulinum toxin is enzymatic; the toxin is a zinc proteinase that cleaves 1 or more of the fusion proteins by which neuronal vesicles release acetylcholine into the neuromuscular junction.

BOTOX is currently licensed for treatment of cervical dystonia, strabismus, blepharospasm,  primary axillary hyperhidrosis, and glabellar wrinkles.  It is also used "off label" for a variety of more prevalent conditions that include migraine headache, chronic low back pain, stroke, traumatic brain injury, cerebral palsy, achalasia, and various dystonias.

REFERENCES

Botulinum Toxin as a Biological Weapon;  JAMA. 2001;285:1059-1070 (consensus statement)

Bogus Botox® (botulinum toxin type A) Suspected in Botulism Outbreak; Medpage Today, November 30, 2004; Jeff Minerd

Caution About a Bioterror Attack on the U.S. Milk Supply; June 2005; Marguerite Rigoglioso