Help me kill someone in a story by CDI.
January 16, 2011 9:09 PM   Subscribe

ForAStoryFilter: how to best kill someone by CDI!

Okay, the pairing is going to be fairly innocuous: alcohol + either a) a sedative or b) an anti-anxiety med. I suspect the former is going to be easier than the latter in terms of character execution, although realism/chemical nature trumps that small preference.

The scenario: family of three, stepmom + father + young child. Parents have very tense relations; stepmother is stepping out of the relationship, father is too afraid of divorce proceedings and other complications to actually file for divorce (he is in a massive amount of debt, he is a schoolteacher, she is a lawyer). She is verbally abusive, and often threatens to leave/mocks him/etc., and is very cool (albeit not outright mean) to the child. She is rather stressed out (due to profession), and often takes either a) an anti-anxiety med and/or b) a sleeping aid to treat either anxiety or insomnia. She likes to have a light drink of some alcohol in the evenings.

The idea is that the girl would one day, under the impression that "since she 'calms down'/'goes to sleep' whenever she ingests this med and is generally less mean, I'll put some in her drink', in the hopes of calming her down and keeping her home more often instead of always going out to visit her beau, which makes her father upset. (Possibly they were fighting about her infidelity.) Next time stepmom happens to drink some, she spaces out/gets woozy very quickly, passes out, and dies from CNS depression/stops breathing late one night when no one else is home.

The setting is in Japan, modern day.

1) Specifically, what drug should be married with what type of alcohol to achieve the best (read: most deadly) results? Availability in Japan is a consideration here, although less important/easier to fudge than a realistic combination. I'm concerned about the solubility of a given drug in a given type of alcohol (wine/beer/gin/etc), its taste (the drug should preferably not add any peculiar tastes), and its chances and/or window of resuscitation--that is, what are the chances the victim'd survive, whether with medical aid or just on her own without aid. [Assume since the girl was too young to know better, she just dumps a random amount of drug into the drink--ergo, should it dissolve, it is definitely a high concentration of the drug, never mind that alcohol and this kind of drug tends to synergize.]

2) The child is projected to be aged between 7 to 11 years old. I'm hoping to have her on the older end of that spectrum to allow me to slip in a particular cameo, but again, realism is more important. Is it plausible that children not know about drugs + alcohol = bad bad idea? Most people I've queried says they didn't really know that until late high school, so I'm hoping I can be safe here. The understanding is that both are Adult Things and she doesn't touch them for herself, but since her stepmother has both and is just fine then having both at once wouldn't occur to the child to be harmful.

3) This should be fairly easy for the police labs to figure out, yes? I'm assuming drug presence, especially prescription drug presence, is very easily testable in samples, even when dissolved in alcohol.

4) Any other considerations I should have here?

Thanks in advance for keeping my stories realistic--even if my readers may not notice.
posted by Hakaisha to Science & Nature (27 answers total) 1 user marked this as a favorite
you really should tell people what CDI stands for instead of just hoping they read the tags for clues
posted by mulligan at 9:16 PM on January 16, 2011

CDI = combined drug intoxication.
posted by dfriedman at 9:17 PM on January 16, 2011

I'd go with a monoamine oxidase inhibitor + EtOH. The death wouldn't be from CNS depression, though; it'd be from stroke secondary to a blood pressure spike due to a drug interaction with Tyramine, which is found in fermented beverages. The only hiccup in the plan is that MAOIs are a second- or third-line drug against anxiety and depression (due to their possibly fatal interactions).
posted by The White Hat at 9:29 PM on January 16, 2011

I recommend Ambien. No taste, quite common - docs throw it at you if you travel internationally or have insomnia, and a larger-than-normal dose causes hallucinations and then vomiting/respiratory depression. Ambien gives you a lot of reality-cred and also a wide range of dramatic potential.
posted by SakuraK at 10:42 PM on January 16, 2011

This is a difficult scenario because you are positing that the mother already takes this medication and already likes to have a glass of wine in the evening. And yet when the daughter puts the med in the wine the mother dies. The problem I'd have: Why hasn't the mother died long before if this med is so deadly when mixed with a small amount of alcohol? Anyone who takes a medication which is fatal in small quantities when taken with small amounts of alcohol would not casually drink wine in the evening. The possibility of accident is far too high.

It is almost certain that the stepmom in question would, under those circumstances, being taking a benzodiazepine like Xanax. Hell, working mom + anxiety + wine + benzo is basically a cliche. Mixing a bunch of her pills into the wine is very much not a good idea but the odds of her dying are really, really low. Massive amounts of benzo + alcohol is the classic "cry for help" suicide attempt because it's so dramatic but relatively benign (as suicide attempts go).

White hat suggets MOAIs. But that doesn't fit in your scenario for a number of reasons. I wouldn't buy it at all, it wouldn't make any sense. MAOIs are a last resort for severe problems not something you pop into your mouth once in a while because you're kind of anxious. And the mom wouldn't go anywhere near wine if she were taking an MAOI. MAOIs have a list of "STUFF WHICH WILL KILL YOU" as long as my arm so people taking them aren't casual about these things.

I'm afraid that I wouldn't buy the common, innocuous anti-anxiety med plus one glass of wine = DEATH scenario. You may want to rethink one part of the equation. She either needs to be on a really serious regimen of meds or the kid has to put a different med into the wine by mistake or something.
posted by Justinian at 10:45 PM on January 16, 2011

The only hiccup in the plan is that MAOIs are a second- or third-line drug against anxiety and depression (due to their possibly fatal interactions).

Someone taking MAOIs wouldn't routinely drink though, would they? This might work if the kid steals it from a friend's parents - like her best friend's parents were going to get divorced but then they didn't because friend's mom/dad got these pills that made her better. So the girl thinks, wow, it's as easy as that, I'll just slip these pills in there and...
posted by atrazine at 10:50 PM on January 16, 2011

Response by poster: Justinian: as is probably evident by this question, I don't have much knowledge of pharmaceuticals. I was under the (likely wrong, given your valid questions) impression that as long as the ingestion of the drug is usually far separate from ingestion of alcohol, it should be fine. E.g. if she takes her medicine in the early morning, drinking wine or something in the late evening is okay. Are anxiety meds very different in that regard?

If the scenario I'm proposing is very unlikely due to chemical natures, so be it, I'd probably have to work at another angle...any suggestions similar to the ones I'm proposing? I can of course return to the drawing table and start from scratch, but if something would work in a similar framework I'm all ears.

posted by Hakaisha at 10:50 PM on January 16, 2011

Further problem of which the Ambien suggestion reminds me: A lot of these pills are big honking horse-chokers. You can't just dump some Ambien into a glass of wine. You'd end up with a glass of wine with a couple giant white tablets floating around in it.

Dumping it into the wine isn't enough. She'd have to grind up the tablets in like a mortar and pestle. And then even if the pills fully dissolved it would almost certainly make it taste truly awful if included in quantities large enough to do much more than knock her on her ass for 12 hours. And a 10 year old, even if dumb enough to try this, is not going to grind up 20 tablets or whatever.
posted by Justinian at 10:51 PM on January 16, 2011

Part of the problem is that the most common happy-pills are specifically designed to make overdoses (including CDI) less likely.
posted by atrazine at 10:52 PM on January 16, 2011

I was under the (likely wrong, given your valid questions) impression that as long as the ingestion of the drug is usually far separate from ingestion of alcohol, it should be fine. E.g. if she takes her medicine in the early morning, drinking wine or something in the late evening is okay. Are anxiety meds very different in that regard?

It depends on what you mean by "fine". Taking most anxiety meds with alcohol just kind of amplifies the effect. You get really groggy and out of it, slurred speech, etc. So to avoid that you don't drink alcohol close to when you take the pill. The thing is, if you make a mistake and take them too close together you just don't drive until it wears off.

You're talking about something which kills you dead if you take them too close together. Nobody goes "okay, this will kill me if I drink the wine 4 hours after taking my pill but it has been 8 hours so BOTTOMS UP". You avoid alcohol completely under all circumstances unless you have a death wish.

The downside of a screwup with the former is "I can't drive until I take a nap". The downside of a screwup with the latter is "my family attends my funeral". So people do the former all the time... even for fun... while nobody in their right mind does the latter.
posted by Justinian at 10:56 PM on January 16, 2011

any suggestions similar to the ones I'm proposing?

To preserve the idea of the daughter accidentally poisoning her mom with meds found in the house mixed into wine? Honestly, if the mom commonly enjoys a glass of wine in the evenings there's probably no way to make it work such that the mom's own medication kills her. Have you considered the daughter screwing up and mixing somebody else's meds into the wine? Her dad's? Something?
posted by Justinian at 10:58 PM on January 16, 2011 [1 favorite]

Make the Step mom a recreational heroin user. Have the stepchild put stepmom's stash of heroin in her wine to make her happier. Voila!
posted by zia at 10:59 PM on January 16, 2011 [1 favorite]

Maybe barbiturates would work. They're still prescribed for migraines and they're much less safe then benzos. The combination with alcohol has taken quite a few lives.
posted by TungstenChef at 11:25 PM on January 16, 2011

Better either make it a fictional drug, or a very well-known dangerous combination that the manufacturer has a warning about. What if your book sells a million copies, and then the makers of Ambien sue your pants off for defamation?
posted by ctmf at 12:11 AM on January 17, 2011

Barbiturates are an interesting suggestion. That would indeed be something you might not take every day and use as-needed and would interact badly with alcohol. Maybe the mom takes anxiety pills more often but the daughter makes a mistake and puts barbiturates in the drink instead, which the mom only takes rarely? I might buy that.

The only problem is that I think they are hardly ever prescribed anymore and are mostly used for like epilepsy. But I could be wrong about that. You'd have to check if they are ever used in Japan for other things; I have no idea.
posted by Justinian at 12:17 AM on January 17, 2011

Why not mix things up a bit further? Sure, mommy dearest is popping a Valium or two to unwind after a high stress case, and she knocks back a drink at the end of the day to help her fall asleep. Not healthy, but unlikely to cause any serious problems under normal conditions. However, that's just the start.

Daughter doesn't know Valium from Oxycontin. One is for step-mom's stress. One is for, let's say a berated husband who was backing off from his angry wife, fell over a table, and landed on his wrist, breaking it. Heavy painkillers are less common in Japan, but not outside the realm of possibility.

Today was a really bad day for step-mom. Work was horrible, the weather was bad, and dad's broken wrist means he can't do as much to help take care of the apartment. Step-mom pulls out the whiskey and bitters. Add half a dozen crushed Oxycontin pills. Step-mom thinks she just added too much of the bitters, but finishes the glass anyway in frustration at a bad day.

Mixing a glass of whiskey, a couple Valium, and half a dozen Oxycontin is a recipe for disaster. The more Oxycontin you add, the worse it gets. The drink is strong enough that a bit of a peculiar taste can go quite unnoticed. It's not absolutely certain to be lethal, but quite possible. It's a well known killer combination even in healthy men twice as large as this woman.

Police labs will figure this out easy. Even the most basic drug test will include opioids and alcohol. Whether you want this to look like a suicide, a homicide, or an accident, you could easily do so with the right details.

Remember to research trade names. Certain drugs like Valium (diazepam) may be sold under different names in Japan, something you'd want to note. If you want to avoid brand names (ctmf does raise a good point), you can just use "anti-anxiety medication" and generic morphine. Morphine isn't as scary as Oxycontin, but it's still the same idea. Opioid painkillers + alcohol = dangerous and potentially deadly.
posted by Saydur at 12:22 AM on January 17, 2011 [1 favorite]

If stepmom occasionally drinks several glasses of wine per night and if stepdaughter grinds one large Ambien into each one, I guarantee wacky things will happen. Passing out and choking on her own vomit would be an easy result to explain. Or if you want something more dramatic, she could go on a post-wine. Post-Ambien dissassociative rant or eat all of the spare food in the pantry before she vomits and dies

This iteraction between Ambien and alcohol is well established, so you won't face libel issues referencing it in fiction.
posted by SakuraK at 12:30 AM on January 17, 2011

However, I think it will take several drinks/drug administrations for this to lead to death. I can't think of a thing commonly prescribed for anxiety/sleep which would kil you mixed with a single glass of wine. If one glass + one dose is a requirement try other medications, like warfarin -lethal at low doses. (possibly the stepdaughter mistakes this medication for her stpmom's anti anxiety meds?)
posted by SakuraK at 12:36 AM on January 17, 2011

Or what Saydur said - Oxycontin as the mixer would produce death a lot more surely than Ambien or benzos.
posted by SakuraK at 12:46 AM on January 17, 2011

Response by poster: Saydur: can you clarify what "bitters" is? I'm assuming it's Oxycontin since that has the bitter taste, but that (according to your post, unless I'm totally reading it wrong) means the lawyer added both ingredients to her cocktail of death since you've already stated she pops Valium? Or was the kid adding the Oxycontin secretly, mistaking it to be Valium which she has seen her mother consume?

I'm also looking into the barbiturates. For the record, this isn't a published story but fanwork...I know, I know, legal grey area to begin with, but given the warnings from you all I'll probably stick to the active ingredients/medical names (likely in the technical police reports) to cover my butt.

Thanks all for the suggestions--keep them coming! I love MetaFilter. =D
posted by Hakaisha at 12:53 AM on January 17, 2011

I think the bitters were just to add character.
posted by sesquipedalian at 1:53 AM on January 17, 2011

Yes, bitters are alcoholic and often added to a number of drinks, many including whiskey. You could take your pick from a variety of cocktails, whiskey was just an easy pick for being particularly strong. Painkillers are often themselves bitter tasting, thus easier to hide in a drink like that. You could go for a Manhattan, which adds sweet vermouth to whiskey and bitters. A little out of place for a light drinker in Japan, but not impossible for a well connected lawyer.

First, the lawyer pops Valium, then has a drink with bitters, but the kid added the Oxycontin secretly somewhere along the line, thinking it to be Valium. It's more of an overdose on painkillers, but it's the best way to get respiratory failure/CNS depression with only one alcoholic drink.
posted by Saydur at 3:21 AM on January 17, 2011

Have you considered the daughter screwing up and mixing somebody else's meds into the wine? Her dad's? Something?

I think this is the way to go. Mom is taking whatever anti-anxiety med, but also has a stash of something considerably more powerful, or interacts badly with the anti-anxiety meds she already takes (or Dad has something that Mom is allergic to). To their credit, they keep these medications in separate places to avoid accidental ingestion. The kid sees her Mom popping pills from a pill container and, not knowing anything about this kind of stuff, uses the first pill bottle she finds, which happens to be the wrong one.
posted by googly at 6:37 AM on January 17, 2011

What if the daughter puts the meds into the wine and then the mom drives to meet her beau and dies from DUI?

That seems completely plausible, since the daughter's motivation is to relax her mom enough that she won't go out to meet her boyfriend. Not realizing that the drugs take a while to work, she puts some sedative in her mom's after-work wine. The mom gets in the car and is driving down some windy road when the sedatives kick-in.
posted by justkevin at 7:22 AM on January 17, 2011

I also agree with the mixing-up meds idea. The girl mistakes dad's heart medication (some kind of stimulant - in a classic Golden Age mystery it would be atropine) for mom's anxiety meds, doubles up the dose for good measure, bam, mom has a heart attack and dies. It's not a CDI, though, and the wine is basically unnecessary.
posted by mskyle at 8:22 AM on January 17, 2011

I wasn't aware that teachers in Japan married people in other professions.
posted by KokuRyu at 4:55 PM on January 17, 2011

I'm late to the party here. PD James wrote a short story/novella with a somewhat similar plot, set in nineteenth century England (this plot is pretty meta, I guess).

I'm going to spoil the ending for you -- the young boy killed his beloved great-uncle-whatever by mixing his food with the beauty mask of his great-uncle's much too young wife. The boy innocently wanted to make said adored great-uncle beautiful, not realizing that beauty treatments in those days were mostly arsenic. Young boy grew to adulthood never realizing he had killed the old man.
posted by heigh-hothederryo at 8:23 AM on March 12, 2011

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