1. Opioids
One fear of mine with overdosing on opiates is not getting enough into the system and waking up with brain damage instead, a device that constantly injects more should prevent that.
That is true. I did not think of that, though I knew, and this also solve many opioid-ctb problems like vomiting or plugging. See SC instead IV in parts (3) & (4) :) Just to recap, from PPH:
The biggest problem associated with taking opioids is predicting the effects of particular dose. There is a remarkable individual variability in sensitivity to these drugs within the normal population. People who are similar physically (same height, weight, sex, etc) can have a vastly different response to the administration of the same dose of a drug.
A small opioid dose may have almost no effect on one person, while the same dose could kill another person. Prediction the effect of the drug on an individual is difficult. When these drugs are used cilinically, where accidental death would be disastrous, the rule of thumb has been to 'start low and go slow' untill the individual's sensitivity to the drug is established .
2. PPH Device
There is a picture of such a device (Small, spring loaded) in the newest PPH handbook. I don't recall the name, but it was pictured with the discussion of thiopental
Nice one, thanks. PPH says:
An Exit contributor's personal solution:
A spring powered assembly inspired by the original Deliverance machine.
An IV catheter needs to be correctly placed. Opening the line tap, bottom left, allows for the self administration of a lethal dose of thiopental.
The Deliverance Machine was a laptop computer and program that gave these individuals the ultimate control over their deaths . . .
After pressing the button for a third time , The Machine would deliver a lethal dose of the barbiturate, Nembutal.
Your post starts as personal and ends as general; apologies if I am misinterpreting a generic wish for a personal goal.
An autoinjector is pretty easy to design, especially if you use gravity and a bag of saline as the propulsive force.
It is indeed personal and general. I was thinking of the ideal ctb, and it was mostly brainstorming and fantasizing. A saline bag is good solution but I would like to keep it minimal in size and setup.
The 'solution' in PPH is "Springfusor". It's a low cost, non-sterile, reusable pump that requires no programming or external power source. People can Google it and here's a
video of it. There are two problems: it's not readily available to purchase (say in big sites) and one needs to buy different tubes (CFT) for different flow. It is pretty cool though. If it is intended to use with barbiturate it needs to by IV, so person need to practice on insert it into the vain, which may be painful and distressing.
I wasn't thinking of this solution in practical terms, but ....
3. Ideal Solution
Like an Insulin Pumps. So neat.
So this is also an
easy SC solution (no need for IV):
Morphine is typically given by intramuscular or intravenous injection but there are theoretical advantages for the subcutaneous route of administration. Fifty-nine patients entered a prospective randomized double-blind cross-over study comparing intermittent intramuscular and subcutaneous morphine boluses. Patients received 0.15 mg/kg of morphine by subcutaneous or intramuscular injection. They were reviewed at the time of injection, after 15 minutes and each hour for four hours. The majority of patients indicated a strong preference for the subcutaneous route. There were no significant differences in pain scores, respiratory rate, arterial oxygen saturation, heart rate, mean arterial pressure, sedation or nausea scores between intramuscular and subcutaneous administration of morphine. Postoperative analgesia by subcutaneous morphine bolus injection is as effective as intramuscular injection with a similar side-effect profile but with greater patient acceptance and less risk.
Those cost around $3000 :) It's a great future solution -- or
real option now if you have money. This needs to be tested and researched further but an insulin pump should be readily available , and from that point it's buying morphine (not easy but possible) .
Easier, nicer and cheaper than Dignitas .
(Opioid patches deliver over time (24h) and one need to stick themselves all over with these patches)
4. Practical Solution?
There are really good simple auto-injectors , especially for a single predetermined dosage of a medication, pretty common with
Insulin or
Epinephrine. That can be useful but tricky with morphine -- due to dosage variability. The good ones are also costly. EpiPen costs $300 to $630. But that is Epinephrine . An Insulin pen from china can cost 15$ or 30$. The needle is pretty tiny and it is not like IV. Still requires some handling or practice -- inserting at an angle to a fatty tissue etc. Insulin pens have dosage selection.
If the flow rate is flexible and controlled, patients could basically "start low and go slow" (as medical practice) and when they feel "they've had
enough" -- then "pump up the volume" .. and "go to sleep".
I would like to have a real auto injector that is cheap and available . That you don't have to mess around with inserting it or anything . This is used by army -- atropine. I don't think they sell atropine out there on the market ;) This is really really hassle free .
As for the "needle issues" , one can buy lidocaine cream (OTC). But it's really a tiny needle and less than 2 seconds.
The big problem here is morphine . Some think opioids are basically available (street, darknet) but it's not that easy for members, compared to ordering from big sites -- or even TCAs OD from online pharmacies (ami)
I'm not suggesting to buy needles or inject anything !
