I once bought some pure botulinum toxin for an experiment (it blocks the release of acetyl choline at neuromuscular junctions). I want to say it was a milligram, but I don’t remember (that would have been 1000 times the lethal dose by inhalation). We had to get special export permission from the US government.
When the tiny vial arrived in a very large multilayered package, I sat down and read the Materials Safety Datasheet and contemplated the implications. I then decided never to open the package. We stored it under a big hollow block of concrete until the hazardous waste disposal people could figure out what to do with it.
Botox is amazing for a large amount of chronic pain conditions caused by musculoskeletal abnormalities, as well as being used as a diagnostic tool for nervous system dysfunction.
I was pretty amazed reading a writeup about the facility in either Irvine or Anaheim CA that the toxin is processed at. They take the delivery/transport security incredibly fucking seriously because the amount is enough to kill a lot of people if used as a bioweapon iirc
Hmm, I'm not sure about that - at least with Botox.
For what I was referring to - take Neurogenic Thoracic Outlet Syndrome for example. This is a very tricky medical condition, not yet fully understood in all cases, and requires ruling out a lot of other things.
For example, you're having symptoms of carpel tunnel or tennis elbow. Normally docs would do an EMG to see if the nerve has been damaged in the wrist or elbow. Nerves end up coming back fine - in the sense that there's no permanent damage, but the symptoms are still obviously there... now obviously, there's a larger tree of things to rule out/processes to do, but to keep it simple, we get to a point we suspect the issue is coming from the brachial plexus nerve bundle... we then inject Botox to the pec minor and scalenes. This eliminates the symptoms for some short amount of time, and thus indicates you would be a good surgical candidate to have your pec minor, anterior scalenes (or more), and first rib surgically removed, so that the nerve/arteries are no longer being impinged upon by the muscles/bone structure.
That is what I mean in the sense of using it as a "diagnostic tool"
However - Botox also helps with things like cervical/other dystonias. Sometimes, completely curing, but they really don't know exactly why in many cases. That is somewhat more of the turning nerves off w/Botox alone.
Botox contains a neurotoxin produced by Clostridium botulinum. This toxin prevents the release of acetylcholine in neuromuscular junctions. Neurons release this chemical signal in order to make muscles contract. Blocking that signal also blocks muscle contraction. It's more or less the inverse of nerve agents such as sarin.
As with all toxins, the dosage makes the poison. It's deadly yet has medical applications. Can be used to treat muscle spasms, neuropathic pain... Most famous for its cosmetic applications though: it relaxes the muscles of the face, removing wrinkles. I know doctors who literally live off of this stuff.
In fact Botox was originally approved for hyperhydrosis as that was a much easier approval path. It was then used off label* for many years before Allergan sought approval for cosmetic use.
In the U.S., licensed M.D.* can prescribe any approved drug for any reason (note this doesn’t mean they’d be immune for a malpractice suit if it didn’t work out, nor that someone might not taken a look if they wrote a lot of opiate prescriptions. And insurance companies may decline to pay). However the drug companies can’t advertise for any use, or any consequences, that they haven’t sought approval for and demonstrated in the lab. Allergan’s sales people (and those of many other companies) would “just visit” and just happen to drop off a scientific paper that looked at research use for other indications…papers that Allergan might have funded. There’s been some crackdown on these practices but of course they still go on.
* The “label” is the package insert with the formula, mechanism of action, side effects etc. It’s not really aimed at the consumer. Your clinical trials are aimed at writing that label, and everything in it is supposed to be supported by your submitted studies.
* M.D.s only, not other prescribing practitioners like dentists, podiatrists or PAs.
Botox is also used to treat severe cases of migraine patients, where they knock out nerves along the migraine pathways. The patients will still have incidents, just with much less pain as the nerves in the pathway are paralyzed.