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In the television show Dexter (2006-2013) whenever Dexter captures one of his victims, he does so by injecting them with a syringe of animal tranquilizer. Usually we see him inject them in the neck but there have been several times where the potential victim notices him first and he injects them in a different body part. Or for example, when Dexter is trying to capture the Doomsday Killer in season 6, he gets dizzy and DDK is able to inject Dexter with the syringe in the hand. My point being that no matter where on the body one is injected, it seems to take affect within seconds.

My question is how realistic is this? Especially the example of the hand? I can accept that injection directly into the neck where there are major arteries could work quickly, but how realistic is the show in depicting how quickly these injections take affect?

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TL;DR;

  • All sedatives take at least 1 to 2 minutes before taking effect; hence, the immediate passing out seen often in Dexter is unrealistic. The biggest hindrance to opioids is BBB.
  • Dexter uses a tranquilizer so potent that it will just kill the victim. Aww, there goes the speech.
  • I can't recall any episodes with a different 'attacking spot' than the neck vein (jugular vein), but an abrupt insertion of the needle in an unstable subject is most probably IM injection, and thus, acting even slower.

It seems that use of chloroform in fiction to sedate patients goes back so long it was a widely known phenomenon in 1864. You could argue it's one of the most tired clichés of all time. In fact, the whole idea of sedatives/tranquilizers/anesthetic drugs acting instantly — i.e., in a matter of few seconds — is ridiculous. Inception dodges this by showing us that there's some passage of time not being covered on the screen by a deliberate breaking of the flow of events, and it could be a matter of seconds, or minutes for a member of the team to go unconscious.

As far as I'm concerned, there are numerous anesthetic drugs and tranquilizers which belong to a vast group of different chemicals, and their scopes are tangled within each other, with anesthesia being more focused on the individuals' well-being than tranquilizing (as the word usage usually implies). More people would be familiar with the former if they've undergone some form of surgery, and they can confirm that you would first feel drowsy, then too heavy to 'move a muscle', and then the next thing you see is rehabilitating on a bed. Point being, that it is not instant. In fact, that's perhaps the only thing that's invariably consistent among tranquilizers.

The police don't use tranquilizers for good reason. It's way too easy to miss the mark of the right dosage, either providing insufficient dosage, resulting in a still-conscious but slightly drowsy subject marching forward with a lethal weapon, or overdosing the subject, which usually kills them.

Dexter uses a tranquilizer named etorphine, notable for its potency. Realistically, the subject would wobble back and forth before dropping to the ground after a good 1–3 minutes, and then most probably die of overdose. It's an opioid used for elephants and rhinos, but that doesn't mean it'd act faster on humans. It just means its LD50 is ridiculously, dangerously low.

Passing out is not instant, even for this chemical, notable for its fast action. This study analyzed the symptoms of the drug in mice, rats, dogs, and a few other species. One notable quote would be

The predominant effect of etorphine given parenterally to dogs was the rapid development of catatonia associated with total analgesia. Thus the effects of the drug in nine animals, seen within 2 min of intravenous injection of 2–5 μg/kg and lasting 30 min–2 hr. were ataxia and miosis followed by deep narcosis during which surgical procedures could be performed.
Catatonia: Lack of movement and communication
Analgesia: Inability to feel pain
You can safely ignore the rest of the jargon. Emphasis mine

Also check out this page, which serves as a compilation of bad things that happens to people in touch with such a potent opioid.


To answer your question on the difference between an injection in the neck, and an injection in the hand, there are several types of injection, the most common being:

  • intravenous (IV) (the fluid being inserted right into a vein): Very fast, as the circulatory system in directly involved.
  • intramuscular (IM) (the fluid being inserted into a muscle): The drug is absorbed by the blood vessels, slower
  • subcutaneous (the fluid is injected barely under the skin): Slowest absorbance, just not enough blood to 'go around'. My point is, access to the circulatory system is the limiting factor here.

A prepared strike means Dexter can go for the central vein (referred to veins that are in torso and often close to the heart), but basilic vein is also commonly used for IV injections. There is more blood flow on a bigger vein, but I doubt that, if it is indeed IV injection, there will be a significantly different result, since blood circulation to vital organs is pretty fast, and the biggest blockage to etorphine, or any sedative, is blood–brain barrier.

I haven't seen the episode you're referring to (I've only been sporadically watching the show), but aiming for the arm/hand of a subject that is not immobile almost certainly means it's going to be an IM injection, and that's typically slower than IV, and your suspicions would most probably be correct. I can tell it would almost certainly be IM since it's actually pretty hard to inject even huge, visible veins, as is evident from all the poor patients whose veins collapse after numerous injections, by trained professionals.

  • is there any indication about Dexter manipulating with the common tranquilizer to improve/modify it to act fast? +1 for the nice answer – Vishwa Jun 17 at 3:55
  • @Vishwa No. Dexter gets his tranquilizer (I believe he calls it M99) from the police station where he has access to the lab and can cover up the missing drugs. Having seen the whole series (sadly including that ridiculous last episode) I cannot recall any modifications of or even specific detail about the application of the drug to his victims – Ian Jun 17 at 10:23
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    @Vishwa the biggest problem here is not anything in the tranquilizer. It's that getting something in the blood, which is the whole point of injections in the first place, means it'd get to the heart, liver, kidney etc. very fast (which is why poisons can act really fast), but the veins in the brain almost don't have any holes, and they're very selective, which means that it won't get as fast to the brain cells. You'd have to change the course of evolution if you want instant-acting tranquilizers, or any drug that affects brain cells. – M.A.R. ಠ_ಠ Jun 17 at 11:56
  • Nice explanation, but can you clean up your artery/vein confusion in the middle. No-one in their right mind would go for an artery - they can be under considerable pressure. Veins aren't. btw, if you've ever had a GA for an op, how far did you count back from 10? 8... 7...? – disassociated Jun 17 at 18:22
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    Right, sorry @Tetsujin. I'm not used to these English terms and I wrote in a pretty exhausted time of my day. Busy now, I'll clean it up in an hour. – M.A.R. ಠ_ಠ Jun 17 at 18:29

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