In 2013, several U.S. news outlets began reporting on the threat of a terrifying drug called krokodil that had made its way from Russia to our shores. One story called this substance “the world’s deadliest drug” 1 and referred to videos that showed its “flesh-eating” properties.”
What does krokodil do that makes it so dangerous? Should we be more worried about this drug than other more common injectable substances like heroin?
What is Krokodil?
Krokodil is the street name for homemade desomorphine. Desomorphine is a semi-synthetic injectable form of morphine that works quickly to provide sedative and pain-relieving effects. Early in the 20th century, desomorphine was touted as a much more potent substance than morphine and caused fewer side effects.
But shortly after the drug was patented, the U.S. government classified desomorphine as a Schedule I controlled substance. Schedule I drugs are defined as having no accepted or legal medical use and are highly addictive.
Those looking to achieve the effects of the now-banned desomorphine found a way to make it using codeine as a base, along with several other harmful additives. One suspected reason for the drug’s name is that those who use krokodil develop green, black, and scaly skin – similar to a crocodile (krokodil is the Russian spelling for the reptile).
What’s in Krokodil?
Those who try to make a synthetic version of desomorphine begin with a codeine derivative known as chlorocodide and and “cook” it with solvents like: 7
- Hydrochloric acid
- Iodine
- Gasoline
- Lighter fluid
- Paint thinner
- Red Phosphorus (the substance used for a match box’s striking surface)
These solvents are rarely fully cooked off in the heating process, which is why people who inject krokodil experience many of the harmful side effects.
What Does Krokodil Do?
Within 2-3 minutes of injecting krokodil, the user experiences an effect that’s 10-15 times more potent than morphine. 3 The euphoria tends to last less than two hours, so users will repeatedly inject the drug to maintain the high and avoid withdrawal symptoms. Frequent use is likely to lead to physical dependence and addiction. Withdrawal symptoms are similar to heroin and can last as long as a month: 4
- Diarrhea
- Insomnia
- Nausea
- Depression
- Severe muscle cramping
- Body aches
- Possible seizures
Additional health hazards caused by the combination of a potent opioid and toxic ingredients include: 3
- Skin infections that may require skin grafts and surgery
- Gangrene (necrosis)
- Muscle and cartilage damage
- Blood vessel damage
- Blood poisoning
- Potential for blood virus transmission (from needle sharing)
- Limb amputation
- Meningitis
- Pneumonia
- Periodontal disease (gum disease and tooth loss)
- Organ damage (liver, kidneys)
- Bone infection
- Loss of motor skills and speech impairment
- Memory loss
- Inability to concentrate
- Difficulty breathing
- Overdose
- Death
Background and History
Krokodil originated in the outlying areas of Russia during the early 2000s. Heroin was expensive and difficult to get, and a mold-infested Afghan opium crop mid-decade made it even more scarce. Russians turned to readily available codeine tablets (no prescription required) to produce a less costly drug and much more potent than heroin. The other materials needed to make krokodil could be found so easily that krokodil quickly became the drug of choice.
In 2010, official Russian estimates reported that between several hundred thousand and a million people in Russia were injecting krokodil. 2 And based on the large quantity seized between 2009 and 2011, it was evident that the problem was growing considerably worse. At a meeting between the former Russian President, Dmitri Medvedev, and other government officials, two attending governors told the President that krokodil accounted for more than half of the drug-related deaths in their regions. At that same meeting, the Russian drug czar, Viktor Ivanov, told President Medvedev krokodil had replaced other opiates in the country.
Has Krokodil Use Spread to Other Countries and the U.S.?
Russia is the only country that has experienced a krokodil epidemic, despite isolated reports that the drug has spread to Ukraine, Europe, other regions of Asia, and the United States. So, why did it appear that the U.S. was on the verge of developing a krokodil crisis?
It’s possible that when the media began reporting sensational stories about a flesh-eating drug, it fueled fears about a new health emergency in the U.S. However, reports that krokodil had made its way to Arizona, Illinois, Ohio, and Utah were based only on patients’ admissions that they had used the drug. Forensic lab reports could not substantiate their claims.5 People who were in no position to corroborate the claims were telling the public about this scary new trend, which led to misinformation and confusion. To this date, neither the U.S. Drug Enforcement Agency (DEA) nor the National Institute on Drug Abuse (NIDA) has been able to confirm a single case.
The Reality of Krokodil’s Presence in the U.S.
The fact that the symptoms exhibited in suspected U.S. cases looked similar to those from Russia didn’t surprise anyone familiar with how intravenous drugs can affect the human body. Evidence of necrotizing skin lesions in conjunction with heroin use was observed as early as 1972, resulting from subcutaneous injection of certain substances cut with the drug. 6 Injecting any drug can lead to skin and blood infections and abscesses.
Experts say Russians were using Krokodil because it was difficult and too expensive for them to use heroin. 5 Americans have a much easier time finding heroin than they do codeine, so it seems unlikely that a krokodil epidemic would occur in this country. Dr. Andrew Kolodny, an expert on the prescription opioid and heroin crisis, told The Daily Beast, “We don’t have a Krokodil epidemic, we have a heroin and painkiller epidemic.” 5
Get Help for Heroin and Opioid Addiction
Whether they’re injected, snorted, smoked, or taken orally, opioids can quickly take over your life. To combat addiction, individuals must first safely detox and then acquire the tools to manage without drugs. At Ocean Hills Recovery, we provide a supportive environment to help you learn to rebuild and thrive. Our knowledgeable staff is committed to your recovery and can customize a program that’s targeted to your specific needs.
If you’re struggling and don’t know where to turn for help, we want to be your trusted partner. Contact us and we’ll explain how our treatment plans can lead to lasting sobriety.
Sources:
[1] https://time.com/3398086/the-worlds-deadliest-drug-inside-a-krokodil-cookhouse/
[2] http://content.time.com/time/world/article/0,8599,2078355,00.html
[3] https://www.drugs.com/illicit/krokodil.html
[4] https://www.narconon.org/drug-rehab/krokodil-withdrawal.html
[5] https://www.thedailybeast.com/behind-the-krokodil-panic
[6] https://jamanetwork.com/journals/jamadermatology/article-abstract/532643
[7] https://pubmed.ncbi.nlm.nih.gov/25710781/
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