20 Nov 2013
Desomorphine, also known by the Russian nickname Krokodil or the English language equivalent Crocodile, is a synthetic substance based on the opioid narcotic drug morphine. This drug, outlawed in America, has much stronger chemical effects than morphine and produces severe side effects in long-term users that can include tissue destruction, limb loss or death. Desomorphine users commonly take a homemade form of the drug that contains one or more additional toxic substances. Until recently, desomorphine abuse was not known to affect any segment of the U.S. population. However, in September 2013, the country’s first identified cases of this abuse allegedly occurred in Phoenix, Arizona.
Morphine is an opioid substance taken directly from the sap of a plant called Papaver somniferum (commonly referred to as the opium poppy). Like all other natural and synthetic opioids, it achieves powerful, potentially addicting drug effects by accessing key portions of the brain and creating intense spikes in pleasure levels, as well as a reduced ability to feel pain. Desomorphine was invented in a laboratory setting in the 1930s by changing morphine molecules’ natural chemical structure. Compared to morphine, it produces roughly 10 times the level of effect at any given dose. This drug effect comes on rapidly and also fades away in a relatively short amount of time.
Even in its most chemically pure form, desomorphine is capable of producing significant damage when used repeatedly over time. The most common side effect of chronic use—a form of blood vessel and soft tissue damage that results in green, scaly skin—gives the drug its nickname, Krokodil (Crocodile). If left untreated, desomorphine-related vessel and tissue damage can ultimately result in tissue death (gangrene) or a clot- and inflammation-based ailment called thrombophlebitis. People with these conditions can lose their affected limbs to amputation or even die. Doctors can potentially combat the active drug effects of desomorphine with the anti-narcotic medication naloxone or other treatments used to address heroin addiction. However, there is no specific, fully developed treatment for the drug. In addition to dealing with the brain effects of desomorphine addiction, doctors commonly need to address the severe physical injuries associated with the drug’s use.
Today, desomorphine abuse doesn’t typically involve batches of the drug made in a laboratory. Instead, most users make an injectable form of the drug themselves by boiling tablets of another opioid narcotic, called codeine, then combining the resulting liquid with any one of a number of additional toxic additives, including gasoline, red phosphorus, hydrochloric acid or paint thinner. Together, these substances can produce a level of blood vessel and tissue damage far above that associated with pure desomorphine, and users can develop large pockets of rotting flesh or even lose their flesh all the way down to the bone. Current evidence indicates that chronic users of “bootleg” Krokodil commonly die within a period of two or three years.
International Patterns of Krokodil Usage
The first known cases of bootleg Krokodil abuse occurred among heroin users in Russia in 2003. These users were looking for a cheaper alternative to the normally available narcotics in their country. According to current estimates, roughly 1 million people in Russia and another million people in other European regions use the drug. However, these estimates are likely quite imprecise, and no one really knows how many people in Europe or other areas across the globe take some form of Krokodil. In the U.S., desomorphine belongs to a highly restricted class of substances called Schedule I substances. All drugs with this federal classification are illegal, present a strong potential for the onset of abuse and/or addiction, and have no accepted usefulness in medical treatment. Still, some amount of pharmaceutical-grade desomorphine likely enters the U.S. through illegal Internet sales or other unlawful avenues. Americans also have access to the materials required to make bootleg desomorphine.
First Krokodil Cases In The U.S.
In September 2013, a poison control center in Phoenix, Arizona, reported two cases of Krokodil abuse among local residents. The directors of this facility believe that the cases in question are related, a situation that indicates that use of the drug is not widespread. However, since they represent the first nationally reported incidences of Krokodil abuse in the U.S., the two cases are naturally garnering significant amounts of scrutiny and media attention. As of now, no one can truly say what course the use of homemade desomorphine will take among American IV drug abusers in the years and decades to come.
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