Category Archives: Substance Abuse

Substance Abuse

Federal Bill Proposal Aims To Create Database of Designer Drugs

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Brooklyn Rep. Nydia Velazquez recently introduced a bill to allocate $2.5 million in federal funding to start an outreach and educational campaign, as national efforts against synthetic drugs continue to push on. The bill aims to help in the campaign to combat synthetic drug use, and develop a comprehensive database of designer drugs that will require the help of several government agencies.

In a news statement, Velasquez said that this is in response to the surge of overdose cases in July, which rendered the busy streets of New York looking like a scene out of a Walking Dead episode. In a single week, more than 130 victims have been recorded to have suffered from health problems due to the use of synthetic drugs. This prompted Velasquez to create a bill that will help in funding her cause.

This fight against the epidemic of synthetic drugs includes unregulated chemicals that can cause adverse side effects and increase danger for other users.

The bill is entitled “Synthetic Drug Overdose Prevention and Education Act”, and it requires the Centers for Disease Control and Prevention (CDC) to develop necessary measures and comprehensive strategies to prevent the use of synthetic drugs. CDC will have a year to come up with new strategies in the rehabilitation of the users. The proposed bill now calls for the Drug Enforcement Administration (DEA) together with Secretary of Health to jointly develop a national database for synthetic drugs.

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Substance Abuse

What is Clonazolam and Why Is It Dangerous?

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Another drug that has recently become popular among benzodiazepine users is one called Clonazolam. This is currently being sold online as a designer drug and is easily accessible through online vendors.

Various forums and threads such as those found on Reddit discuss accounts of user’s experiences when using the drug. They also exchange information as to how and where to purchase it, as well as its effects, advantages and disadvantages. Some threads also show users comparing the drug with others of the same class such as Etizolam and Xanax. The number of entries would probably surprise a reader as to the number of people who are probably hooked on benzodiazepines and are always looking for new ones that could work better than the previous drug.

What are Benzodiazepines?

Benzodiazepines, also known as “benzos” are a class of psychoactive drugs that affect the neurotransmitter called gamma-aminobutyric acid (GABA). The drug acts as a sedative, anxiolytic, anticonvulsant, and muscle relaxant. These drugs are medically prescribed for conditions such as anxiety, agitation, insomnia, alcohol withdrawal, seizure control, muscle relaxation, and inducing sleep before surgical procedures.

When used appropriately and for a short duration, benzodiazepines are relatively safe. However, they have the potential for developing tolerance, dependence, and abuse. Long-term use can cause impairment and unpleasant behavioral effects such as aggression and rebound anxiety. The sleep-inducing properties of benzodiazepines have also been found to decrease in effect for users who have been taking for a relatively long time.

Some of the most familiar names are Valium, Xanax, and Ativan. While there are approximately more than 2,000 benzodiazepines that have been produced and are available in the market today, only 15 of these have been currently approved in the United States. New types, however, have come out and are sold over the internet. One of which is the drug called Clonazolam that is also becoming a trend among benzodiazepine chronic users.

What is Clonazolam?

Clonazolam, also known as Clonitrazolam is a medium-duration psychoactive drug that also belongs to the class of benzodiazepines. It produces anxiolytic, sedative, hypnotic, muscle relaxant, anticonvulsant, depressant, and amnesic effects. It is a derivative of the FDA-approved benzodiazepines clonazepam and alprazolam.

Compared to the other mentioned drugs, however, clonazolam has been reported to be more fast-acting and its effects can be felt within 20 to 60 minutes. It also has the reputation of being highly potent as it produces very strong sedation and effects even when taken in small doses such as 0.5 mg. As such, it may be more dangerous that the other benzodiazepines available in the market.

As with most benzodiazepines, abrupt discontinuation of use can pose serious threats to the frequent users including seizures and sudden death. It is medically recommended that one’s dose is tapered off gradually before it is stopped altogether. Quitting clonazolam abruptly may produce intensive withdrawal effects.

Effects of Clonazolam

The physical effects of clonazolam include extreme sedation which can result in severe lethargy. It has been reported that some users may feel extremely sleep deprived and may even feel as though they are on the verge of passing out. This forces them to avoid engaging in regular activities. This may cause them to fall into complete unconsciousness.

The other physical and cognitive effects include respiratory depression,  dizziness, muscle relaxation, seizure control, spasms control,  loss of coordination, amnesia,  impaired cognitive skills, impaired motor skills, lapses in judgement, thought deceleration, and reduced reaction time.

Long-term use of clonazolam can result in increased seizures among epileptics, aggression, increased anxiety, violent behavior, loss of impulse control, irritability, and suicidal tendencies. These effects have been observed among recreational users, people diagnosed with mental disorders, elderly patients, and those who take the drug at high doses.

Potential for Tolerance and Addiction

Compared to other benzodiazepines, clonazolam has been found to be both physically and psychologically addictive. Tolerance may develop within a few days of continuous use.

As with characteristics of other tranquilizers or sedatives, withdrawal symptoms may be experienced by the patient or user when consumption is ceased abruptly. To avoid this, users are advised to observe a gradual reduction in dosage instead of stopping the use immediately.

Because of clonazolam’s potent sedating effects, the withdrawal symptoms may be more severe. There is an increased risk for hypertension, seizures, and death. Painkillers such as tramadol should be avoided during the withdrawal period.

Potential for Dangerous Interactions

Clonazolam can be dangerous when used in conjunction with other pharmaceutical preparations. The combined effect can produce life-threatening results. Some of the drugs that may produce some dangerous interactions when used with clonazolam are the following:

Depressants

The combination of clonazolam and depressants such as alcohol, barbiturates, and opioids can cause fatal respiratory depression. Depressants have the tendency to maximize the sedative and muscle relaxant effects of clonazolam. The combined effect can produce unexpected loss of consciousness when taken at higher doses. There is also the increased risk of vomiting during sedation which can lead to suffocation and death.

Dissociatives

When combined with any form of dissociative, there arises a risk of vomiting during unconsciousness. This can also lead to suffocation and death.

Stimulants

It is never advisable to combine stimulants with benzodiazepines. Stimulants alter the effect of benzodiazepines by decreasing their sedative effects. However, once the stimulant wears off, the effects produced by benzodiazepines are increased. When using both cannot be avoided, users should strictly limit the dosage of the benzodiazepine.

Conclusion

In recent years, novel benzodiazepines have also proliferated as part of designer drugs sold online or in the black market. They are very accessible and can be bought at a minimal cost, making them very attractive to recreational users and to those who practice self-medication.

Because most of these drugs do not have recognized medical purposes and are not medically prescribed in other countries, they can cause great harm to those who use the drugs recreationally. As such, law enforcers and the public in general should be forewarned of the dangers of these substances as they have a high potential for abuse that may lead to fatal consequences.

Alcohol Testing Substance Abuse

Study Successfully Stops Alcohol Dependence in Mice

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In a recent issue of The Journal of Neuroscience, a study revealed findings based on other studies indicating that the frequent use of alcohol can activate specific groups of neurons. The more a person drinks, the more the neuron circuit is activated, which then prompts more drinking. However, the findings from the new study postulate a different study.

The study aims to identify if there is a way to influence certain neurons that make-up the circuit. Scientists from the Scripps Research Institute (TSRI), with Professor Olivier George leading the study, based the findings from experiments on lab rats. In both humans and rats, the neurons only make up five percent of the neurons in the brain’s central amygdala.

The experiment used lab rat models of alcohol dependence wherein a special protein will only distinguish the neurons that are activated by alcohol. The rats were then given a compound wherein it can inactivate only alcohol-linked neurons.

TSRI Research Associate Giordano de Guglielmo, who spearheaded the experiment, was surprised with the results. The rats stopped their compulsive drinking for as long as they were monitored. “We’ve never seen an effect that strong that has lasted for several weeks,” said George in a news item. “I wasn’t sure if I believed it.”

The experiment ran 3 times and each time, the rats ceased drinking alcohol. However, when given sugar water, the rats were motivated to drink which shows that the researchers had targeted only alcohol-linked neurons and not the entire reward system. The rats also did not exhibit any withdrawal symptoms.

The researchers hope to track the formation of alcohol-activated neuronal circuits and to find a way to be able to transcend the work to humans.

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Substance Abuse

New Designer Drug ‘Pinky’ Causes Death of Two Teens

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“Pinky” may sound like something innocent, but this emerging designer drug has caused the death of two teenagers in Utah.

According to a news release, Park City resident Grant Seaver was found dead on September 11 inside his home. Meanwhile, his best friend Ryan Ainsworth was also discovered dead on his home couch two days later. Both were 13 years old and students of Treasure Mountain Junior High School.

Although Utah State Medical Examiner’s Office has yet to release the results of the autopsies and toxicology tests, Park City Police Chief Wade Carpenter is considering the potential involvement of Pinky, the street name of the designer drug U-47700. “We have received a lot of different social media hits during our investigation. We looked at potentially this pink could possibly be a cause, we don’t know that. There was nothing to suggest at the scene it was ingested,” Carpenter said.

In a statement, Park City School District superintendent Ember Conley explained how synthetic drug use has drastically changed the way authorities and parents take care of kids. “This is a whole new ballgame for parents. This is something that every single one of our parents in Utah need to be aware… This is an all around difficult situation,” Conley said.

Pinky or U-47700 is still relatively new in the United States. As a result, the drug is not yet illegal or banned in the country. However, some European countries have already set policies to ban the said substance.

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Substance Abuse

DEA Seeks Placement of Kratom Metabolites Under Schedule 1

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Heads up for those who are planning to use kratom: The Drug Enforcement Agency (DEA) has recently issued an intention to categorize the active components of kratom as Schedule I controlled substances.

The compounds in question – mitragynine and 7-hydroxymitragynine – mimic the effects of opioid medication, leading kratom to become one of the most highly abused substances in recent times. Despite support from users due to the alleged therapeutic benefits of the drug, the DEA cited that the substances fall under Schedule I due to the following factors:

  • High abuse potential
  • No proof to be effective for any medical treatment
  • No safety precautions for use, even under medical care

Kratom has figured in several cases of medical and even criminal cases in the U.S. According to a press release by the DEA, more than 55,000 kilograms of kratom in various forms – capsules, powder, liquids, and patches – have been seized at U.S. entry ports between February 2014 and July of this year. This figure does not include at least 57,000 kilograms reported to be set for import into the country in the same time frame.

The health risks and toxicity of kratom has led the DEA and other federal agencies involved in the drug watch to consider the substance unfit for human use. Although the plant is popular in some parts of the world because of its pain-relieving and sedative effects, abuse of kratom may lead to a wide array of health signs ranging from dryness in the mouth to delusion and schizophrenia.

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Substance Abuse

Expect Higher Designer Drugs Use in Night Clubs, Says Study

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As more designer drugs are being discovered in recent years, recent reports claimed that there are about 700 new street drugs circulating all over the world. Some of these substances are now infiltrating festivals and electronic dance music night clubs.

A survey taken from more than 2,200 U.S. residents revealed that almost half of them have tried using a new drug, the most common of which was synthetic cannabinoids. Joseph J. Palamar, an affiliate of New York University Center for Drug Use and HIV Research  (CDUHR) said in a news item that at least 5 percent of night club attendees are users of psychedelic drugs known as NBOMe. This drug, according to the researchers, is highly potent and dangerous.

It was also found out patrons of night clubs are unaware that the ecstasy that they’re taking may possibly be mixed with “bath salts”, as seen on hair samples taken from them.

According to researchers, frequent club goers have greater risks of taking these designer drugs, and there is also a higher risk among the unemployed to engage with these drugs.

There really should be a widespread awareness program to prevent and reduce the risk of being exposed to these designer drugs. Otherwise, more people will be hooked into using them and would be endangering their lives.

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Substance Abuse

What Is Carfentanil and Why Is It Being Abused?

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There is a huge crusade against the propagation of illegal substances in the U.S. as well as other countries. These illegal substances have claimed many lives with unlawful usage of painkillers where they are commonly sold through the black market.

People who engage in the use of illegal drugs may or may not be aware of the long-term effects. Despite reports of the proliferation of these drugs, authorities could not pinpoint as to where these drugs originated.

Opioids are the drugs of choice to relieve moderate to severe pain that cannot be alleviated using ordinary pain medications. Some common opioids include codeine, fentanyl, meperidine, methadone and oxycodone. These drugs can be purchased through a prescription by a physician with a special license.

Unfortunately, there are those who buy them through the black market beyond its appropriate medical use. What happens then is a subsequent drug abuse and increase in the number of deaths due to overdose.

Authorities have recently faced another challenge with this new street drug called fentanyl. One popular case involving fentanyl is the death of Prince in April 2016. Another drug is set to take the growing drug problem by storm, and the substance is called carfentanil.

What is Carfentanil?

Carfentanil, believed to be 100 times stronger than fentanyl, is a sedative commonly used by animal handlers for big mammals such as elephants. The drug is found to be 10,000 times stronger than morphine. It is a fast-acting analgesic that instantly immobilizes an individual after intravenous injection.

It is marketed as a general anesthetic and commercially known as Wildnil. This was first synthesized in the 1970s for veterinary purposes and not for any medical treatment for humans.

The spotlight on carfentanil emerged lately due to its high abuse potential. This drug is categorized under Schedule II – drugs having a high risk for abuse – and has now become the new drug of choice, which can pose extremely dangerous consequences because of its high potency compared to using heroin.

This substance is being sold to users as heroin or mixed with a certain amount of heroin. Carfentanil is now considered as the most potent of all opiates.

When carfentanil is laced with heroin, its potency and danger grows exponentially. Once ingested, the effect is felt instantly, which can be too much for the body to handle. This kind of drug can be injected intravenously, smoked or snorted.

Just like fentanyl, carfentanil is easily absorbed through the skin or through inhalation. Getting in contact with this drug even in minute amounts will definitely require medical help. As a result, veterinarians who administer this drug are in full protective gear (face shield, gloves and apron) to ensure their safety.

Cases of carfentanil use

Over the last few months, there has been an increase in heroin overdose cases, and law enforcement officials believe that carfentanil may be involved with these cases. The effect of the drug mimics that of the natural euphoria after having a hearty meal or being surprised by a loved one. With the use of carfentanil, a euphoric sensation may be felt by an individual who has ingested it.

If taken regularly and in large doses, carfentanil may lead to cessation of breathing, which in turn may cause brain damage, coma, and eventually death. Any mixture of drugs can pose extreme danger to our health, and its side effects can create serious damage to the body.

The deadly combination of heroin and carfentanil has been reported from Hamilton County and other areas around Akron, Cincinnati and Columbus in Ohio. Cases of rampant selling on the streets resorted to increased number of carfentanil users.

Reports revealed that for three consecutive days, there were 25 overdose cases from which four were fatal. In Columbus, out of 10 reported overdose cases, two of them resulted to death, all within a period of nine hours.

Rayshon Alexander pled guilty when he was charged for murder, for causing the death of two individuals due to carfentanil use. It was reported that Alexander sold the drug to these individuals. Survivors, however, said that they didn’t know that it was carfentamil, because the drug was sold to them as heroin.

Hamiton County Health Commissioner Tim Ingram said that this particular drug would definitely kill so many people. Nalcone may be available as an antidote for opiate overdose, but it may not be strong enough to save lives.

Death involving opioid abuse has increased since 2014, leaving about 14,000 deaths due to overdose.  Cases involved with carfentanil overdose have been sprouting in different states such as Ohio, Florida and Kentucky, with the drug believed to be sold as heroin. Authorities are still unaware where these drugs are originating – whether they are stolen from a legitimate source, shipped from abroad or manufactured in the U.S. Some users say that carfentanil can be bought online from several companies in China.

The Danger in Carfentamil

The use of combination of drugs may pose a high risk of harm to individuals because of extreme effects that the heart and lungs may not be able to handle. Because of its colorless and odorless properties, carfentamil can easily pass through visual detection unless a laboratory test is performed.

A former fentanyl user may have switched to heroin. However, with prolonged use, the effect may not be the same as the first time he has used it. What he would do is to find a replacement that could give him a different kind of “high”, and that is when it becomes extremely fatal when a cocktail of two drugs is being introduced into the system.

Drug dealers have taken a step further in increasing their supply of heroin by mixing it with carfentanil. Some unknowing users would readily buy these drugs.

The Journal of Veterinary Medicine published an article pertaining to the dangers of being exposed to carfentanil. This is something that should not be ignored. Proper knowledge in the handling and counteractive treatment should be at hand; otherwise, it can cause serious health conditions.

Meanwhile, the American Journal of Emergency Medicine revealed an incident involving a man who accidentally came in contact with carfentamil. The person immediately felt the effect of being drowsy. He was hurriedly taken to the hospital and was injected with 100 mg of naltroxene. This goes to show that an individual can immediately be symptomatic even at a very small amount of exposure to carfentanil.

People who have ingested carfentanil would not easily suspect the substance as carfentanil because it is colorless and odorless. When heroin overdose is expected, a single dose of naloxone should be enough to treat the case. However, if the ingested heroin has been laced with other drugs such as fentanyl, it is required to use multiple doses of naloxone.

The drug was created for animal use only, specifically large animals such as African elephants. The weight of an average African Elephant is 10,000 lbs. A single dose of 10 mg of Carfentamil is powerful enough to sedate an elephant. Imagine the effect that it does to a human with an average weight of 180 pounds!

Information has been circulating about how carfentanil may have been used as a chemical weapon during the hostage crisis in Russia back in 2002, causing death to 170 people. The gas ultimately killed 130 of the hostages and 40 attackers. The survivors’ urine samples were tested and found to have carfentanil as one of the chemical agents pumped to kill the hostages.

Uses of Carfentanil

Carfentanil was originally designed for the following purposes:

  • Wildlife Management Programs
  • Veterinary and Animal Practices
  • Research Purposes

Administration is only done by licensed practitioners.

Extreme precautionary measures are taken when handling this drug. Animals are strictly monitored because of the drug’s potency and for its possible adverse effects. The same goes with those who are handling the drug. Extreme care is always taken because of any accidental exposure or misuse can be lethal.

It is also required to keep Naltrexone HCl within reach as a means of counteracting the effect of carfentanil in case of accidental exposure. Veterinarians who are qualified to handle this drug need to be well informed about how to properly use the drug and how to reverse the effect during unexpected exposure.

Veterinarians using carfentanil should take note of the following:

  • measurement of pulse and respiration
  • prevention of aspiration
  • relief of bloat
  • obstetrics
  • control of shock and hemorrhage
  • recognition of hyperventilation and heat exhaustion
  • immobilization of fractures

Any inappropriate use of this drug on animals may lead to respiratory and cardiovascular complications.

Animal Drug on the Street

With widespread selling on the internet and on the streets, carfentanil is indeed something that parents would want to warn their children about especially those who frequent clubs and parties. Trading happens every night.

This is not the first time that an animal tranquilizer has been inappropriately used by humans. In the 90’s, ketamine, an anesthetic designed for cats, has become popular as a date rape drug. It was reported that a dealer used a stolen DEA licensed number to order a large quantity of ketamine in vials for selling in New York City.

Carfentanil Chemistry

Carfentanil Citrate is methyl 4- (1-oxopropyl) phenylaminol-1-(2 phenylethyl)-4-piperidinecarboxylate-2 hydroxy-1, 2, 3-propanetricarboxylate (1:1).Each ml contains: Carfentanil citrate 4.46 mg (equivalent to 3 mg Carfentanil), sodium chloride 8 mg, methyl paraben 1.8 mg, propyl paraben 0.2 mg in water for injection.

In Related News

Senator Rob Portman said he will introduce a bill that will make it difficult for drugs to be shipped into the U.S. He added that the postal system should include electronic advance data on packages before it is shipped into the U.S. The following information should be filled:

  • Origin and destination of the package
  • Complete name of sender and recipient
  • Full description of the content of the package

In doing so, it will be difficult for drug traffickers to send fentanyl and carfentanil through mail.

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Substance Abuse

Los Angeles Reports Cases of Synthetic Marijuana Overdose

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The effects of marijuana have recently manifested in cases encountered through eighteen cases reported in Skid Row, downtown Los Angeles. It was mentioned via a news item that the rescue incident of overdose victims caused by the use of marijuana has been recorded two times in four days. A similar incident, wherein eighteen victims were also involved, took place a few blocks away the week before. All cases were presumed to have been connected to the use of synthetic marijuana, or more commonly known as Spice or K2.

Medical practitioners seem to have traced trends and similarities in the symptoms found in the victims. Most of them showed signs of alterations in mental states and frequent seizures. This led to the idea that there must have been a wider market for synthetic marijuana in downtown Los Angeles, specifically in Skid Row Area, causing manufacturers and sellers to easily dispose the drug.

The effects of the drug were said to be strengthened by the summer heat and other medical conditions, which may result to emergency situations.

The drug sells at one dollar per joint in the area, which is easily accessed in the streets. The presence of the said substance in the human body is said to be undetectable in drug tests, although more drug testing companies are developing new methods to facilitate detection of this kind of substance.

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Substance Abuse

Oregon Pharmacy Board Bans Synthetic Fentanyl and Other Opioids

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Oregon Board of Pharmacy alarmed the public about the widespread trading of mislabeled drugs – in the form of synthetic opioids and synthetic fentanyl – which is widely being sold as heroin. Although the effect of these designer drugs is the same as that of heroin, this is still considered as illegal, as reported in a news release.

The Controlled Substance Act (CSA) is a listing of drugs developed to be able to categorize and identify the acceptable usage of a drug or substance for medical use and the potential for dependence by an individual. There are 5 categories under this act, with the drug dependency level and abuse increasing as the category changes.

Under Schedule 1, drugs or substances have no medically accepted use and have a high potential for abuse. Among the drugs under this category are marijuana (cannabis), lysergic acid diethylamide (LSD), methaqualene and methylenedioxymethamphetamine (ecstasy).

Schedule II are drugs or substances with high potential for abuse and may lead to severe psychological or physical dependence. Examples include dexidrine, fentanyl and demerol.

Among the drugs stated above, fentanyl and heroin are being carefully monitored because of how these are being marketed in the U.S. in a different form.  Heroin has a high market value, which means that only those who really have the money can purchase it. What happens now is that these drugs are being manufactured in China and are sold to the U.S. and in different countries in combination with other drugs, making them more dangerous to use.

Drug manufacturers either mislabel these substances as high grade heroin so that they can be sold at a much higher price, or add another chemical substance to give that extra “kick”, which with heroin alone may not be as potent.

These designer drugs have been able to penetrate into different countries and are widely sold, affecting a lot of people and eventually becoming the number one killer among young popular celebrities and athletes.

These drugs are now being added to the schedule of Oregon’s substances so that enforcers have a basis to prosecute those involved with trade and possession of these designer drugs.

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Substance Abuse

All You Need To Know About Krokodil

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A few years ago, some news reports said that the zombie drug called krokodil – which has caused a widespread drug addiction epidemic in Russia – may have crossed over to the United States.

Apparently, there have been some isolated reports of users who exhibited the symptoms of exposure to krokodil injections. This has caused alarm because of the known dangers of the abuse of krokodil, a synthetic drug that is said to cause the most harm compared to other illicit substances.

What is Krokodil?

Desomorphine, also known by its street name krokodil, is a derivative of morphine that produces fast-acting opioid effects including sedation and analgesia. It has been said to be eight to ten times more potent than morphine. Desomorphine is a powerful drug that renders dangerous effects, and is highly addictive.

However, synthetic krokodil is mostly impure and may not even contain the desomorphine but it contains codeine. The drug is easily manufactured and may be produced in homes in the same manner that illicit methamphetamine and pseudoephedrine are produced.

Homemade versions of the substance are concocted by “cooking” codeine-based pills that are purchased over the counter with a poisonous mixture that includes solvents (such as gasoline, paint thinner, or lighter fluid), iodine, hydrochloric acid, and red phosphorus scratched from matches. The end product is a yellow or caramel liquid that distinctly smells like iodine, resembling an antiseptic. The smell can be overpowering and it could not be washed off the clothing of Krokodil addicts. The home or the apartment where the drug was manufactured can rarely be reused for residential purposes as it could never be entirely cleansed of the lingering odor of iodine.

Because of the combination of the toxic chemicals from these substances, those who inject the drug into their veins can develop skin ulcerations, scales, discoloration, and gangrene. Their skin resembles the scales of a crocodile. This prominent effect is what lends the substance its nickname as krokodil, which means “crocodile” in Russian. In Ukraine, it is also known as “Himiya.”

krokodil desomorphine molecular structure

History of Krokodil

Desomorphine was first synthesized in 1932 and patented in 1934 in Switzerland where it went by the brand name Permonid. It was used medically for the treatment of severe pain. Due to its side effects, however, medical use of the drug was terminated in 1981.

The clandestine production of Krokodil is most popular in Russia where it has been manufactured for more than a decade. While heroin used to be the drug of choice in the country, users found Krokodil to deliver the same euphoric effects at a much lower cost.

In 2003, when the government authorities carried out crackdown operations on heroin production and trafficking, heroin users began producing Krokodil in their homes. The unavailability of heroin coupled with the cheap cost of Krokodil production prompted the drug’s popularity among addicts who belong to the lower economic strata. It was reported that between 2009 and 2011, the amount of Krokodil seized by Russian authorities increased by 23 times. In 2011 alone, there were about 100,000 people who had injected Krokodil.

In 2012, the Russian government imposed restrictions on the sale of over the counter drugs that contain codeine. While the legislation diminished the number of addiction cases, it failed to effectively eradicate the problem. It continues to be considered as the most dangerous subject of drug addiction in the country.

Cases of Krokodil use have also been reported in other countries including Ukraine, Georgia, Germany, Norway, and Kazakhstan.

Krokodil first entered the United States in 2013 with the first case being that of a 30-year-old addict in Missouri whose skin began to rot after injecting Krokodil. Following this, other cases were reported in Illinois and Oklahoma.

The U.S. Drug Enforcement Administration (DEA) has categorized desomorphine as a Schedule I drug under the Controlled Substances Act (CSA).

Adverse Effects of Krokodil

The illicit production of Krokodil involves the use of considerable amounts of toxic chemicals which are “cooked.” Since no efforts are made to remove toxic by-products that result from the synthesis, injecting the concoction can produce extremely dangerous effects on the skin, blood vessels, bones, and muscles, which can lead to gangrene and amputation of the limbs.

Within a few days from the injection, the skin around the area of the point of entry can get severely infected with abscess or skin ulcerations. It can even lead to tissue damage and necrosis, leaving the bone exposed. Scaly, green patches also develop in other areas of the skin. Thus, Krokodil has earned its nickname as the “flesh-eating” or “zombie” drug.

The other adverse effects include the following:

  • Gangrene
  • Phlebitis
  • Thrombosis
  • Blood vessel damage
  • Muscle damage
  • Meningitis
  • Septicemia
  • Bone infection
  • Rotting gums and tooth loss
  • Liver and kidney damage
  • Brain damage
  • Nervous system damage
  • Speech and motor skills impairment
  • Memory loss and impaired concentration
  • Weight loss
  • Pneumonia
  • Blood-borne diseases such as HIV, AIDS, and Hepatitis C
  • Overall deterioration of health
  • Overdose
  • Death

Krokodil Addiction

Krokodil is highly addictive, and dependence can develop right after the first use. This is intensified by the fact that its half life is short and the euphoric effects last for less than two hours.  As a result, frequent injection is necessary to recreate the “high” as well as to avoid the withdrawal symptoms. The need to consume large amounts of the drug on a more frequent basis can prompt binge patterns where users lock themselves up in the apartment or the home to “cook” Krokodil and use it repeatedly. It has been said that being a Krokodil addict is a full-time job because of the cyclic patterns of cooking and injecting.

In addition, modifications in the ingredients and cooking process place a user at an increased risk of overdose and death. Krokodil use reduces life expectancy by two years. An addict is most likely to die from a fatal overdose or from the complications arising from Krokodil use within two to three years.

To date, no other drug causes the same destruction that Krokodil does. While it affects the brain in a manner similar to most drugs – by targeting the neurotransmitters that associated with pleasure, learning, and memory – the long-term effect of Krokodil addiction leaves a damaging mark. Most Krokodil addicts fail to fully recover their motor skills and their eyes assume a vacant, distant look.

Psychological Effects of Krokodil

In addition to dependence and addiction, chronic users of Krokodil are also likely to develop anxiety and worsening depression as the euphoric effects of the substance wear off. Krokodil addicts may develop some forms of psychosis and exhibit abnormal behavior when they are not under the influence of the drug.

In efforts to avoid the effects of withdrawal, Krokodil addicts commonly resort to illegal means to purchase supplies to cook the drug or to find other sources of Krokodil. They may steal from friends or even family members. They may also resort to other crimes.

As with most chronic drug users, Krokodil addicts will often deny their dependence on the substance and will rarely seek medical help. In most cases, they are brought to emergency rooms and referred to rehabilitative treatment only when their bodies rot away or begin to suffer tremendously from the physical damage caused by the substance.

Withdrawal from Krokodil

The withdrawal symptoms of Krokodil have been described to be similar to that of heroin, but the physical and psychological effects are long-lasting. The discomfort includes:

  • Intense flu-like symptoms
  • Vomiting
  • Diarrhea
  • Tremors
  • Fever
  • Profuse sweating
  • Severe anxiety
  • Intense drug cravings
  • Muscle pain and twitching
  • Chills and goosebumps
  • Depression
  • Relapse into abuse

Going through the withdrawal phase can be very painful. The symptoms and physical discomfort may last for more than a month from the cessation of use.

Krokodil Rehabilitation

A person who displays the signs and symptoms of Krokodil abuse or withdrawal needs immediate medical and psychological attention. Since the life expectancy of chronic users is significantly reduced, a delay in seeking professional help could have fatal consequences.

Several treatment and rehabilitation centers offer intensive detoxification and recovery programs that could help users beat the addiction. These programs include medically managed detoxification, behavioral therapy, counseling sessions, and physical therapy for those whose motor skills have been impaired.

Because Krokodil has one of the highest relapse rates among opiates, enrollment in a long-term inpatient therapy is strongly recommended to help an addict sustain abstinence and regain control over his life.

While the effects of Krokodil abuse can be extensive and may last a lifetime, a timely rehabilitation can, at least, save the addict’s life.

Confronting a family member, colleague, or friend who has a dependence on Krokodil can be very challenging but a slight delay may be fatal. It is crucial that help is sought as soon as possible.

Recovering from Krokodil Addiction

In Russia, one of the documented cases of Krokodil rehabilitation is that of a former addict, Irina Pavlova, who was admitted to the rehabilitation center in a tiny village called Chichevo. Hers, however, is not a typical case because she survived six years of injecting the drug almost every day. This period is double that of an average user who is expected to die within two to three years from the inception of use.

But Pavlova did not escape the addiction unscathed. She suffered brain damage that impaired her motor skills and speech. As with other Krokodil addicts, her eyes also came to assume a vacant gaze.  She has never fully recovered from these effects and she must be assisted each time she attempts to take some steps forward only to jolt and fall back.

Pavlova recalls that she had learned to cook Krokodil and did so in her brother’s apartment where she hung out with other addicts. Sometime in 2008, she went on a binge for two weeks and did nothing but cook Krokodil and inject it into the femoral artery in her groin. Afterwards, she developed gangrene and blood poisoning around the area. She was brought to the hospital to be treated where she was invited to a rehabilitation center. She agreed to seek professional help.

Recovery did not come easy. About a year into rehabilitation, she could no longer bear the drug cravings. She escaped from the center which is about two hours away from Moscow and separated from the nearest town by vast fields and pine forests. She hitchhiked to Moscow and went all the way to Vorkuta to get high again.

During the second course of her rehabilitation, she finally passed the stage of intense and almost unendurable cravings that are characteristic of Krokodil withdrawal. She has also found the commitment to stay away from drugs for fear of returning to what she calls the “horrible swamp” of Krokodil addiction.

Pavlova’s story is only one of the hundreds of thousands who have lived the life of a Krokodil addict. Most of them are not as fortunate. They only spiral in the darkness of drug abuse until the damage sets in and leads to their deaths.

Conclusion

With accounts like these, it is hoped that the public would be forewarned of how destructive Krokodil is so that addiction may be prevented. Those who have begun to use Krokodil should also seek treatment as soon as possible. The sooner medical intervention is accomplished, the higher their chances of survival and recovery.

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