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.”
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:
- Blood vessel damage
- Muscle damage
- 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
- Blood-borne diseases such as HIV, AIDS, and Hepatitis C
- Overall deterioration of health
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
- Profuse sweating
- Severe anxiety
- Intense drug cravings
- Muscle pain and twitching
- Chills and goosebumps
- 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.
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.
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.