When the nasty, highly addictive street drug krokodil appears in a new area, it tends to spread fast. So when doctors at the Banner Good Samaritan Poison and Drug Information Center got two separate reports of suspected krokodil use in the last month — possibly only the second and third cases ever reported in the US — they alerted media, government, and the medical industry.
"We’re taking it very seriously because we’re worried that this drug has finally made it here in some substantial quantity," says Dr. Aaron Skolnik, a toxicologist at Banner. "We would love to be wrong, but whenever we hear about stuff like this, we usually get more."
Krokodil has been called a "moonshine drug," because addicts often cook it at home using codeine pills and household chemicals like lighter fluid and iodine. It’s more addictive than heroin, cheaper than prescription painkillers, and gets you 10 times as high as morphine — but for half as long.
It's more addictive than heroin, cheaper than painkillers, and gets you 10 times as high as morphine
Worse, the cooking process for Krokodil tends to leave traces of toxic substances and even heavy metals in the final product, which addicts inject into their arms, legs, and groin. Prolonged or even short-term use can damage the blood vessels, muscle, thyroid, cartilage, and bone. Because it is taken intravenously, krokodil can cause serious infections in the heart, brain, spine, or lungs. It can also lead to brain damage, organ failure, and necrosis, where skin becomes green and scaly and rots away at the injection site.
Pictures and videos of krokodil users in Russia show blackened fingertips, large open wounds, and even exposed bone where skin has fallen off, as well as the scaly, crocodile-like skin effect that gives the drug its name. Extensive amputation is frequently the only way to save a patient’s life. According to media reports, the mean survival time for a krokodil addict is two years.
The mean survival time for a krokodil addict is two years
Krokodil became popular in the slums of Siberia despite its devastating effects because it is intense, affordable, and easily synthesized. The drug was first discovered in Russia in 2003. In 2011, Vice introduced the rest of the world to the phenomenon in a documentary, "Krokodil Tears," which showed how heroin addiction drove impoverished addicts along the Kazakh border to cook their own krokodil from ingredients available at ordinary pharmacies.
The recipe for krokodil varies, but the psychoactive ingredient is an opioid called desomorphine that was developed at the National Institute of Health in the 1930s as a morphine alternative. It was quickly set aside because of its addictive qualities and limited duration. "Desomorphine is the most powerful painkiller known, but it is very short-acting," wrote The Science News Letter in 1951.
This is the basic preparation (emphasis ours) according to a paper written by researchers in Germany at the University Medical Center of Mainz and University Hospital of Ulm in the journal Substance Use and Abuse entitled "Krokodil" — Revival of an Old Drug with New Problems":
