What is krokodil? Krokodil drug, or, in pharmaceutical terms, desomorphine, belongs to the class of opioid drugs, being a derivate of codeine. This substance is a semi-synthetic opioid, and up to eight times more potent than morphine.
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Krokodil Drug Facts
Desomorphine was first synthesized in Switzerland, in 1922, without being recognized by the medical community. However, in the following decades, medical professionals started to appreciate the substance, and not long after it entered commercial use under the name Permonid.
Russian physicians also prescribed desomorphine to treat severe pain, but by the end of the 20th century, it was practically a forgotten medicine.
Only after the outbreak of desomorphine addiction epidemic in Russia, in 2010, did this drug start to gain attention, this time for its detrimental side-effects and innumerable casualties. Quickly, desomorphine became known as the Russian drug krokodil, and it spread throughout the whole ex-Soviet Union.
Due to a relatively fast and simple synthesis process, this substance has found its way to most drug markets all around the world, albeit with a much weaker impact. A case of krokodil abuse in the USA has been recorded and analyzed, although the experts agreed that this was an isolated case.
Statistics on Abuse
In 2011, Russian experts estimated the number of krokodil addicts at about 30,000. In 2012, this estimate was much more alarming, as the number of Russians addicted to desomorphine increased threefold- with more than 100,000 addicts.
The drastic consequences of desomorphine addiction quickly contributed to the media coverage of this phenomenon, and Google searches involving the term desomorphine immediately surged in 2011.
National Institute on Drug Abuse has stated that there are virtually no cases of krokodil addiction nor production in the US. Thus it seems that this was a reasonably isolated phenomenon, mostly confined to the borders of Russia.
Krokodil Ingredients And Mechanism Of Action
Besides desomorphine, many other krokodil drug ingredients contribute to the severity and consequences of addiction. For instance, clandestine desomorphine synthesis involves numerous dangerous components such as Codeine pills, red phosphorus, iodine, lighter fluid, hydrochloric acid, ethanol, and paint thinner. The result is a mixture of various substances called krokodil.
There are many other ingredients present in desomorphine mixtures, as addicts can easily make their batch of this substance, which means that krokodil recipe varies. These additional ingredients, along with the ones above such as phosphorus and paint thinner, only contribute to the detrimental effects of pure desomorphine, which is dangerous on its own.
Thanks to its agonist effect on the brain’s opioid receptors, desomorphine acts as an analgesic and sedative, producing euphoria and relieving pain. This drug is also a muscle relaxant, and this can sometimes lead to serious health complications. The additional ingredients, like red phosphorus, act peripherally, destroying the surrounding tissues.
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Krokodil is an extremely hazardous substance. Never attempt to recreate any recipe of this drug as it may lead to terrible health consequences as well as legal issues. The manufacturing of this drug is punishable by law.
How Is Krokodil Used?
Desomorphine addicts usually inject the drug intravenously. This, in turn, leads to various dermatological problems and health complications, as each time addicts use desomorphine, various infections, ulcerations might appear as the result of injecting the drug. Why do people use krokodil? As with any other addiction, there are many precursors and risk factors that should be taken into consideration, but these are the main reasons people take desomorphine:
- Desomorphine is extracted easily from codeine pills.
- Additional ingredients needed for extraction (like phosphorus or ethanol) are also easy to procure.
- This substance is cheap.
- Its euphoric effects are intensive, albeit short-lasting.
Desomorphine effects, on their own, are intense and potentially life-threatening. This substance is a powerful opioid with strong sedative effects. Other ingredients, that can be found alongside desomorphine, only increase the dangers of this drug.
People abusing this substance experience a fast onset of euphoria as the drug is injected into the person’s bloodstream. In the next few hours, the sedative and stupefying effects of krokodil drug take hold.
Desomorphine addicts experience both short-term side effects and long-term side-effects of abusing this dangerous substance.
Short-Term Side-Effects of Krokodil
Short-term krokodil effects resemble that of other opioids, although desomorphine is more potent than most of them. As a result, people addicted to this substance experience negative consequences quite fast; shortly after the drug is injected. These are the most dangerous short-term effects of krokodil.
- Respiratory failure
- Localized skin lesions surrounding the puncture
- Lack of coordination (inability to walk properly)
- Powerful sedation
Long-Term Side-Effects of Krokodil
The exact nature and quality of long-term side effects depend on the ingredients found alongside desomorphine. When addicts continuously inject elements such as red phosphorus, paint thinner, lighter fluid, serious chronic side-effects tend to occur. These are the most severe chronic consequences of abusing street desomorphine:
- Krokodil wounds
- Skin krokodil necrosis (gangrene)
- Damaged blood vessels
- Bone damage
- Crocodile-like, black, scaly skin
These are only the most drastic consequences usually linked with desomorphine addiction. Practically the whole organism suffers under the weight of this ghastly substance, and these are the most serious krokodil drug health effects:
- Central and peripheral nervous systems
- Liver damage
- Blood poisoning
- Kidney problems
Krokodil side-effects are quite drastic, which contributed to the drug’s notoriety and increased people’s awareness about the dangers of addiction. Unfortunately, some people continue to use street desomorphine as a cheap heroin substitute. In comparison with heroin, krokodil produces much more damage to the body due to its impurity.
While the additional ingredients found in this drug quickly destroy people’s appearance and their whole lives, desomorphine is what keeps them addicted. This powerful opioid produces powerful sedation, euphoria, and a sense of relaxation.
Krokodil high effects are so strong that addicts continue using it, even though skin damage, vein infections, and other problems become more prominent after each krokodil injection.
How People Get High On Krokodil
While it’s theoretically possible to snort krokodil, intravenous injection is the most common method, as the onset of krokodil high is much faster if the drug is injected directly into the bloodstream.
How Does Krokodil High Feel Like?
This substance produces a plethora of immediate narcotic effects, and these are the most frequent ones:
- Feeling relaxed
- Forgetting about one’s troubles/ being indifferent to them
- Powerful body high
- Slow breathing
As addiction becomes more and more chronic, high effects tend to wane, while all the negative effects become even more prominent. With krokodil, this universal trend is the most pronounced, due to the plethora of toxic substances found alongside desomorphine.
Krokodil overdose has two basic components:
- Desomorphine overdose
- Acute toxic effect of additional ingredients (like, for instance, red phosphorus)
Desomorphine overdose resembles that of other opioids.
Symptoms Of Overdose
Addicts who take large quantities of this drug will experience severe symptoms such as complete respiratory failure, extreme nausea and vomiting, and inability to move and talk properly. Individuals who overdose are often unconscious or completely unresponsive to external stimuli.
If these symptoms are not appropriately treated, death will ensue in most cases. Anyone who experiences these symptoms while using desomorphine or other opioids should contact a medical provider immediately.
What To Do If Someone Overdosed On Krokodil?
First of all, people who find a person overdosing on krokodil should call 911 immediately. There are a few things that can be done before the ambulance arrives, and these are:
- Clear airways- check the person’s nose and mouth. Sometimes, overdosing addicts swallow their tongues, which then leads to choking.
- Move the person to their side in case of vomiting.
- Try to wake the person up gently.
- Stay around and wait for the ambulance to arrive.
- Use Narcan.
Narcan is a potent opioid receptor antagonist (i.e., it reverses the effect of desomorphine), and it is the first line of defense against overdoses.
It is equally important to know what not to do when someone overdoses:
- Do not wait until it wears off.
- Do not give any substance to the person who’s overdosing, except Narcan.
- Do not leave the individual alone.
Signs And Symptoms Of Krokodil Use
These are the most conspicuous signs of krokodil use:
- Very small pupils
- Lack of muscle tonus, the person who uses desomorphine, may appear overly relaxed and slouched
- Prolonged reaction time
- Nodding out
- Slurred speech
Aside from these krokodil symptoms, severe skin ulceration and damage will be the easiest to notice.
Desomorphine is an extremely addictive substance. Individuals who abuse it are ready to accept abhorring changes to their bodies in exchange for short but powerful effects of the drug.
These are the most important symptoms of psychological addiction to krokodil:
- Inability to think properly, lack of focus
- Restlessness, anxiety, jitteriness
- Depression and lack of motivation (due to abstinence)
It is important to note that psychological addiction may ensue after the first use of the drug.
Chronic consumption of desomorphine will lead to the development of physical addiction, characterized by tolerance and abstinence syndrome.
Tolerance simply means that a krokodil addict needs to take more and more desomorphine to get the same effects. Abstinence syndrome happens when an addict stops using desomorphine, and symptoms may vary from flu-like health complications, high body temperature, shivering, sweating, to delirium, and psychological breakdown.
Abstinence syndrome is further complicated by constant skin infections and other symptoms experienced by krokodil addicts.
Krokodil Withdrawal And Detox
Sudden cessation of use will lead to krokodil withdrawal. It is important to note that, due to its relatively fast mechanism of action, desomorphine quickly produces withdrawal symptoms. They sometimes appear as fast as only six hours after the last desomorphine injection. This is another reason why this drug is hazardous and addictive. Withdrawal symptoms will reach their peak 1-2 days after stopping use and ultimately wane after about six days. Addicts who go through withdrawal phase experience these symptoms:
- Emotional disturbances
How Long Does Krokodil Stay In The System?
Desomorphine quickly starts showing its effects and wanes quickly. The half-life of desomorphine is about 2 hours, and its effects disappear quickly, which is why addicts tend to re-dose and aggravate the negative consequences of desomorphine use.
Treating Krokodil Addiction
Treating substance addiction encompasses both psychological (mental) healthcare and physical healthcare.
Due to severe physical damage caused by desomorphine addiction, most addicts should first be treated in controlled hospital conditions.
For instance, treating various life-threatening infections and health complications like gangrene or sepsis are by far, the primary goals of treating desomorphine addiction.
After solving these primary physical health problems, an individual can be treated in the rehabilitation facility for addicted ones, where more emphasis is put on the psychological causes of substance abuse problems.
- Alessandra Haskin, Noori Kim, Crystal Aguh. A new drug with a nasty bite: A case of krokodil-induced skin necrosis in an intravenous drug user. JAAD Case Rep. 2016 Mar; 2(2): 174–176. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4864092/
- Andrey Zheluk, Casey Quinn, Peter Meylakhs. Internet Search and Krokodil in the Russian Federation: An Infoveillance Study. J Med Internet Res. 2014 Sep; 16(9): e212. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4180331/
- “Krokodil”. National Institute on Drug Abuse. Archives. https://archives.drugabuse.gov/emerging-trends/krokodil