Krokodil: Russia’s Designer Drug That Will Eat Your Flesh
It sounds like a direct-to-Netflix horror movie plot — a cheap, addictive drug available in a foreign land, that turns the user’s skin a scaly green color. Soon it rots the flesh, causing the user’s skin to emulate that of a crocodile, leaving bone and muscle tissue exposed to the world. But the Russian drug known as krokodil is real.
Warning: Disburbing images of the effects of Krokodil below. This article may be shocking or upsetting for some people. Please proceed with caution.
YouTube videos emanating from Russia displaying the after-effects of Krokodil use have been available for months. The clips often spotlight the gore factor, displaying the gangrene, exposed bones, and scale-like skin that lent the drug its name. What makes people use a drug that will destroy their body, to the point where their bones are exposed and require amputation? Why is usage (so far) contained to Russia?
What is in Krokodil? Just as crack is the broke addict’s cocaine, krokodil is a substitute for a much more expensive drug, heroin. The chemical behind krokodil, desomorphine, was available as a morphine substitute shortly after laboratory synthesis in 1932. Desomorphine is 8-10 times more potent than morphine. The medicinal use of desomorphine was concentrated to Europe, particularly Switzerland. The synthetic opiate has a structure nearly identical to heroin.
The final product is often an impure, orange-colored liquid, with this impurity causing skin irritation, a scale-like look, and eventual destruction of the skin. This is likely due to the presence of hydrochloric acid still in the final liquid solution prior to injection, with red phosphorous, obtained by solvating and removing the “striker” portion of matchboxes, playing a role in furthering sickening the user. Once the skin around the injection site is damaged, the area becomes a target for gangrene. This leads to skin decay around the injection site, and, in time, the skin sloughs off, often exposing the bone below.
Addiction is a full time job The high associated with krokodil is akin to that of heroin, but last a much shorter period. While the affects of heroin use can last four to eight hours, krokodil users are lucky to get an hour and a half of bliss, with the symptoms of withdrawal setting in soon after. Krokodil takes roughly 30 minutes to an hour to prepare with over-the-counter ingredients in a kitchen.
The short time table causes addicts to be trapped in a full time, twenty-four hour a day cycle of cooking and injecting in order to avoid withdrawal. Once someone becomes addicted, it is common for the individual to die within two-three years of heavy use from exposure and associated health issues, with many dying within a year.
Why is use prevalent in Russia? The major reason krokodil use is confined to Russia is due to the availability of codeine for purchase without a prescription — anyone can walk into any pharmacy and buy tablets containing the starting point of krokodil synthesis. Access could quickly be cut off by making codeine containing analgesics a prescription-only pharmaceutical in Russia. This has been met with backlash from citizens, as most believe that krokodil users will find another avenue for codeine, while preventing “proper” users from obtaining the analgesic tablets.
A lack of government infrastructure also plagues krokodil users. Russia lacks a significant state-sponsored rehabilitation system, nor have they made any significant moves to ban the over the counter sale of codeine tablets. Speaking on this subject, Viktor Ivanov, head of Russia’s Drug Control Agency, said:
A year ago we said that we need to introduce prescriptions […] These tablets don’t cost much but the profit margins are high. Some pharmacies make up to 25 per cent of their profits from the sale of these tablets. It’s not in the interests of pharmaceutical companies or pharmacies themselves to stop this, so the government needs to use its power to regulate their sale.
Apart from wanting to name this article In Soviet Russia, Drugs Eat You, there is not a lot to laugh about in regards to krokodil. It is a debilitating, body-destroying drug that’s consumed predominantly by the poor. Reports of usage in Germany have also surfaced as of October 2011, where codeine drugs require a prescription. Codeine products have been considered “prescription only” narcotic for decades in U.S., the UK and Sweden. But pills containing codeine can still be purchased without a prescription in a Canada, Australia, Israel, France, and Japan. We may soon see the devastating effects of krokodil in these regions too.
Images of Krokodil use courtesy of stopnarkotik.com.ua and youtube user kay8x. Sources linked within article.
Someone asked a question about the post regarding the dialysis photosensors shutting down the machine because they sense a false blood leak into the dialysate due to the red color of hydroxocobalamin. The questioner had been previously instructed to avoid hydroxycobalamin use in the context of a patient that was potentially headed towards dialysis.
While this phenomenon has the potential for delaying dialysis, it shouldn’t prevent it completely. There is an internal machine override that an experienced dialysis nurse/tech should be familiar with. I guess it’s a slightly different issue to convince the nephrologist and dialysis nurse to actually execute the override, but I think that’s just an opportunity to use your excellent communication and teamwork skills.