Krokodil: “The World’s Deadliest Drug”

Maxim W. Furek, MA, CADC, ICADC

Like an alien spore oozing from a sci-fi film, krokodil has emerged as one of the worst drugs of abuse. Called “the Zombie Drug,” and “The World’s Deadliest Drug,” krokodil is the nightmare scenario that officials hoped would never happen. But, it has. And it is here. And it is bad!

Desomorphine (Dihydrodesoxymorphine) is an opiate analogue invented in the United States. The drug is a derivative of morphine, though more potent. According to writer Mary Bellis:

Krokodil or desomorphine began its history as a patented drug. US patent 1980972 was issued to chemist, Lyndon Frederick Small for a “Morphine Derivative and Processes” on November 13, 1934. The drug was briefly manufactured and marketed by the Swiss pharmaceutical company Roche under the brand name of Permonid but was abandoned as  a commercial product for its short shelf life and highly addictive nature.

Initially, the sedative was used pre-and post-operatively because of its calming effect on excitement and fear. Permonid was found to have a faster onset and shorter duration than morphine, with less nausea and respiratory depression. It was erroneously thought to be less addictive than morphine and some reports said that respiration depression was greater with permonid. Decades later, a dangerous homemade version of desomorphine has flooded the streets of Moscow.

Russian Far East

The Russian street name for homemade desomorphine is “krokodil” (crocodile), reportedly due to the scale-like appearance of skin of its users. Addicts who inject krokodil have  experienced severe tissue damage, including destruction of internal organs, and gangrene. Human flesh turns grey, green and scaly. The drug ruptures blood vessels and rots the flesh around the injection site, exposing bones and connective tissue. One of numerous medical horror stories reported that:

Gangrene and amputations are quite common, and bone tissue – often in the lower jaw is eaten up by the drug’s acidity. The smell of rotten flesh permeates the room. Intensive treatment and skin grafts are required, but they often are not enough to save limbs or lives.

Compromised immune systems are highly likely to occur with IV krokodil abuse leading to susceptibility to infections including hepatitis C and other blood-borne diseases. Further consequences have included severe withdrawal, spread of HIV through the reuse of contaminated needles, and overdose death.

Krokodil is 8-10 times more powerful than morphine, and like the opioid class in general, the drug has fast-acting effects of analgesia and sedation. Abuse of homemade desomorphine was first reported after Russia started a major crackdown on heroin production and trafficking, but in the past ten years the drug has spread throughout Russia and the neighboring former Soviet republics. Researchers believe it first appeared in Siberia and the Russian Far East around 2002.

Since 2009, the amount of krokodil seized in Russia has increased 23-fold, according to the head of the Federal Drug Control Service. In 2010, between a few hundred thousand and a million people, according to various official estimates, were injecting krokodil into their veins. Use has spread to other European countries including Germany, but Russia is, so far, the only country to see the drug grow into an epidemic.

In part, due to its close proximity to Afghanistan, Russia has suffered a significant opiate problem. Krokodil emerged as an inexpensive heroin alternative after heroin become scarce or too expensive. Krokodil is roughly one-tenth the cost of heroin. The sedating drug is simply produced from codeine tablets, available without a prescription, combined with substances like gasoline, hydrochloric acid, iodine, lighter fluid, paint thinner, or red phosphorus. The clandestine manufacturing process is similar to that of methamphetamine, as both homemade drugs are highly impure and contaminated with various toxic and corrosive byproducts. Manufacturing of this drug is dangerous and, like methamphetamine, leaves several pounds of hazardous waste.

The Russian government has considered some steps to curb this epidemic, including banning websites that explain how to make the opiate, placing codeine back into the prescription-only category and increasing enforcement with escalated confiscation. In 2012 the Kremlin introduced new restrictions for the sale of codeine-based medications, the prime opiate ingredient in the street drug.

The Russian epidemic has not gone unnoticed by the global press. According to a Time Magazine article titled “The World’s Deadliest Drug,”

Krokodil, a cheap substitute for heroin, was one of the deadliest designer drugs ever to sweep through Russia. Appearing on the black market in the early 2000s, it wound up ensnaring hundreds of thousands of addicts across the country, and it spread especially fast in poor, industrial areas like Uralmash.

Its appeal was simple: addicts could easily learn to cook it in their kitchens using  ingredients purchased at local pharmacies and hardware stores, among them hydrochloric acid, paint thinner and red phosphorous, which they scraped from the sides of match boxes. For a fraction of the price of heroin, the drug produced a similar high and was just as addictive.
“The most horrible drug”

Krokodil has been called “the most horrible drug in the world.” Reports of the drug have been found in scattered states including Arizona, Illinois, and Utah.

After the United States cracked down on the sale of codeine in June of 2012, it became much more difficult to gather the necessary ingredients and users who knew how to prepare krokodil had a more difficult time making it. Still, it didn’t stop them from finding ways to purchase codeine on the thriving black market. Because of this, krokodil is still relatively easy to produce at home, and is not going away anytime soon. The drug is cheap  and the krokodil high lasts approximately 11⁄2 hours longer that that produced by heroin.

Officials first started seeing the flesh-eating “zombie drug” in Utah back in 2013. Health officials in the state indicate that there have been two cases in Utah they believe are tied to the drug. Doctors around the country are seeing more effects from the zombie drug, including a woman who was suffering from krokodil addiction. The woman lost a significant portion of her legs due to the drug. A 2014 episode of the National Geographic Channel series “Drugs, Inc,” suggested the drug had reached the southwest. A significant drug bust in Utah revealed that along with 12 pounds of meth that was seized, two additional pounds of what was determined to be krokodil was also found. CNN reported that:

Although it’s not clear how widely used the drug is in the US, reports show that the use is rising, and the fact that it could be hitting closer to home in Utah is especially of concern. The fact that krokodil is cheaper than heroin and can be easily cooked up in someone’s home much like meth makes it easier to create than some other drugs. Further, mortality rates are high among users. Medical help is often only sought after users are in the late  stages of their addiction and end up with severe mutilations, rotting gums, bone infections, decayed structure of the jaw and facial bones, sores and ulcers on the forehead and skull  as well as rotting ears, noses and lips and liver and kidney problems.

Around 2013, the Delaware Valley Intelligence Center, one of the first agencies to sound the alarm about the drug, warned that a regular krokodil addict’s life expectancy is shockingly only two to three years. That horrific report is the strongest anti-drug message ever created. krokodil will kill you slowly and painfully, and the user will suffer the most grotesque and torturous manner of death imaginable. This is the one substance that drug users need to stay away from and this warning needs to be heeded.

Maxim W. Furek has a rich background that includes aspects of psychology, addictions,  mental health and music journalism. His book Sheppton: The Myth, Miracle & Music blends facets of the miraculous and supernatural into a psychological profile of survival. Learn more at shepptonmyth.com