Krokodil first surfaced in Russia several years ago, where users discovered the drug was much cheaper than heroin and could easily be cooked in a kitchen by combining codeine with gasoline, oil, alcohol or paint thinner, Fox News reports.
And now, krokodil has arrived in the United States: Two cases of people addicted to the drug have been reported in Arizona. "As far as I know, these are the first cases in the United States," said Dr. Frank LoVecchio, director at Banner Good Samaritan Poison and Drug Information Center in Arizona, as quoted by Fox News. "So we're extremely frightened."
Krokodil is injected with a hypodermic needle, and necrosis — the death and decay of living tissue — can quickly set in. Gangrene and amputations are common among addicts, who have an average life span of about three years, according to the Daily Mail.
Like other opiates, krokodil is powerfully addictive, and even those users who kick the habit often walk away severely disfigured: severe scarring, bone damage, amputated limbs, speech impediments, poor motor skills and varying degrees of brain damage — for life.
And it doesn't take much lab equipment to make. The illegal production of krokodil in Russia and the Ukraine is similar to the chemical process used to home-produce methamphetamine, according to a review by Jean-Paul C. Grund, of Charles University and General University Hospital in Prague, and colleagues detailed online June 3 in the International Journal of Drug Policy. To make krokodil, producers reportedly transform codeine into its opiate analog called desomorphine, whose analgesic effect is about 10 times greater than that of morphine, and so stronger than heroin; it's about three times more toxic than morphine, Grund wrote.
Krokodil users may avoid seeking help partly due to the stigma attached to drug use. "In countries where public campaigns or media position drug use as social evil and where health providers are viewed as closely aligned with law enforcement or other systems of social control (e.g. child protection agencies), PWID [people who inject drugs] are likely to postpone seeking treatment for medical problems that need urgent professional care," Grund and colleagues write in their journal article.
"This is really frightening," Dr. Aaron Skolnik, a toxicologist at Banner Good Samaritan Poison and Drug Information Center in Phoenix, told Fox News. "This is something we hoped would never make it to the U.S. because it's so detrimental to the people who use it."
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