Krokodil – Desomorphine is the street name for clandestinely produced desomorphine, a highly potent and addictive synthetic opioid used as a cheap alternative to heroin, primarily in Russia and Eastern Europe. Its name is derived from the severe skin damage it causes, which can result in a scaly, green-black appearance similar to a crocodile’s hide.
Key Facts about Krokodil and Desomorphine
- Active Ingredient: The main psychoactive substance is desomorphine (dihydrodesoxymorphine), a morphine derivative about ten times more potent than morphine, with a rapid onset and short duration of action.
- Production: Krokodil is typically homemade using a “bathtub chemistry” method involving easily available over-the-counter codeine tablets and various toxic household chemicals such as iodine, red phosphorus (from matchboxes), gasoline, and organic solvents.
- Toxicity: The severe health effects are largely due to the caustic contaminants and byproducts from this crude manufacturing process, which are not purified out of the final injectable liquid.
- Health Consequences: The injection of this contaminated mixture causes extensive damage to blood vessels, soft tissues, muscles, and bones around the injection sites, leading to thrombophlebitis, abscesses, gangrene, and osteonecrosis. This often results in the need for limb amputation and a very short life expectancy for users, with a mean survival time of only two years after first use.
- Medical Use: Desomorphine was formerly used medically in some countries (like Switzerland, under the brand name Permonid) for severe pain relief, but its use was terminated due to its high addictive potential and significant side effects, including respiratory depression. It has no accepted medical use in the United States and is a Schedule I controlled substance.
- Epidemiology: Its use surged in Russia and neighboring regions due to the easy availability of codeine products and the high cost/unavailability of heroin. Following the implementation of stricter codeine access in Russia in 2012, reported cases significantly declined. Confirmed cases outside of these areas, such as in the United States and Western Europe, remain rare and often unsubstantiated by toxicological evidence.
