Flesh eating Drug – Krokodil ( or Desomorphine )

A flesh-eating drug that turns people into zombie-like creatures seems to have made its way to the United States.

This extremely addictive injectable opioid is called krokodil (pronounced like crocodile) or desomorphine. It’s so named in part because users report black or green scaly skin as a side effect.

Krokodil causes serious damage to the veins and soft tissue infections, rapidly followed by gangrene and necrosis, according to a 2013 study (PDF).

More on Krokodil Desomorphine (Dihydrodesoxymorphine)

Desomorphine (Dihydrodesoxymorphine) is an opiate analogue invented in 1932 in the United States that is a derivative of morphine, though more potent. Like the opioid class in general, it has sedative and analgesic effects when used. It was used in Switzerland under the brand name Permonid, where it was found to have a faster onset and shorter duration than morphine, with less nausea and respiratory depression. It appears to be used quite extensively in Russia, especially when heroin becomes scarce or too expensive. (Russia has a significant opiate addiction problem partially due to its close proximity to Afghanistan.

Desomorphine has attracted attention in Russia due to its simple production, utilizing codeine, iodine, gasoline, paint thinner, hydrochloric acid, lighter fluid and red phosphorus. The clandestine manufacturing process is similar to that of methamphetamine. Desomorphine made this way is highly impure and contaminated with various toxic and corrosive byproducts. The street name in Russia for home-made Desomorphine made in this way is “krokodil” (crocodile), reportedly due to the scale-like appearance of skin of its users, and it is used as a cheaper alternative to heroin, as codeine tablets are available without a prescription in Russia.

Since the mix is routinely injected immediately with little or no further purification, “Krokodil” has become notorious for producing severe tissue damage including injury to the veins (phlebitis) and gangrene. Other consequences of use have included severe withdrawal, spread of HIV through the use of contaminated needles and death.

Use in Russia is estimated as high as 1 million and use has spread to other European countries including Germany. 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.

The DEA reports that they are looking at the drug overseas but have not as yet seen it in the US.

 

The soft tissue damage happens around the injection site. The drug also seems to clump in the veins as it fails to dissolve completely in the blood. The clumps make their way to distant places in the body and start to damage tissue, said Dr. Robert Geller, medical director of the Georgia Poison Center. 

So far there are no officially confirmed American cases of krokodil abuse. To have official confirmation, the Drug Enforcement Administration would need to have a sample of the drug that caused the problem.

A DEA fact sheet about the drug released this month said the National Forensic Laboratory Information System, the DEA database that collects scientifically verified data on drug items and cases, identified two exhibits submitted to these labs as desomorphine in 2004 but none since then.

There have been many confirmed cases of krokodil abuse in Russia and Ukraine.

An estimated 100,000 in Russia and around 20,000 people in Ukraine are estimated to have injected the drug in 2011, according to a study that ran in the International Journal of Drug Policy this year. Experts theorize the drug first spread across Russia and Ukraine when heroin became less available.

Krokodil is cheaper than heroin and can be easily cooked up in someone’s home much like meth.

People making krokodil combine the painkiller codeine with easily available chemicals. They can use iodine; strong alkalies such as Mr. Muscle, a kitchen and bathroom cleaner; hydrochloric acid; red phosphorous from matches; and/or organic solvents such as gasoline or paint thinner, according to the study.

Mortality rates are high among users, according to the study.

In Russia, users frequently are young people with relatively short drug histories, the study found. 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.

“This may be an inexpensive high compared to other drugs, according to its reputation, (but it) is more likely to cause withdrawal symptoms and be a real problem for users.

The short half-life of the drug means a user’s attention is narrowed to the “process of acquiring and preparing and administering the drug, leaving little time for matters other than avoiding withdrawal and chasing (the) high,” according to one medical study, hence its reputation for creating “zombies.”

 

“I think it’s the tip of the iceberg; I think it’s going to get a lot worse before it gets better,” said Singla, the addiction specialist. “I think if it stays on the market long enough, you’re going to have people who are desperate addicts that can’t support their heroin habit but can utilize this drug, not really caring about the consequences, and get the same high for a third of the price.”

Dr. Abhin Singla is an internist and addiction specialist at Joliet‘s Presence St. Joseph Medical Center

 

Information Networking : Source – CNN By Jen Christensen October 16, 2013

 

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