Is Europe At-Risk for Krokodil Trafficking from Russia?
It turns into a stinky yellowish substance after being cooked in a cauldron, in the form of a pot. People who take it act like zombies and grow dark, reptilian-like scaly patches on their skin. What is it? A witch’s brew?
It’s not a witch’s brew, but the answer as to what it is comes from yet another harrowing tale of Addiction’s “Believe it or Not.”
The smelly substance that causes meningitis, rotten teeth, memory loss, liver damage, bone infections, rots flesh and more, is an addictive drug call Krocodil—labeled by the Independent of the UK as “The drug that eats junkies.”
With such severe consequences, including a painful withdrawal that lasts a month, the question is, why would anyone even consider taking such a drug? That is best answered by looking at the drug’s beginnings in Russia.
Krokodil became popular in Russia in 2003 when the street price of heroin went up due to the country’s somewhat successful efforts to stop the trafficking of heroin from Afghan.
Predictably, without adequate drug treatment availability, increased prices in heroin left two million heroin addicts scurrying for a way to find their next fix—one they could afford. And hence the Krokodil problem began. With a high similar to heroin’s, it is cheap, easy to get the ingredients for, and easy to make.
Some now describe the Krokodil problem as an epidemic in Russia. The New York State Office of Alcoholism and Substance Abuse Services reports that about one million people in Russia use krokodil.
More About Krokodil
Krokodil is a relatively new name for the older drug, desomorphine that was synthesized in the United States in 1932. At that time, desomorphine was developed as an alternative to morphine. But when desomorphine was found to be more addictive and potent than morphine, it was assessed as having no medical accepted use. Now it has emerged in Russia under the name Krokodil.
Krokodil got its name because the drug creates dark, scaly patches on the skin of users. The patches of skin become almost reptilian (like a crocodile). When doctors started to notice strange wounds on drug users’ bodies, it became apparent that the new drug was making its way across Russia.
Krokodil is taken intravenously. Blood vessels die, and skin rots away, sometimes falling off the bone, wherever krokodil is injected. There’s more. Krokodil can cause severe skin problems and swelling of the extremities, to an extent where amputation is required.
Krokodil is easy to make with ingredients and instruments easily purchased at pharmacies and hardware stores. The main component of krokodil is codeine—either obtained through prescriptions or cheaply from the black market. Addicts mix the codeine with iodine and various toxins and poisons like paint thinner, hydrochloric acid, and red phosphorus. There is a boiling and distilling process to create desomorphine, the synthetic opioid in krokodil. Desomorphine is similar to heroin, but the concoction is not as clean as heroin. Usually, all the chemical ingredients don’t burn off through cooking—some remain in the injectable product, causing harm.
Reportedly, there is an awful smell of iodine that never seems to go away for those who use and manufacture the drug.
Krokodil becomes addictive quickly because of the length of the high—less than two hours (as opposed to several hours with heroin). The shorter high causes a more frequent administration of the drug and quicker dependence.
Krokodil Addiction in Russia
Time Magazine reported an alarming statistic from Russian counternarcotics agencies. Quoting contributing writer Simon Shuster, "The drug quickly became popular among Russian addicts. In 2005, the country's counternarcotics agency reported catching only 'one-off' instances of the drug; six years later, in the first three months of 2011, the agency confiscated 65 million doses, up 23-fold from two years earlier. At its peak that year, krokodil use had spread to as many as a million addicts in Russia."
In 2012, Russia outlawed the over-the-counter sale of codeine to bring krokodil use numbers down, without success. Russian addicts have continued to get their high by obtaining codeine on the black market or convincing a physician to write a prescription.
Is there Krokodil Abuse in the United States?
The Time Magazine article cited earlier reported at least one verified krokodil toxicology case in the United States. In 2014 the California Poison Control System said that krokodil abuse cases had made their way to California.
However, there is little evidence to be found of much krokodil abuse in the US. But the US should be alert to the possibility.
Krokodil Abuse in Europe
The 2014 report in the California Poison Control System describes a problematic situation with abuse of krokodil in Russia and other European countries. Quoting study author Dr. Alicia Minns, "In late 2011, Krokodil use in Germany was reported with devastating dermatologic lesions typical of Krokodil use. Due to the high dependence potential and the toxicity of Krokodil, the mean survival time after first use is reported to be 2 years. At this point, Russia and Ukraine seem to be the countries most affected by Krokodil, however Georgia, Germany, Kazakhstan, Czech Republic, France, Belgium, Sweden, Norway as well as the USA have reported Krokodil use and related injuries. The victims of Krokodil are usually young people between ages 18 and 25, who turn to this drug for economic reasons."
Additionally, a report in the American Journal of Medicine indicated that krokodil had spread to European countries, but it did not specify which countries. It discussed the risk factors inherent in krokodil use and the more than considerable dangers that addicts faced.
Krokodil has made its way into Europe, but the degree of its use in those countries is still unclear. Also called Russian Magic, Crok or Krok, it is deadly by any name. The addictive drug merits critical international review to prevent the spread of its use to Europe and North America.
Preventing Krokodil Addiction in Europe
There isn’t enough reported data among European agencies to determine the exact extent of krokodil use in Europe. However, there is enough preliminary data to suggest this incredibly toxic substance has spread from Russia to other European countries. What should European residents do to stop the spread?
A first logical step would be to provide access to drug treatment for opioid addicts. Krokodil is often a replacement drug for those who can’t afford heroin. Any heroin user, if unable to obtain a heroin fix, could be at risk for searching out krokodil to avoid withdrawal. The move from heroin to krokodil is easy to predict if treatment is not available, but krokodil is. The withdrawal from heroin, though difficult, is reportedly nothing like the month of pain and nausea that accompanies krokodil withdrawal. And the average lifespan of an addict after their first use of krokodil is only two years. Why not address the opioid addiction before it turns into a point from which there is almost no return? A krokodil epidemic across Europe could be as nightmarish as any plagues in the past.
Education is another essential element in the prevention of krokodil abuse in Europe. The truth could lead to desperate opioid addicts seeking treatment rather than taking a chance with the horrific drug. Also, If Europeans are informed about the risk factors and utterly frightening side effects of krokodil use, they will be much less likely to experiment with the substance.
European agencies and governments would be wise to inform as many residents as possible about the dangers and risks inherent in experimenting with krokodil through state-wide public health announcements, PSAs, school education programs and household discussions. At the same time, Europe must increase treatment availability for opioid addicts, who might use krokodil as a substitute for heroin.
What to Do if a Loved One is Addicted to Krokodil
If you know someone who is already using krokodil, they are at risk for early death. Get them into treatment immediately. Withdrawal from krokodil can be rough, but a drug treatment center should be able to get them through it. The alternative is horrendous.
If your loved one uses krokodil, it is improbable that they will get off the drug on their own. Please do everything you can to get the person into a drug and alcohol addiction treatment center as soon as possible.
Reviewed by Claire Pinelli, ICAADC, CCS, LADC, RAS, MCAP