Krokodil regularly tops the list of the world’s deadliest drugs. The major danger of krokodil is not necessarily the opioid compound present in the substance, rather it is the process of making the drug that can cause severe health problems.The use of krokodil has been associated with severe flesh-eating bacterial infections, and there have been reports that the drug has made its way to the United States. The opioid contained in krokodil is desomorphine. Desomorphine is a synthetic morphine analogue that was first created in the 1930’s. The drug is ten times more potent than morphine, and has a very fast onset but extremely brief duration. Due to the brevity of the high it creates, users are more likely to inject more frequently than with other opioids. It can quickly cause tolerance, physical dependence, and addiction. According to the DEA, long-term users of krokodil often develop green and scaly skin as a result of blood vessel damage. The skin resembles that of a crocodile’s green scaled. It can also cause thrombosis and damaged soft tissue where the drug was injected. The DEA explains, “the skin injuries can eventually develop into severe tissue damage leading to thrombophlebitis and gangrene. These conditions usually result in limb amputation or sometimes death.” Krokodil began appearing on the black market in Russia in the early 2000s and caused notable health damage to IV opioid users. Simon Shuster, in a 2016 TIME article entitled The World’s Deadliest Drug: Krokodil’s Legacy, explained that the appeal of the drug came from the fact that “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.” Therein lies the true danger of krokodil– the dangerous process of production. The raw materials of krokodil are codeine tablets, alkali solution, organic solvent, acidified water, iodine, and red phosphorous. When a person makes the drug, they are unable to entirely remove the dangerous materials. According to a 2005 Forensic Science International article entitled The Harmful Chemistry Behind Krokodil (Desomorphine) Synthesis and Mechanisms of Toxicity, krokodil can cause thrombophlebitis, ulcerations, gangrene, and necrosis that can evolve into limb amputation or death, and these effects “ are thought to result from the toxic components produced as byproducts during the homemade drug synthesis.” Jen Christensen, in a 2013 CNN article entitled Flesh- Eating ‘Zombie’ Drug ‘Kills You From the Inside Out’, further explains, “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,”
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