After two cases involving the drug Krokodil popped up in Arizona last week, we decided to revisit what’s often described as the “flesh-eating drug.” To read our post from a year ago on krokodil, click here.
What is it?
Krokodil is the street name given to homemade version of the drug desmorphine. It's a make-it-yourself drug that sprang up from the isolation of Siberia. Russia is home to a horrendously high number of heroine users. Drug laws passed in recent years slowed the flow of heroine coming into the country from Afghanistan, so heroine users have turned to krokodil in desperation. It's infamous for causing the skin of users who inject it to rot away.
What’s in it?
Anything. Everything. The drug’s main component is codeine tablets, available without a prescription in Russia. The production process of distilling and boiling usually includes adding match tips, gas, paint thinner, and iodine. If made from the proper chemicals in a proper lab, desmorphine doesn’t include all the toxic byproducts of making it at home.
Is it really here in the US?
Frank LoVecchio, co-medical director at Banner Good Samaritan Poison and Drug Information Center told a CBS affiliate that they had seen two instances of krokodil use in the past week, adding that they believed the cases were related.
Should we be worried?
Officials hope that the drug’s main ingredient, codeine, being a controlled substance in the United States, will make it too hard to obtain. That doesn’t mean desperate addicts won’t tweak the recipe according to what is available to them, possible making the final product even more dangerous.
In Russia, krokodil use spread the fastest in poor, isolated regions where the unemployment rate is high and people are in a constant state of boredom. Does that sound familiar? 500 more coal miners were recently laid off from a large local mining company here in eastern Kentucky, joining so many others who are now out of work. Perpetual boredom is a way of life in Appalachia. Thanks to ol’ Purdue Pharma and their targeting of this area when Oxycontin was released, these mountains have a big bulls eye painted on them.
Does krokodil really eat the flesh of users?
Much research needs to be done on this relatively new drug, and while differing opinions as to why it happens have been put forth, medical professionals are in agreement that the drug does horrific, irreversible damage to the users.
Some say the rotting is a result of the drug being injected and damaging blood vessels and tissue. Another possibility put forth is the rotting is a result of necrotizing fasciitis, commonly known as flesh-eating bacteria. The bacteria could be introduced through open wounds, or by scratching vigorously and breaking the skin, itching being a hallmark of codeine’s histamine release.
These wounds just spread, infections get worse, and gangrene often sets in. Amputations are common among krokodil users who seek medical help.
Are the Arizona cases the first time krokodil has been seen in the US?
No. While they appeared to be isolated incidents, popping up and disappearing just as quickly, reports of its use were made in Memphis, TN in late 2011 and in West Virginia last year. Officials are hoping the Arizona cases are the result of an isolated incident as well, but worry that it will eventually settle in, offering a cheap alternative to hopeless addicts.
What are the signs of krokodil use?
You mean other than gaping holes with rotting flesh hanging off and exposed bone all over people? The iodine used in the cooking process leaves a smell that is impossible to get out. Users continually smell like burnt iodine.
How addictive is krokodil?
"With heroin withdrawal, the main symptoms last for five to 10 days. After that there is still a big danger of relapse but the physical pain will be gone. With krokodil, the pain can last up to a month, and it's unbearable. They have to be injected with extremely strong tranquilizers just to keep them from passing out from the pain." 
Different reports give different numbers, but commonly included are assertions like “Krokodil is 8 times as potent as morphine and three times as addictive as heroin.”
How is krokodil related to bath salts?
Both drugs are synthetics, meaning they mimic the effects of other drugs. Most of the chemicals being used to manufacture bath salts and synthetic marijuana are coming from China. It’s feasible that Chinese chemists are already developing a chemical that mimics codeine. That would be all these “neo-moonshiners” would need to start krok production.
Can't you come up with some conspiracy to tie it to? (lol)
Can't you come up with some conspiracy to tie it to? (lol)
Some crazy Unabomber type (who just may be leading some country or terror cell) could catch wind of an idea like this and target a population. Could be a different kind of bio-weapon, slowly rotting your enemies to death...? Isn't that what our government was supposed to have done with the black population and crack? Alright, that may be a little paranoid, but "users may be using it for two or three weeks before becoming aware of the dangerous side-effects and thus realizing that what they were sold was something other than heroin." 
In a comment section on an article about the Arizona cases one anonymous reader wrote "Man I'm glad I came across this article. My dealer's all the time throwing stuff at me and sayin 'Here this is new, try it.' I'll think twice now before I do it."
Where does it go from here?
It’s possible that the Arizona cases are isolated incidents. Time will tell if more krokodil finds its way here.
There’s always the possibility that some junkie somewhere will conjure up a cocktail of synthetic drugs like bath salts and krokodil, and make headlines after shambling all over town with their skin rotting off, eating the faces off those they encounter. Life imitates (Romero/Walking Dead-type) art. But that too would just be an isolated incident….right?
This video was featured in the older blog on krokodil, but it’s so unbelievable it bears re posting. Pretty graphic, but should be seen:
Following are the token gruesome photos of krokodil aftermath. As graphic as they are, I think videos like the one above and photos like these should be mandatory viewing for teenagers. Nancy Reagan preaching to "just say no" didn't work.
**Not for the squeamish, you’ve been warned.**
If you want to see more gruesome pics of krokodil effects a quick google search will return all you're eyes can handle.
For more info on krokodil, here's a couple good links:
Krok Kills - our previous blog on the subject
Siberia: Krokodil Tears - an excellent short documentary
***UPDATE*** 9-10-13: Three cases of krokodil use have now popped up outside Chicago, at least two of them using the drug thinking they were using heroin. For more details, read the newest blog here.
 "The terrifying, flesh-eating drug krokodil has reportedly surfaced in the US" Adrianne Jeffries Sept 27, 2013 http://www.theverge.com/2013/9/27/4775564/super-addictive-flesh-eating-drug-krokodil-reported-in-the-us
 "Krokodil: The Drug That Eats Junkies," Shaun Walker, independent.co.uk/news June 22 2011