Flesh-eating drug 'krokodil' appears in the US

[Questionable]

Not sure where this belongs, figured I would post it here since it could be considered related to health science.



A powerful heroin-like drug that rots flesh and bone has made its first reported appearance in the United States, an Arizona health official says.
Known on the street as "krokodil," the caustic homemade opiate is made from over-the-counter codeine-based headache pills mixed with iodine, gasoline, paint thinner or alcohol. When it's injected, the concoction destroys a user's tissue, turning the skin scaly and green like a crocodile. Festering sores, abscesses and blood poisoning are common.
Frank LoVecchio, the co-medical director at the Banner Good Samaritan Poison & Drug Information Center (https://www.bannerhealth.com/Locations/Arizona/Banner+Good+Samaritan+Poison+and+Drug+Information+ Center/_Banner+Poison+Control+Center.htm), told (http://www.kpho.com/story/23521413/first-cases-of-flesh-eating-drug-reported-in-az) KPHO-TV that Arizona health officials have seen two cases during the past week.
"As far as I know, these are the first cases in the United States that are reported," he said. "So we're extremely frightened."
LoVecchio did not say where in the state the patients were located or provide details about their conditions.
The drug — chemically called desomorphine (http://en.wikipedia.org/wiki/Desomorphine) — emerged around 2002 in Siberia and the Russian Far East but has swept across the country in just the past three years, according to a Time magazine investigation (http://content.time.com/time/world/article/0,8599,2078355,00.html).
Krokodil became popular in Russia because heroin can be difficult to obtain and is expensive. Krokodil costs three times less, and the high is similar to heroin though much shorter, usually 90 minutes.
The average life expectancy among krokodil addicts in Russia is two to three years, according to Time, which called the narcotic "the most horrible drug in the world." Gangrene and amputations are common, and the toxic mix dissolves jawbones and teeth, much like the methamphetamine that Walter White cooks in Breaking Bad.
As with all intravenous drug addicts, krokodil users are susceptible to HIV, hepatitis C and other blood-borne diseases, and have compromised immune systems.
One recovering Russian krokodil addict, Irina Pavlova, told Time in 2011 that she injected the drug almost daily for six years. She has a speech impediment and impaired motor skills because of the resulting brain damage.
Her brother was among the dozen or so addicts she shot up with. "Practically all of them are dead now," she said. "For some, it led to pneumonia, some got blood poisoning, some had an artery burst in their heart, some got meningitis, others simply rot."
A Russian woman using krokodil in June 2011 told (http://www.independent.co.uk/news/world/europe/krokodil-the-drug-that-eats-junkies-2300787.html)The Independent that a fellow junkie refused to go to the hospital.
"Her flesh is falling off and she can hardly move anymore," she said.


http://www.usatoday.com/story/news/nation/2013/09/26/heroin-krokodil-flesh-rotting-arrives-us-arizona/2879817/

[Art Vandelay]

I suppose it was only a matter of time before it made its way to North America. Its a pretty nasty substance.

[Sinister Intents]

That's a scary drug :( I remember reading about it a while back

[Skyhilist]

You'd have to be a complete idiot to take this or extremely delusional if you knew what it was.

So, tell me: is this a drug that is marketed as something else like heroin (because people don't want this but they want things like heroin) because it's cheaper to produce than things like heroin?

Or, is it sold as what it actually is but people just don't know the effects that it has?

Or, are people actually suicidal/fucked up/whatever enough to be crazy enough to try this knowing full well what its effects are?

[adipocere]

I saw a video of a doctor tapping some metal instrument on the exposed arm bone of a woman who used that drug. It was shocking.

over-the-counter codeine-based headache pills mixed with iodine, gasoline, paint thinner or alcohol How does this even occur to people? :unsure:

[Art Vandelay]

You'd have to be a complete idiot to take this or extremely delusional if you knew what it was.

Addiction doesn't make one a 'complete idiot' but yes it can lead to 'delusions,' as well as other things, which can lead one to make decisions that they normally would not have.


So, tell me: is this a drug that is marketed as something else like heroin (because people don't want this but they want things like heroin) because it's cheaper to produce than things like heroin?

Or, is it sold as what it actually is but people just don't know the effects that it has?

Or, are people actually suicidal/fucked up/whatever enough to be crazy enough to try this knowing full well what its effects are?

Its most likely a combination of all of these, with the your last point (people being suicidal/addicted enough that they do not care about the effects) stemming from your first one (people getting hooked on it, while ignorant of the side effects).

[Sam_b]

You'd have to be a complete idiot to take this or extremely delusional if you knew what it was.

If only drug abuse and addiction was this simple to quantify. You've obviously never been in such a position so be thankful.

[Flying Purple People Eater]

You'd have to be a complete idiot to take this or extremely delusional if you knew what it was.

At first this seems to be the logical conclusion. I mean, who the hell would take this stuff?

The problem is that you forget the extremely powerful coercion that plays on peoples' minds with the physical addiction heroin creates. If you were experiencing major physical withdrawal, were poor, felt as if you needed to pump yourself with the stuff and learned that there was another drug on the market that had the same effects as Heroin but was three times cheaper, then taking krokodil would end up be the 'logical decision' in the mind of an addict, sadly.

I'd vouch that the exact thought process I just outlined above is probably the reason the drug has become epidemic in Russia.

[Skyhilist]

At first this seems to be the logical conclusion. I mean, who the hell would take this stuff?

The problem is that you forget the extremely powerful coercion that plays on peoples' minds with the physical addiction heroin creates. If you were having withdrawal, were poor, felt as if you needed to pump yourself with the stuff and learned that there was another drug on the market that had the same effects as Heroin but was three times cheaper to be, then taking Krokodil would be the 'logical decision' in the mind of an addict, sadly.

Well yeah -- then the mind of the addict is delusional. I'm not saying individuals who take drugs are entirely to blame for this though. Material conditions lead to delusions and uninformed/somewhat idiotic decisions.

[Flying Purple People Eater]

I'm not saying individuals who take drugs are entirely to blame for this though. Material conditions lead to delusions and uninformed/somewhat idiotic decisions.

This is true. In fact, alternative drugs for highs like krokodil spawning from the Russian far-east makes perfect sense in the gloomy reality of an isolated, cold, poverty-stricken Siberian city.

[Trap Queen Voxxy]

Tbh, I did not see that coming, damn, I thought it was isolated.

[RedBen]

oh no... i seen a documentary on that stuff... i'm afraid for people, not everyone will know what it is. i was very drunk and high on marijuana and someone gave me something to smoke when i was 18. i asked what it was and they kept saying "just smoke it". i did, i found out later it was freebase(essentially crack). i left all drugs alone after that. it was one of the most shameful moments of my life because i remember asking what it was repeatedly with no answer but i smoked it anyway. when signing up for the army i had to refill out some forms because i was honest about prior drug use and my recruiter told me it would disqualify me. this makes me very sad that some young person somewhere is using this shit.

[tachosomoza]

This is a testament to the power of addiction. Skin falling off? Brain damage? Gasoline it is? Ain't no thing, I need more. Now.

This is why all controlled substances should be decriminalized and regulated. We wouldn't have the need for people to make and use such as this.

[Popular Front of Judea]

The illegal trade in oxycontin, as everybody knows, spawned drug empires, turf wars, and dramatic TV shows. It was typically cleaner than heroin—at least black tar heroin—since oxy is made in laboratories by Purdue Pharma, and contains fewer corrosive additives than many mystery batches of home-cooked drugs.

Despite oxy's smashing success on both markets—legal and illegal—Purdue responded to pressure in the US and Canada to make the drug more difficult to divert for off-label use with anti-counterfeit packaging, tracking features, and OxyNEO, a new pill design that supposedly makes the drug harder to crush for sniffing or injection.

In Canada, where OxyNEO is completely replacing oxy, doctors and First Nations leaders warned that switch could trigger a public-health crisis. From an article in February of 2012:

An Ontario First Nations leader says a catastrophe is looming with the decision to stop manufacturing the drug OxyContin.
Nishnawbe Aski Nation Chief Stan Beardy says thousands of residents of Ontario reserves are addicted to the drug, which is up to twice as strong as morphine. The organization, which represents 49 First Nation communities in northern Ontario, estimates close to half its members are addicted to OxyContin...
For chronic OxyContin users to stop, they will either have to replace it with something else or go into withdrawal, Juurlink said...
"You respond to an epidemic as if it were an epidemic," [Dr. Claudette Chase] said. "When it was H1N1, there were extra nurses, there were flu clinics all over the north — help."

So what's filling the void? Some say heroin is making a comeback and, more worryingly, doctors are beginning to see signs of krokodil, a cheap injectable opiate recipe from Siberia (made by cooking codeine with gasoline, ammonia, iodine and/or red phosphorus, and more) that got its name from what it does to some users' skin: severe tissue damage, gangrene, and bleeding ulcers, which sometimes require amputations.

Krokodil is turning up in the US and in Canada:

“Addicts, being as creative as they are, didn’t miss a beat,” Tom says. “Within weeks of Oxy being gone there was already stuff online about how to make these chemicals at home.”
... Rhonda Thompson, the StreetWorks co-ordinator at AIDS Niagara, is closely following rumours of the arrival of a “homemade heroin” imported from Russia called Krokodil that can cause brain damage and gangrene. “It’s really the Wild West out there now,” Thompson says. “We’ve never seen it like this.”
For the millionth time: People are going to use drugs—at this point, that's simply irrefutable—and the harder the forces of prohibition work to keep the safer drugs away, the more dangerous the alternatives will become.

It's no different from alcohol prohibition, which turned us from a nation of beer and wine drinkers into a nation of liquor drinkers. During those years, tainted liquor killed an average 1,000 Americans a year. All because some legislators decided booze was too dangerous for public consumption*. Drugs can be dangerous. Prohibition makes them more dangerous.

But you knew that already.


Goodbye Oxy, Hello Krokodil (Or, Yet Another Example of How Prohibition Does More Harm Than Good) | Seattle Stranger (http://slog.thestranger.com/slog/archives/2013/09/26/goodbye-oxy-hello-krokodil-or-yet-another-example-of-how-prohibition-does-more-harm-than-good)

(FYI: "Meth mouth" is caused by reduced saliva flow and poor dental hygiene -- not by adulterants in the drug)

[RedBen]

This is a testament to the power of addiction. Skin falling off? Brain damage? Gasoline it is? Ain't no thing, I need more. Now.

This is why all controlled substances should be decriminalized and regulated. We wouldn't have the need for people to make and use such as this.
this is one of very few circumstances where i say throw the fucking book at the motherfucker. people who make smuggle and deal these kinds of drugs, rapists, murderers and child molesters need to be hung or shot or both. these people profit from the destruction of other people, they are no better than capitalists because they seek to exploit in the worst way for self gain. they all need to be covered in gas, lined up in front of a bus and shot.

[The Garbage Disposal Unit]

they are no better than capitalists because they seek to exploit in the worst way for self gain.

In fact, I would say they are capitalists, plain and simple (or, actually, neither, but you get my drift). Sadly, they're the "low-hanging fruit" - the bottom rung of petit-bourgeois suckers. Rather than "lining them up and shooting them" - since they'd quickly be replaced by the invisible hand - we need to aim higher. If people had access to clean, unadultered opiates on demand (ie regardless of financial barriers), this shit wouldn't happen. And if people had better things to do with their lives probably we'd need very few drugs period.

[blake 3:17]

http://en.wikipedia.org/wiki/Desomorphine

http://www.cbsnews.com/8301-204_162-57604865/ariz-poison-control-center-reports-first-u.s-cases-of-krokodil-use/

Hmmm...

[blake 3:17]

(FYI: "Meth mouth" is caused by reduced saliva flow and poor dental hygiene -- not by adulterants in the drug)

It would be very hard to know what the relationship was between drug & lifestyle. But a lot of home brews can be nasty...

Methderine and Dexedrine are essentially the same drug with Dexedrine being slightly more potent.

[Popular Front of Judea]

I have experience with doctor sanctioned use of amphetamine. A reduced saliva flow and teeth grinding (bruxism) are common side effects. The teeth grinding often kicks in as the drug wears off.

Methedrine -- methamphetamine -- would be more potent by weight due to the potentiating effect of the methyl molecule. Dexedrine -- dextroamphetamine -- is the 'dextro' isomer of amphetamine. Many prefer it due to it's smoother action compared to the levo isomer of amphetamine, benzedrine. Meth, dexies and bennies. That's our chemistry lesson for today kids.

One can only wonder what Marx could have accomplished with a typewriter and ready access to legal amphetamine -- like Alyssa Rosenbaum aka 'Ayn Rand' did.


It would be very hard to know what the relationship was between drug & lifestyle. But a lot of home brews can be nasty...

Methderine and Dexedrine are essentially the same drug with Dexedrine being slightly more potent.

[Os Cangaceiros]

oh no... i seen a documentary on that stuff... i'm afraid for people, not everyone will know what it is. i was very drunk and high on marijuana and someone gave me something to smoke when i was 18. i asked what it was and they kept saying "just smoke it". i did, i found out later it was freebase(essentially crack). i left all drugs alone after that. it was one of the most shameful moments of my life because i remember asking what it was repeatedly with no answer but i smoked it anyway. when signing up for the army i had to refill out some forms because i was honest about prior drug use and my recruiter told me it would disqualify me. this makes me very sad that some young person somewhere is using this shit.

Don't worry bro, we all accidentally smoke some crack every now and then! :lol:

Yeah, and needless to say you should never be honest about your former drug use, unless you're speaking to your doctor, or your lawyer, or your priest. I was half-honest with the authorities when I was ensnared into the system and it was one of the biggest mistakes I've ever made. If I could be given a second chance I'd say big fat lies without hesitating.

[Sam_b]

Kokainum!

Do not post spam one-liners and youtube videos of this nature in serious parts of the forum. This is a verbal warning.

[Sasha]

How does this even occur to people? :unsure:


you know the "weed doesnt lead to harddrugs, it leads to carpentry" sketch by dennis leary? hard drugs follow the same pattern, necessity(/desperation) is the mother of all invention...
people will get high, no matter what, the choice of society is whether they do it to something safe or something dangerous.

[Sasha]

Goodbye Oxy, Hello Krokodil (Or, Yet Another Example of How Prohibition Does More Harm Than Good) | Seattle Stranger (http://slog.thestranger.com/slog/archives/2013/09/26/goodbye-oxy-hello-krokodil-or-yet-another-example-of-how-prohibition-does-more-harm-than-good)

(FYI: "Meth mouth" is caused by reduced saliva flow and poor dental hygiene -- not by adulterants in the drug)

follow up:

"Breaking Worse" and More on Krokodil (http://slog.thestranger.com/slog/archives/2013/09/26/breaking-worse-and-more-on-krokodil)

Posted by Brendan Kiley (http://www.thestranger.com/seattle/brendan-kiley/Author?oid=1124) on Thu, Sep 26, 2013 at 4:16 PM

Earlier today, I posted about the crackdown on oxy (http://slog.thestranger.com/slog/archives/2013/09/26/goodbye-oxy-hello-krokodil-or-yet-another-example-of-how-prohibition-does-more-harm-than-good) in North America, which physicians and community leaders predicted would lead to public health problems—without seriously ramping up readily available drug treatment, you'd have a lot of people in withdrawal desperately looking for a way to cure it, some of them not too concerned about the consequences.
In Canada, where the oxy crackdown has been more severe, black-tar heroin seems to have made a comeback and both Canada and the US are beginning to see signs of krokodil, a dangerous distillation of codeine with gasoline, ammonia, and other substances that causes serious tissue necrosis and gangrene.
Slog commenter venomlash puts it best:
http://www.thestranger.com/binary/b044/1380235323-veonmlash.jpg
This afternoon, a Slog reader forwarded me a 2012 artlce by Dr. Jean-Paul C. Grund (and others) titled "Breaking worse: The emergence of krokodil and excessive injuries among people who inject drugs in Eurasia." (http://download.journals.elsevierhealth.com/pdfs/journals/0955-3959/PIIS0955395913000510.pdf)
Different continent, in some ways different universe, but similar problem: scarcity of cleaner drugs, lack of available drug treatment, social stigma, and a prohibitionist legal and social attitude have cultivated an environment where the drugs keeps getting more dangerous and the harms—for individuals, families, and communities—keep getting more severe.
Dr. Grund warns journalists against hysteria and fear-mongering when it comes to krokodil. So, at the risk of mongering fear, allow me to repeat some of the harms reported in the paper (besides the usual risk of simply dying from overdose or blood poisoning): soft tissue infections to the bone, rotting gums resulting in tooth loss, bone infection, decayed structure of the jaw and other facial bones, neurological damage, speech impediments, veins that ulcer and rot away from the inside, and rotting ears and noses and lips, and more.
So, yes, being addicted to oxy or other opiates is not ideal. But the alternatives can be even worse.

[Red Commissar]

regarding the ingredients

The use of components like gasoline function as a cheap solvent in order to dissolve codeine into a solution for the rest of the procedure. This helps with breaking done the pills codeine is found in, particularly since the capsules tend to be waxy (which would possibly also involve the acidic stuff used in the creation of this drug). The ones that would work as intended with no impurities are more controlled and would be too expensive for the people producing this in large quantities.

Even though these will help with the chemical processes transforming codeine to this potent pain killer, it is not easily washed out and these contaminants remain. It gets enough for the kick and that's really all that matters both for the dealer and the addict. Most of these ingredients are cheap and easily available, which adds to its appeal.

Red Phosphorus is used here too- if you're not familiar with this it's the same stuff that is used to make matchboxes (the red part where you get the spark... I wouldn't be surprised if they got it from here). This is used to help with the process of creating the final product, and ends up compounding with the iodine that is used by the maker. Not only does this help with making that nasty smell apparently, it ends up forming into hyrdoiodtic acid (HI, with remnants from HCl previously), which is corrosive. This process is also used when people make meth, but it doesn't end up in the final product if done correctly since meth is returned back to a solid, where as krokodil is kept in the liquid form. Of course though, shooting yourself up with something this corrosive in addition to the red phosphorous that doesn't completely react is going to do hell on anything it touches.

And if it wasn't already bad enough, as best I can understand from common ingredients they also use Hydrochloric Acid early on to break down the tablet (after all, this is why the pills are swallowed, so they can be affected by the HCl in the stomach). This is a very strong acid and will already compound the crap from hydroiodic acid since it has likely not been completely used up. In sum this liquid ends up being very dangerous to anything it touches.

This isn't an uncommon phenomenon when making drugs, a lot of problems that compound drug addiction tend to come from street chemists creating essentially impure compounds which can really mess people up. Crack was made a lot worse because of this. In the case of krokodil, The impurities can clog up blood vessels as well as cause other forms of damage from some of the other compounds associating with cells and burning into them. Even worse if you happen to just hit skin and not the desired blood vessel I imagine.

Looking up the origins of the drug, it said it started in eastern Siberia. This is a particularly depressed area of Russia, having been hit hard by the transition to market economy and consequently many losing work and industries had originally been the purpose of the towns. Doesn't help either that particular part of Russia is isolated and less populated, probably adds to feelings of depression and alienation. Being as easy as it is to make with the above ingredients, it wouldn't be surprising that people who're already in a crapshoot of a life will see this as a way to escape and spread to other parts of the fallout from the economic upheaval across the former Soviet Union and Eastern Bloc. They had likely started off with heroin or some equivalent, but had to switch to something like this in order to continue getting their fix with their resources in mind.

Coming to the states would make sense seeing how crack blew through in a similar way. I wonder if we'll see this in other countries soon too.

[Trap Queen Voxxy]

To be honest, I understand there have been some alleged cases of krokodil coming to the states but someone mentioning oxies made me a little skeptical. I mean, as anyone whom has fucked around with opiates knows, getting well is an almost hourly struggle which leads to almost inconceivable ways of obtaining the medicine; scams, robbery, getting fronts, etc. Also, in America pharmaceutical opiates and opioids are extremely easy to come by due to states like Florida where all you need is some cash and you can get painers like 500 at a time, multiple scripts and so on. Given this availability of opiates and other usual junkie ways of getting well, it makes me sort of skeptical that krokodil has indeed made it's way to the states and isn't just some isolated incidents. I mean, if I was dope sick as fuck, like no other, I would rather cash some bad checks, badger friends for a rinse, use some resin collected on dollar bills, steal some shit and pawn it or get a dodgy front from a dealer or something along those lines, than shoot krokodil. I mean, yeah, I've shot up ice before and it's somewhat similiar in it's preperation but idk, the whole leprosy aspect of it and not just tooth decay associated with heavy addiction really puts me off. Then again though, everyone is different and heroin is a helluva drug and I happen to know about it and am aware of it's effects, so I guess I could see someone whom is sick and doesn't know about it just doing it to stop the hellish pain of withdraw. Idk, this is weird, more thinking is necessary, buffering.

[Fred]

oh no... i seen a documentary on that stuff... i'm afraid for people, not everyone will know what it is. i was very drunk and high on marijuana and someone gave me something to smoke when i was 18. i asked what it was and they kept saying "just smoke it". i did, i found out later it was freebase(essentially crack). i left all drugs alone after that. it was one of the most shameful moments of my life because i remember asking what it was repeatedly with no answer but i smoked it anyway. when signing up for the army i had to refill out some forms because i was honest about prior drug use and my recruiter told me it would disqualify me. this makes me very sad that some young person somewhere is using this shit.

I guess the only upside is that it kept you out of the military.

[Comrade Jacob]

I have a friend that said he wants to try every drug (even Meth!) so I showed his some pictures of what krokodil does, it smacked some sense into him.

[RedBen]

I guess the only upside is that it kept you out of the military.
no it didn't. as i said, i was told simply to redo the paperwork, i was advised to exclude it.

[Popular Front of Judea]

no it didn't. as i said, i was told simply to redo the paperwork, i was advised to exclude it.

That should tell you all you need to know about such questions.

[Paul Pott]

When I first heard of it, I thought it's only a matter of time until this comes to replace something they successfully crack down on.

[blake 3:17]

This is criminal. Some people will use needles, some people will use opiates, and some people will use needles and opiates together. Not going away. So sick of this far right garbage from my government, especially when there's a pretty good infrastructure in place to do this thing called science, ie based on past knowledge but open to change, good public health policies (realized or not...) and just meeting the needs of folks in need. The Conservatives hate everyone that comes from the AIDS movement.

The hard / soft drugs debate is a weird one. I consider alcohol a hard drug. Anyways...


Health Canada heroin decision draws minister's rebuke

Health Minister Rona Ambrose says her department's decision to provide heroin to certain addicts under a federal program is wrong and won't happen again.

The federal Special Access Program is designed to allow patients in exceptional cases to get medications normally not allowed in Canada.

The decision that drew the minister's ire will allow doctors in B.C. to prescribe heroin to certain chronic addicts.

A news release quotes Ambrose saying: "This decision is in direct opposition to the government's anti-drug policy and violates the spirit and intent of the Special Access Program."

Citing privacy restrictions, the minister and her officials are not identifying the successful applicant approved by Health Canada.

But sources say it is almost certainly an experimental drug treatment program in Vancouver that is testing an unrestricted pain medication as an alternative to heroin.

The drug trial involves 322 addicts, some of whom are being given the experimental drug, while others are getting heroin. The participants are not told which one they are receiving.

A source familiar with the program says its application for special access to heroin has been approved by Health Canada.
The program is run by Providence Health Care, which operates a chain of Catholic hospitals, clinics and other facilities in B.C.

Ambrose is quoted in her news release saying: "I am taking immediate action to ... ensure this does not happen again."

But government officials say the Special Access Program is merely under review, and there is no immediate plan to block future applications of the kind approved for the B.C. drug trials.

http://www.cbc.ca/news/politics/health-canada-heroin-decision-draws-minister-s-rebuke-1.1862601