Krokodil, a “flesh-eating” narcotic from Russia, may finally be in America

Krokodil is a narcotic made from codeine that has gained popularity in Russia over the past several years.  Krokodil is named after the Russian word for crocodile, because of what it does to your skin before your skin rots and falls off entirely. Nonetheless, Krokodil is a popular drug, and may have finally come to American shores.

Krokodil is the name for “desomorphine,” a drug that was developed over fifty years ago. It’s reported to be about eight times more powerful than morphine, and two to three times more powerful than heroin. Estimates are that about 1,000,000 people in Russia have, or are, using it. Many may be using it on a regular basis.

Understandably, Russia is not very forthcoming about krokodil and its users. Some sources estimate that between three million to six million Russians use drugs on a fairly regular basis, with heroin and methamphetamine being the two most commonly used. Krokodil is fairly simple to make from codeine, which is easy to get in Russia and requires no prescription there. Reportedly Russian criminal elements are making it and selling it. It appears to be easier to obtain than heroin and, since it’s more potent, it’s sought after.

Krokodil users develop scaly, leathery skin at the injection point

Krokodil users develop scaly skin lesions and leather-like skin in the areas where the drug has been injected. The name “krokodil” is Russian for “crocodile,” presumably so named that because of the skin changes that are produced after it’s been used. Sometimes, these areas become large enough that they can deteriorate and lead to serious infections, like gangrene. The user’s limb(s) may then need to be amputated. Krokdil itself doesn’t produce these lesions. The chemicals used in the production of krokodil from codeine are the culprits. Red phosphorus, gasoline, iodine, paint thinner and lighter fluid are among the toxic compounds used in the synthetic process that results in desomorphine. What’s left of these chemicals is the cause the skin damage.

You can google images of krokodil-induced skin lesions for yourself.  They’re rather horrific.

Life expectancy on Krokodil is two to three years

Estimates are that regular krokodil users die about two to three years after first starting to inject the drug.

They continue to use krokodil (or heroin) because they may like the effects but also, to keep from going through withdrawal. Narcotic withdrawals are at best, unpleasant. Shaking, sweating, restlessness, anxiety, nausea, vomiting and other symptoms can last for some time after the addict begins to withdraw. And even when the acute withdrawal symptoms are gone, there are some residual symptoms that are still difficult to deal with: depression, sleeplessness and others. Helping the addict get through this process as painlessly as possible, is the goal of most drug rehabilitation sites. But some countries don’t do anything to help the addict get through withdrawal. Russia is one of those.

Russians try to “cure” Krokodil use by punishing users with forced, unaided, withdrawal

The Russian philosophy seems to be to make the withdrawal as miserable as possible so that the addict will remember the experience and never use again. In many other countries, other medications are substituted to help relieve symptoms. While they don’t make detoxification pleasant, they can make it less nightmarish.

In Russian “rehabilitation” centers, the detoxing addicts are sometimes handcuffed to beds and allowed to remain there as they withdraw. Minimal medical supervision and no other medications are used. After the worst of the detoxification is over, the addicts are then lectured about how they are useless degenerates with no self-control and are burdens on their friends and family. After a variable period of time, the “rehabilitation” center releases the addict and he is pretty much left on his own.

There are some Narcotics Anonymous groups in Russia. The addict who wants to stay clean may be able to find and use them. In other countries, in addition to Narcotics Anonymous and out patient therapy groups, there are options of using other drugs to stay off of heroin and krokodil – like methadone. Some addicts choose to use methadone or other prescription drugs given under medical supervision. But not in Russia. There, these pharmacologic options are not permitted. It is difficult enough for users to stay clean even when they have social supports, psychological counseling, Narcotics Anonymous and prescribed medications to help. In Russia, where those are limited or unavailable, chances of staying off of krokodil are remote.

Krokodil appears to have finally arrived in America

Until very recently, krokodil seemed limited to Russia and its environs. Then there were sporadic reports of it showing up in other areas of Europe. A few cases were reported in Germany and other countries. This past summer the first reported cases of krokodil in the US were reported.

Arizona has had at least two cases and there have been one or two cases reported in a few other states, as well. A few from Illinois, and possibly some from Montana and Colorado. The Drug Enforcement Agency is aware of these cases and is monitoring the situation.  (There was a Chicago Tribune article yesterday casting doubts on the Joliet case, but time will tell.)

Since some health care professionals may be unaware that krokodil even exists, much less is already showing its teeth in the US, there may be more users who just haven’t been diagnosed. Drug addicts usually only get medical attention when they’ve overdosed or have a major medical problem. Krokodil being less expensive than heroin would make it more attractive to users as well. So there may be more people using it in the US who just haven’t surfaced for medical care as yet.

Here’s a CNN broadcast about Krokodil from just a few weeks ago.  Again, very gruesome stuff.

Mark Thoma, MD, is a physician who did his residency in internal medicine. Mark has a long history of social activism, and was an early technogeek, and science junkie, after evolving through his nerd phase. Favorite quote: “The most exciting phrase to hear in science... is not 'Eureka!' (I found it!) but 'That's funny.'” - Isaac Asimov

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34 Responses to “Krokodil, a “flesh-eating” narcotic from Russia, may finally be in America”

  1. Raul Duke says:

    Nobody would intentionally use this here I don’t think but A) would definatly be used as a “cut” for heroin. and B) like he said people addicted to heroin who couldn’t afford it anymore could easily go to Krokodil… If you have ever seen heroin withdrawls, the user will go for any kind of temporary relief. Even with long term results.

  2. Guy says:

    LMAO. So stupid, codeine is available in every pharmacy………Make sure you know what you’re talking about before people read it and believe it……..No doubt about it….it’s here

  3. Drug and Alcohol Rehabilitatio says:

    Nice article about Krokodil.

  4. Mike_in_the_Tundra says:

    That may explain you spelling.

  5. christ says:

    Lmao. Soooo stupid codeine is in every pharmacy. ……make sure you know what ur talking about beforw people read it and beleave it………no dought about it….its here

  6. Tert says:

    Ok this is just pure sensationalism. There is no way that Kokrodil (pretty much a homemade desomorphine) will hit the USA. The precursor needed to make desomorphine is plain codeine which is sold over the counter in rusia(in oral form). In the USA there is no codeine in the pharmacies! period.

    The problem is that addicts in russia get desperate when heroin doesnt arrive in their remote snowy towns. So quoting this form wiki “The drug is easily made from codeine, iodine and red phosphorus, in a process similar to the manufacture of methamphetaminefrom pseudoephedrine. Like methamphetamine, desomorphine made this way is often highly impure and is contaminated with various toxic and corrosive byproducts” So essentially pure desomoprhine will never cause this horrible side effects on users. This just happens in Rusia as i said for addicts that are just too bored with their lives .

    And why will anyone traffic desommorphine when heroin is all over the place? is stronger and way cheaper here in the USA.

  7. linda says:

    i am a recovering addict and i pray that nobody dies from this…it is scary seeing the video OMG who wants to put that in there body no way and thank god for the rooms and support groups people get help don”t kill yourselfs you are all worthy and loved

  8. pericles9 says:

    Doesn’t this sound like a Halloween prank? Scroll through the pics and you’ll find one of (S)miley Cyrus!

  9. BillFromPA says:

    This article emphasizes ‘Flesh Eating’ as if that’s a bad thing.

  10. LanceThruster says:

    Looks like I picked a good time to start sniffing glue.

  11. LanceThruster says:


    Why should proven weight-loss formulas only be available in Eurasia?

  12. fletcher says:

    Damn! In Chicago’s Belmont-Craigin neighborhood there is a nightclub named Krokodil. I’m never going there!

  13. olandp says:

    “The chemicals used in the production of krokodil from codeine are the culprits. Red phosphorus, gasoline, iodine, paint thinner and lighter fluid are among the toxic compounds used in the synthetic process that results in desomorphine.”

    Sounds great, where do I get some? (Ok, that was snark.) It is amazing what some people will do, start this drug, it feels good for the first time, but you’ll be dead in two to three years. I had a very dear friend who died from Oxycontin addiction, if she was alive now she would probably try this. The last couple of years she was a different person and we all just watched as she slowly killed herself, no matter what we did it didn’t help.

  14. Indigo says:

    I scarcely know what to think. The photos are disgusting but probably typical of medical scare tactics, a recognizable tactic so horrendous that it inadvertently defuses people’s concern because it looks too much like just another atrocity photo on the evening news. Gasoline and lighter fluid as solvents for the mix sounds strangely foolish. If a compound develops that catches on in the States, it’s likely to be refined a little more cautiously. But perhaps I overestimate the sensible precautions an eager addict is likely to take. Creepy! These drug alerts are interesting but don’t usually apply to my lifestyle. A 5k bike ride and I’m ready for a nap.

  15. goulo says:

    Indeed! I’d rather have a bottle of Eluveitie in front of me than a Krokodil lobotomy… or something like that.

  16. Bill_Perdue says:

    A relatively speedy, if more horrific road to death than heroin, booze, cigarettes and crack.

    Which nation will be the first to weaponize krokodil.

  17. The_Fixer says:

    Well, for the same reason people try heroin – they’re looking for a thrill, or relief from a bad life situation. They naively think that they won’t get addicted, or that they won’t have problems like other people have.

    Some of them buy this Krokadil thinking it is heroin. As someone said above, injecting it does not cause immediate damage. Any drug that powerful is also very addictive.

    Addicts at some point lose all hope, and some actually wish for death. If they’ve been at it for a while, they are tortured by various physical maladies, side effects of the abuse. They shoot up hoping that this will be the one dose that finally does them in. The high from the drug masks the hopelessness only for a short time. Then they’re miserable again when the dose wears off, and want to die. Self respect is not present in a lot of these people; They are hitting bottom and know it.

    The mindset of someone who is addicted to very hard drugs like that is so far from normal that most reasonably well-adjusted people can’t fathom it. I speak from the experience of having a good friend who was addicted to heroin, and having another who worked in a drug treatment program as part of his education.

    Looking at it from a sane viewpoint means that you’ll never quite understand it. Because it is insanity.

  18. Cletus says:

    I think it’s a misnomer to describe it as “flesh eating”, like necrotizing fasciitis caused by staphylococcus aureus. This is necrosis caused by the toxicity of the mix. Just saying…

  19. stopthebags says:

    First signs krok showed up 3 weeks ago in Joliet, IL. The 2 girls said that they have been using it for around a yr. The flesh eating takes time to manifest, so there may be many more of these stories as more users experience long term use. This can be made with OTC substances that are easily available. Problem is that the cooks do not get the impurities out, and by the time sores show up, you are hooked.

  20. karmanot says:

    Yet another gift from the assh**e of Western nations.

  21. mirror says:

    There was a scare related to cocaine reported more widely 3 or 4 years ago, at least here in Seattle. A cutting agent that had sometimes serious necrotizing effects. Evidently it is still enough of a problem to generate concern in Canada today. Hard to get the warning out to people who are out of touch with information media, even if they could stop themselves from taking the risk.

  22. DrDrey says:

    A lot of meth in US comes from cartel-run superlabs in Mexico, not from Americans cooking it in their garage.

  23. docsterx says:

    A note on the pictures. Those are from a Google search and may not be actual pictures of krokodil users’ lesions. I’m almost positive that some aren’t. Some are tabloid photos that could be inaccurate. Also, some are of sites where krokodil was supposedly injected, yet some photos show areas where IV drug users almost NEVER inject.

    Medical photos are almost always of excellent quality and almost always have a ruler in place in the frame so that the size of the lesions can be determined. None of these meets those criteria.

    As I said in the article, Russia is not forthcoming about real data on krokodil. I haven’t seen any pictures from Russia or the Ukraine that are from reputable medical sources.

  24. Cletus says:

    Do not, whatever you do, Google images for it…

  25. BeccaM says:

    It’s real. I thought about writing a post a few weeks ago when I was doing all kinds of research on news in Russia and kept running across the articles about it.

    I only relented because my stomach couldn’t handle it.

  26. Naja pallida says:

    Methaqualone (Quaaludes) is one of the few success stories from the War on Drugs. It was widely produced in the 60s and 70s, and into the 80s, until they heavily regulated the constituent chemicals, and made it not economical to produce.

    To be honest, I’m amazed meth is still so readily available. I bought a box of Sudafed a couple of days ago and almost got more scrutiny than I did when I applied for my security clearance at JPL. Seems to me that its prevalence is because there’s too much money to be made to care.

  27. perljammer says:

    Boy, I don’t know. Any injected drug can result in abscesses and sores, along with the usual risk of hepatitis and/or HIV. And then there are the structural brain changes and interesting dental issues that come with meth addiction. But decaying flesh, and death within a year or two? I think we’ve scaled new heights. Or plumbed new depths.

  28. SkippyFlipjack says:

    Are these krokodil stories a response to a real growing threat, or an excuse to post cringe-inducing nasty photos of nightmare skin conditions?

  29. BeccaM says:

    The one small upside as far as the spread of Krokodil here in the U.S.: Codeine can’t be obtained legally without a prescription, actually making it more problematic to manufacture than meth.

    For those who are the least bit squeamish, I really, truly urge you not to look at the photos of the damage caused by Krok use. They’re that horrific. I come from a family of game hunters — from squirrels and rabbits up to deer — and have seen my share of gore. I’ve been up to my shoulders in it, but I’ve never seen anything like this.

    The Krokodil damage photos literally make me want to throw up.

  30. BeccaM says:

    (1) Apparently the high is just about equivalent to heroin.

    (2) It can be made cheaply with easy-to-obtain chemicals and over-the-counter medicine.

    One of the reasons meth became so popular in the U.S. was for similar reasons — a heck of a high for users, plus it could be made from chemicals and a medicine anybody could buy at a pharmacy. By time the Feds and states got around to making it hard to by pseudoephedrine cold medicines, the damage was already done — hundreds of thousands already hooked.

  31. Houndentenor says:

    Exactly. WHY?

  32. Naja pallida says:

    I’m not sure this is really much worse than the effects of long-term use of meth, cocaine or heroin. The physical deterioration can be dramatic in all cases, but it doesn’t seem to stop people from using them.

  33. HeartlandLiberal says:

    I can do with out the drugs and rotting flesh, but I am grateful to keirmeister for pointing to

    ELUVEITIE. Never heard of them, and they appear to be worth hearing.,

  34. keirmeister says:

    OK, today I was introduced to two new strange things: A Swiss band, known as Eluveitie, that fuses Celtic and Death Metal; and now a Russian drug that rots your skin off. The former is pretty interesting (especially if you like that sort of thing). But flesh rotting narcotics?

    I mean, like, WHY would one even play with such a thing? Isn’t there a threshold where the high ain’t worth it?

    I looked at the pictures (’cause I’m gross). EXPOSED bone and flesh?!? WTF?!?

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