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Krokodil, sometimes described as a cheap version of heroin, is spreading around the world. Here is what you need to know about the flesh-eating "zombie drug" that eats you from the inside out.

Imagine a drug you have to cook on the stove for half an hour and then shoot into a vein to get a high that lasts for 90 minutes. That's about seven hours less than the high one gets from shooting heroin.

Then having withdrawal symptoms from the drug just 30 minutes later, along with your skin turning black or green and leathery and peeling off. Your fingertips breaking off. Your toes rotting. Veins turning black and arms being amputated. There aren't many addicts to this drug because they don't live very long.

This is the drug known as krokodil (pronounced either crocodile or krok-o-DEEL), named after the effect it has on human skin, and, coincidentally, a weekly magazine of political cartoons and bad jokes published by the Communist party in the old Soviet Union. 

It's a homemade version of a particularly potent version of morphine called desomorphine that has been around for over 80 years, made deadly by the chemicals used to cook it.

What Exactly Is Krokodil?

Krokodil is codeine on steroids. Codeine-containing cough syrup is mixed with chemicals (we are not going to tell you which) on the stove to turn it into a particularly fast-acting analog of morphine, the painkiller you might get in an IV drip in the hospital called desomorphine, or, more accurately, dihydrodesoxymorphine. Under laboratory conditions with a purification process, the end product of these chemical reactions is used to make the highly regulated prescription drug Permonid.

But when people cook cough syrup on the stove, they don't do a purification process. Since one of the ingredients in the mix is a substance called red phosphorus, which catches on fire at room temperature if you don't pour it out of its vial into the mix just so, gee, maybe people would think there is something potentially dangerous about making this drug at home. But there is only a short list of ingredients and a relatively simple chemical process to make a crude, unrefined, toxic, and deadly form of the drug that can be shot into a vein.

Where Did Krokodil Come From?

It appears that the recipe for krokodil originated at a military base in Siberia about 10 years ago. There are about 100,000 users in Russia and 20,000 in Ukraine. Use of the drug has spread through Russian-speaking communities elsewhere in Europe, and to Poland. 

There was one known use of the drug in Phoenix, Arizona in September 2013 and a number of hospitalizations of users of the drug in Joliet, Illinois in October 2013.
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  • Gahr M, Freudenmann RW, Hiemke C, Gunst IM, Connemann BJ, Schönfeldt-Lecuona C. .Desomorphine goes "crocodile." J Addict Dis. 2012. 31(4):407-12. doi 10.1080/10550887.2012.735570. Review. Erratum in J Addict Dis. 2013
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  • Grund JP, Latypov A, Harris M. Breaking worse the emergence of krokodil and excessive injuries among people who inject drugs in Eurasia. Int J Drug Policy. 2013 Jul. 24(4):265-74. doi 10.1016/j.drugpo.2013.04.007. Epub 2013 May 31
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