Public Health New Mexico
1:24 pm
Thu January 9, 2014

A Krokodil Ripped My Flesh

According to WOAI, the Drug Enforcement Agency has “experienced the first case of a Texan being treated for using a new type of drug which leaves the user with flesh lesions and turns the skin a scaly green color.”

The drug, known as Krokodil, has made headlines in the United States for months, but has only shown up in a few isolated incidents, like the one in Texas.

The 17 year old girl from Houston checked into a hospital in the Mexican state of Jalisco, where she had gone to visit relatives over the holidays.  She was complaining of digestive problems, and doctors notices the fresh skin lesions and diagnosed the drug use.

So far, the drug is also reported to have been found in Arizona, Illinois, Ohio and Oklahoma but that hasn’t stopped people from worrying.

“We’re really worried right now about the whole Krokodil phenomenon,” said Martin Walker, a harm reduction outreach coordinator for Albuquerque Healthcare for the Homeless. “This whole new, dirt cheap form of heroin that’s mixed with gasoline and stuff, that we’re really, really worried about what’s going to happen when that hits.”

Krokodil’s primary active ingredient is desomorphine, “Which is in the opioid family, and you break that down and you mix it with things like gasoline or some other kind of solvent and then injecting it,” said Eduardo Chavez, an agent with the Drug Enforcement Agency in Albuquerque. “We have seen these isolated events, I think it’s already in 11 states in the country that have seen isolated cases of this Krokodil, we are definitely hoping that stays isolated.”

Most news stories have focused on the drug's ability to essentially rot skin, like a rather descriptive story from CNN:

A flesh-eating drug that turns people into zombie-like creatures seems to have made its way to the United States.

But what many news outlets haven’t looked at is how the drug can actually make it in the U.S. marketplace. From Stratfor Global Intelligence:

Ultimately, market conditions in the United States will likely prevent Krokodil from endangering public health on the same scale as cocaine, methamphetamine, heroin or the nonmedical use of prescription drugs.

According to Stratfor, in Russia, where the drug originates, Krokodil was a cheap alternative to heroin.

According to a 2012 report in the International Journal of Drug Policy, 120 rubles ($3.62) worth of over-the-counter codeine yields enough desomorphine to substitute 500 rubles worth of heroin in Russia, meaning heroin addicts could feed their habit for approximately a quarter of the cost.

Codeine is no longer obtained over the counter in Russia, but the drug can still be inexpensive to produce and cheap to buy. However, in the Southwest where substance abuse is high and drugs are cheap, heroin is still king and will likely stay that way. The reason? Pure, drug market economics.

“Krokodil is attractive primarily to those already addicted to opioids with limited available options, whether due to cost or supply issues, to appease their intense addictions,” reports Stratfor. “While Krokodil may be the poor man's heroin in Russia, black tar heroin already fills that role in the United States thanks to Mexican cartels, which would be the likely large-scale suppliers to the United States were there a market for Krokodil.”

At last check, a shot of heroin on the streets of Albuquerque only ran about $20 and doesn’t rot your limbs off. Something some addicts might actually be keeping in mind.

“We’ve had a lot of clients that have seen stories on the news, that have heard things about it, that are coming to us asking questions about it,” said Walker of Healthcare for the Homeless. “But we haven’t had a report of anybody that’s actually using it yet.”

“The only positive aspect within the negative context of drug use here in Albuquerque is the fact that because heroin is still readily available, I can’t see [Krokodil] making a foothold,” said Chavez. “We’re really staying in touch with our state and local counterparts. We’re constantly monitoring the situation.”

To see graphic photos of drug users affected by Krokodil, Fox News has a slideshow.