Krokodil, a flesh-eating drug that first emerged in Russian more than a decade ago, has jumped across the Atlantic, sparking fears of a new killer drug epidemic in the United States. Originally, this drug was known as desomorphine.

The drug’s street name quickly became ‘krokodil’ because it eats the skin tissue from the inside out, causing a scaly effect.

Krokodil’s active ingredient, codeine, is mixed with a brew of toxic substances, including paint thinner, hydrochloric acid and red phosphorus scrapped from the back of matchboxes. The resulting murky yellow liquid mimics the effects of heroin on the body at a fraction of the cost – leading to an addictive and deadly high.

In Europe, a dose of krokodil costs just a few dollars, compared with more than $20 for heroin. Individuals who use krokodil, however, pay dearly for this cheap high. Wherever a user injects the drug, blood vessels will burst and the surrounding tissue die, cause the skin to fall off the bone in chunks.

Because krokodil’s high is as intense as heroin but lasts for a fraction of the time, the drug can quickly become addictive. Without intervention and treatment, an individual who is addicted to krokodil has an estimated lifespan of just two or three years.

From Russia, but not with love.

Krokodil Fact 1

Krokodil abuse is widespread in industrial cities and desolate regions of Russia, including Siberia and the Ural Mountains, where individuals turn to the drug to escape crushing poverty. At the peak of Russia’s krokodil epidemic, Russian authorities estimated that more than one million Russian citizens were addicted to the drug.

In the first three months of 2011, the country’s counternarcotics agency confiscated 65 million doses of the drug – a 23-fold increase from just two years earlier. While a 2012 Russian ban on codeine sales has helped to stop the rise in krokodil abuse within Russia, the deadly drug is now spreading through Europe and hopping the pond to America.

Individuals who abuse krokodile are at risk not only for serious health complications from the drug itself, but also for other problems resulting from using shared or dirty needles. This includes the transmission of blood borne illnesses, such as HIV and Hepatitis C, as well as other bacterial infections. For a body already weakened by krokodil abuse, these infections can be difficult for the body to fight off, and may even lead to death.

Krokodil in America: A New Killer Drug?

Krokodil became a popular drug in Russia thanks in part to the easy accessibility of codeine. Since codeine cannot be purchased over the counter in the United States, some drug enforcement officials doubt that krokodil will gain the widespread following that it enjoyed in Russia.
“Krokodil use in Russia is likely related to the availability of non-prescription codeine in conjunction with the relative inaccessibility and cost of heroin and alternative opioids in that country,” said Dr. Michael Lynch, medical director of the Pittsburgh Poison Center.

And while the Drug Enforcement Agency (DEA) has only two reported cases of krokodil use since 2004, the drug is still making inroads on this side of the Atlantic. In November, local law enforcement officials in Marion, Ohio reported finding krokodil from a heroin dealer. In October, the American Journal of Medicine also confirmed a case of a 30-year old Missouri man whose finger “fell off” after his skin rotted away from krokodil injections. Krokodil has arrived.