A "krokodil" emerges from the murky waters of addiction. Abuse trends of an old drug

Life Sci. 2014 May 2;102(2):81-7. doi: 10.1016/j.lfs.2014.03.008. Epub 2014 Mar 17.

Abstract

"Krokodil" is the street name for the semi-synthetic opioid derivative desomorphine. Although an old drug, it re-staged on "drug arena" during the last decade causing detrimental effects to its users. Despite the fact that Russia and other former Soviet Republics were the initial plagued countries, "krokodil" arrived in Europe and United States lately, as a substitute of the relative expensive, and in many cases unavailable, heroin. It can be easily manufactured in home-environment from codeine and causes significant health problems, even deaths worldwide. The aim of this review is to summarize the current knowledge about this drug, concerning its chemistry, synthesis, pharmacology and toxicology. Published or reported "krokodil" related cases, fatalities or intoxications, as well as self reports from drug users are reviewed. The existing analytical methodologies for the determination of desomorphine in biological samples as well as its legal status are also presented.

Keywords: Crocodile; Desomorphine; Flesh-eating drug; Krokodil; Legislation.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / chemical synthesis
  • Analgesics, Opioid / chemistry
  • Humans
  • Illicit Drugs / adverse effects
  • Illicit Drugs / chemical synthesis
  • Illicit Drugs / chemistry*
  • Morphine Derivatives / adverse effects
  • Morphine Derivatives / chemical synthesis
  • Morphine Derivatives / chemistry*
  • Opioid-Related Disorders / diagnosis*
  • Opioid-Related Disorders / epidemiology*
  • Opioid-Related Disorders / mortality
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / mortality

Substances

  • Analgesics, Opioid
  • Illicit Drugs
  • Morphine Derivatives