Krokodil: The heroin substitute is a real threat. We must warn of the potentially devastating effects

I have only seen one patient where I suspected he’d used Krokodil. But the potential for this drug to worsen the lives of homeless drug users is all too real

Related Topics

Krokodil, the cheap heroin substitute, is believed to have made the switch to the US after a number of cases were reported in Arizona.

The drug captured press headlines a few years ago following reports of the devastating effect on body tissues from use by intravenous drug users. Russia was thought to have more heroin users than any other country in the world, and a steady rise was reported in users switching to Krokodil.

Krokodil (Desomorphine) was first developed as a painkiller in The United States in the 1930’s. It is ten times stronger than the Morphine currently used in medical practice and has a quicker onset of action and more sedative effects. 

The drug causes death of muscle and soft tissues at the site of injection and can lead to marked shortening of life expectancy in users of the drug - some argue once people become full-time Krokodil addicts, they have a life expectancy of less than a year.

Its name (the Russian for Crocodile) is thought to have come from the green scaly colour the affected body tissue becomes, before it is lost completely from the effects of gangrene; the name may also have its roots from one of the substances in the chain of it being made, called Clorocodide.

Sadly this drug is all too easy to make, from readily available substances – including the painkiller Codeine, petrol, and bleach.  When made by users, it is then quickly injected as soon as it is made, unleashing highly toxic substances into the bloodstream and tissues. It is often mixed with other medicines which supposedly enhance its effects.

Its ease of manufacture will be particularly pertinent given the recent problems of heroin being found to be contaminated with anthrax, or Clostridium, the organism that causes tetanus.  Also the availability of heroin had recently been diminished.  At the present time in Gloucester, a quarter gram of street heroin costs £10; elsewhere in the country the price is around £20 per quarter gram. 

To date I have only seen one patient where I suspected he’d used Krokodil.  He was a homeless patient, in his late thirties.  He had been a long-term heroin user, but suddenly lost a great deal of muscle tissue from gangrene at the site of an injection.  He was very wary of other users and so would not attend the clinic here; I would therefore go and redress his wound on the streets, usually carrying medical supplies and equipment in supermarket carrier bags, so as not to attract unwanted attention. 

Eventually with the brilliant help of members of the homeless charity GEAR and the nursing staff at the Homeless Clinic, he was transferred to a plastic surgery unit for debridement of the wound (removal of the dead tissue) and skin grafting which was successful.  Sadly he died earlier this year.

The potential of Krokodil for worsening the already profound misery of homeless drug users is all too real, and we remain vigilant in warning our clients about the potentially devastating effects of this drug.

Dr Allan Harris has been a doctor for 22 years, and has worked as a GP for the homeless in Gloucester for the past 15 years. 

React Now

Latest stories from i100
Have you tried new the Independent Digital Edition apps?
iJobs Job Widget
iJobs General

BI Manager - £50,000

£49000 - £55000 per annum + competitive: Progressive Recruitment: My client is...

BI Project Manager - £48,000 - £54,000 - Midlands

£48000 - £54000 per annum + Benefits package: Progressive Recruitment: My clie...

VB.Net Developer

£35000 - £45000 per annum + competitive: Progressive Recruitment: If you're pa...

SAP Business Consultant (SD, MM and FICO), £55,000, Wakefield

£45000 - £55000 per annum + competitive: Progressive Recruitment: SAP Business...

Day In a Page

Read Next

The law is too hard on sexting teenagers

Memphis Barker

Obama must speak out – Americans are worried no one is listening to them

David Usborne
Screwing your way to the top? Good for Lana Del Rey for helping kill that myth

Screwing your way to the top?

Good for Lana Del Rey for helping kill that myth, says Grace Dent
Will the young Britons fighting in Syria be allowed to return home and resume their lives?

Will Britons fighting in Syria be able to resume their lives?

Tony Blair's Terrorism Act 2006 has made it an offence to take part in military action abroad with a "political, ideological, religious or racial motive"
Climate change threatens to make the antarctic fur seal extinct

Take a good look while you can

How climate change could wipe out this seal
Man Booker Prize 2014 longlist: Crowdfunded novel nominated for first time

Crowdfunded novel nominated for Booker Prize

Paul Kingsnorth's 'The Wake' is in contention for the prestigious award
Tour de France effect brings Hollywood blockbusters to Yorkshire

Tour de France effect brings Hollywood blockbusters to Yorkshire

A $25m thriller starring Sam Worthington to be made in God's Own Country
Noel Fielding's 'Luxury Comedy': A land of the outright bizarre

Noel Fielding's 'Luxury Comedy'

A land of the outright bizarre
What are the worst 'Word Crimes'?

What are the worst 'Word Crimes'?

‘Weird Al’ Yankovic's latest video is an ode to good grammar. But what do The Independent’s experts think he’s missed out?
Can Secret Cinema sell 80,000 'Back to the Future' tickets?

The worst kept secret in cinema

A cult movie event aims to immerse audiences of 80,000 in ‘Back to the Future’. But has it lost its magic?
Facebook: The new hatched, matched and dispatched

The new hatched, matched and dispatched

Family events used to be marked in the personal columns. But now Facebook has usurped the ‘Births, Deaths and Marriages’ announcements
Why do we have blood types?

Are you my type?

All of us have one but probably never wondered why. Yet even now, a century after blood types were discovered, it’s a matter of debate what they’re for
Honesty box hotels: You decide how much you pay

Honesty box hotels

Five hotels in Paris now allow guests to pay only what they think their stay was worth. It seems fraught with financial risk, but the honesty policy has its benefit
Commonwealth Games 2014: Why weight of pressure rests easy on Michael Jamieson’s shoulders

Michael Jamieson: Why weight of pressure rests easy on his shoulders

The Scottish swimmer is ready for ‘the biggest race of my life’ at the Commonwealth Games
Some are reformed drug addicts. Some are single mums. All are on benefits. But now these so-called 'scroungers’ are fighting back

The 'scroungers’ fight back

The welfare claimants battling to alter stereotypes
Amazing video shows Nasa 'flame extinguishment experiment' in action

Fireballs in space

Amazing video shows Nasa's 'flame extinguishment experiment' in action
A Bible for billionaires

A Bible for billionaires

Find out why America's richest men are reading John Brookes