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

Share
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

Recruitment Genius: Web Team Leader

£30000 - £35000 per annum: Recruitment Genius: One of the UK's leading web des...

Recruitment Genius: Client Manager

£27000 - £35000 per annum: Recruitment Genius: A growing, successful, friendly...

Recruitment Genius: Property Negotiator - OTE £20,000+

£16000 - £25000 per annum: Recruitment Genius: This family owned, independent ...

Recruitment Genius: Sales Administrator - Spanish Speaking

£17000 - £21000 per annum: Recruitment Genius: This is a fantastic opportunity...

Day In a Page

Read Next
Separate lives: Boston’s streets illustrate the divide between the town’s communities  

Migrants have far more to offer than hard work and wealth creation, yet too many exist in isolation from the rest of society

Emily Dugan
Harper Lee's To Kill a Mockingbird has sold 40 million copies  

Go Set a Watchman: Harper Lee’s new novel is more than just a literary event

Joseph Charlton
The Greek referendum exposes a gaping hole at the heart of the European Union – its distinct lack of any genuine popular legitimacy

Gaping hole at the heart of the European Union

Treatment of Greece has shown up a lack of genuine legitimacy
Number of young homeless in Britain 'more than three times the official figures'

'Everything changed when I went to the hostel'

Number of young homeless people in Britain is 'more than three times the official figures'
Compton Cricket Club

Compton Cricket Club

Portraits of LA cricketers from notorious suburb to be displayed in London
London now the global money-laundering centre for the drug trade, says crime expert

Wlecome to London, drug money-laundering centre for the world

'Mexico is its heart and London is its head'
The Buddhist temple minutes from Centre Court that helps a winner keep on winning

The Buddhist temple minutes from Centre Court

It helps a winner keep on winning
Is this the future of flying: battery-powered planes made of plastic, and without flight decks?

Is this the future of flying?

Battery-powered planes made of plastic, and without flight decks
Isis are barbarians – but the Caliphate is a dream at the heart of all Muslim traditions

Isis are barbarians

but the Caliphate is an ancient Muslim ideal
The Brink's-Mat curse strikes again: three tons of stolen gold that brought only grief

Curse of Brink's Mat strikes again

Death of John 'Goldfinger' Palmer the latest killing related to 1983 heist
Greece debt crisis: 'The ministers talk to us about miracles' – why Greeks are cynical ahead of the bailout referendum

'The ministers talk to us about miracles'

Why Greeks are cynical ahead of the bailout referendum
Call of the wild: How science is learning to decode the way animals communicate

Call of the wild

How science is learning to decode the way animals communicate
Greece debt crisis: What happened to democracy when it’s a case of 'Vote Yes or else'?

'The economic collapse has happened. What is at risk now is democracy...'

If it doesn’t work in Europe, how is it supposed to work in India or the Middle East, asks Robert Fisk
The science of swearing: What lies behind the use of four-letter words?

The science of swearing

What lies behind the use of four-letter words?
The Real Stories of Migrant Britain: Clive fled from Zimbabwe - now it won't have him back

The Real Stories of Migrant Britain

Clive fled from Zimbabwe - now it won’t have him back
Africa on the menu: Three foodie friends want to popularise dishes from the continent

Africa on the menu

Three foodie friends want to popularise dishes from the hot new continent
Donna Karan is stepping down after 30 years - so who will fill the DKNY creator's boots?

Who will fill Donna Karan's boots?

The designer is stepping down as Chief Designer of DKNY after 30 years. Alexander Fury looks back at the career of 'America's Chanel'