It’s official: Krokodil has reached the United States, and doctors say it’s posing a real threat.
The extremely addictive, injectable opioid is made by mixing codeine with some combination of gasoline, paint thinner, iodine, kitchen and bathroom cleaner, hydrochloric acid and red phosphorous from matches.
Use of the synthetic heroin is widespread in Russia and Ukraine, where opiates are less readily available than in the U.S., and is cooked up in homemade labs like methamphetamine.
There have been scattered reports of the flesh-eating drug across the U.S. for at least a year, although many physicians doubt whether the patients had actually used krokodil.
But two physicians from Missouri reported to the American Journal of Medicine that they treated a patient last year whose skin was rotted away from using krokodil, marking the first official confirmation of the drug’s arrival in the U.S.
Doctors Dany Thekkemuriyil and Unnikrishnan Pillai said they treated a 30-year-old user in December in the emergency room of SSM St. Mary’s Health Center in Richmond Heights, Missouri, who said he had been using the drug for eight months before seeking treatment.
The doctors reported that skin on the patient’s thighs was rotting away and had lost a finger as a result of injecting the drug.
“We saw that his finger fell off and we saw a severe looking ulcer and sores on his thigh and it did really fit the picture of krokodil,” Thekkemuriyi said. “Our case is the first case that’s been published in a recognized medical journal.”
Krokodil, or desomorphine, causes serious tissue damage to the veins and infections that turn soft tissue gangrous and necrotic, particularly near the injection site, and the drug tends to clump in the veins as it fails to completely dissolve in the blood.
Those clumps travel to other parts of the body and damage tissue.
“The damage was more severe compared to a regular IV drug user,” Pillai said. “We want to keep it from spreading across our community. It eats people from the inside, it kills people from the inside literally.”
Officials with the Drug Enforcement Agency have expressed skepticism about the drug’s widespread use and are hoping to find samples of the drug before confirming its use.
Emergency rooms in Arizona, Illinois, Ohio and Oklahoma have reported treating patients whose symptoms match those described in the medical journal, and it’s also being reported in Canada.
In Russia, where an estimated 100,000 people used the intravenous drug in 2011, authorities say krokodil users tend to be young people with short histories of drug use, and they usually seek medical help only after they reach later stages of their addiction and suffer severe mutilations such as decayed facial bones or rotting ears, noses and lips.
The drug also causes bone infections and liver and kidney problems.
“It’s a zombie drug — it literally kills you from the inside out,” said Dr. Abhin Singla, who suspects he treated a krokodil addict last month in Joliet, Illinois. “If you want way to die, this is a way to die.”
Users typically binge on the drug over several days, exhibiting irrational behavior, sleep depravation, memory loss and sleep problems.
Krokodil is less expensive than comparable drugs but more likely to cause withdrawal symptoms, doctors say, but it’s not clear that users are seeking it out over other drugs.
Five suspected krokodil patients in the Chicago area told doctors they thought they were buying heroin.
Watch this video report posted online by KTVI-TV: