Krokodil Comes to the US

[Broomstick]

Apparently, there have been several cases of people using krokodil in the US this year. Quite a few news outlets are reporting this over the past day or so, a quick google will provide plenty of hits although I do feel compelled to mention that pictures of the effects are quite gruesome.

Look, boys and girls, fictional zombies are bad enough, but don't play with shit that turns you into something like looks likes a zombie in real life.

[Dominus Atheos]

I saw this on Snopes' RSS feed and assumed it was Snopes debunking its existence. I guess not. These are the photos that Snopes had saying it was a result of taking "Krokodil":

Warning: Extremely graphic, do not click if easily queasy (or even click for any reason at all. You have been warned)
Spoiler

[Highlord Laan]

What the fuck.

Okay. With effects so horrifying, I have to say it. My sympathy for those people is zero. I've long felt that stupidity should be painful, but it seems Darwin was way ahead of me.

[Channel72]

It's not stupidity; it's desperation. Most krokodil addicts are heroin addicts who can't afford more heroin. Heroin is expensive and harder to come by than krokodil, which can be produced cheaply using over-the-counter materials.

[Broomstick]

Yeah, over the counter - except for the essential codeine which is NOT over the counter in the US.

Look, I can sort of wrap my head around why someone in some crappy little town out in the middle of nowhere who is hooked on opiates might make this shit if they can just wander down to a local store and buy codeine, but that's not how it goes here. In the US codeine is a controlled substance. You either need a prescription or you need to steal it, and either way it would likely make krokodil just as expensive as heroin, or more so.

[Terralthra]

Yeah, that's why it'll not take off the way it has in Russia. By modern standards, codeine is a pretty shit analgesic, even. Lots of side-effects, more chance of them and higher severity than other opioids, not a high amount of pain relief for them. Most US doctors will prescribe prescription-strength ibuprofen or skip straight to vicodin and other synthetic analogues.

[FTeik]

Reading the title I was expecting this to be about the reptile (saltwater and nile-crocodile) becoming an immigrating species and started wondering, if I should start worrying about the Alligators.

[Grumman]

It's not stupidity; it's desperation. Most krokodil addicts are heroin addicts who can't afford more heroin. Heroin is expensive and harder to come by than krokodil, which can be produced cheaply using over-the-counter materials.

Desperation still means taking the least-bad option available to you. Given the choice between withdrawal symptoms and withdrawal symptoms and melting the flesh off your bones, the latter is not the least-bad option.

[Temjin]

Yeah, over the counter - except for the essential codeine which is NOT over the counter in the US.

Look, I can sort of wrap my head around why someone in some crappy little town out in the middle of nowhere who is hooked on opiates might make this shit if they can just wander down to a local store and buy codeine, but that's not how it goes here. In the US codeine is a controlled substance. You either need a prescription or you need to steal it, and either way it would likely make krokodil just as expensive as heroin, or more so.

I don't know how it is down there, but even though it's a controlled substance where I am, Codeine (in the form of Tylenol 3's) is ridiculously easy to come by.

When you're on Welfare in Manitoba at least, it pays for all of your subscriptions. That means you have a lot of people selling their Prescription T3's for anywhere to fifty cents to a dollar a pill. I live in a poor area of Winnipeg, and I know of a pharmacy where if you just wait outside long enough, someone will offer to sell you their T3's. Homeless people selling their prescriptions (or abusing them) is so common that the shelter I work at basically have to take control of them on behalf of the individual, making them hand in their meds and take them under supervision just to make sure there's nothing going on.

This also goes along with some doctors prescribing T3's just a little too freely. The one time I went to a clinic in my area, I had the flu, and was prescribed antibiotics and T3's for my cough...

My point is, just because it's a controlled substance doesn't mean it's particularly hard to get a hold of.

[Terralthra]

Codeine is an antitussive. It's prescribed irregularly for severe coughs down in the states, though it's not particularly better than dextromethorphan, and isn't addictive. $0.50-$1.00 CAD is significantly more expensive than Russia, and in Russia, it's OTC (or was, anyway).

[Lolpah]

It's not stupidity; it's desperation. Most krokodil addicts are heroin addicts who can't afford more heroin. Heroin is expensive and harder to come by than krokodil, which can be produced cheaply using over-the-counter materials.

Desperation still means taking the least-bad option available to you. Given the choice between withdrawal symptoms and withdrawal symptoms and melting the flesh off your bones, the latter is not the least-bad option.

One of the reasons why krokodil has spread so far in Russia is, at least in my understanding, that there are no state-funded drug withdrawal clinics. This means most people would have to quit drugs without assistance, cold-turkey, which would be very difficult with heroin.

[PainRack]

[quote="Temjin]This also goes along with some doctors prescribing T3's just a little too freely. The one time I went to a clinic in my area, I had the flu, and was prescribed antibiotics and T3's for my cough...

My point is, just because it's a controlled substance doesn't mean it's particularly hard to get a hold of.[/quote]
I don't know about the States, but over here, T3 is sold for its extra strength anti cold properties. Well, the normal cold paracetemol is paracetemol with caffeine, but Panadol also sells a variant with codeine targeted for the aches and pain for flu.

[PainRack]

Codeine is an antitussive. It's prescribed irregularly for severe coughs down in the states, though it's not particularly better than dextromethorphan, and isn't addictive. $0.50-$1.00 CAD is significantly more expensive than Russia, and in Russia, it's OTC (or was, anyway).

DMP can be abused recreationally, just like Procodin and when abused, it too has withdrawal symptoms(albeit, of a different form).

Unless you're abusing Procodin(which I must admit, is ALWAYS very tempting because the damn thereauptic dose always feels like it doesn't work after a mere 5 min), the risks of dependence isn't that high.

[Terralthra]

Codeine is an antitussive. It's prescribed irregularly for severe coughs down in the states, though it's not particularly better than dextromethorphan, and isn't addictive. $0.50-$1.00 CAD is significantly more expensive than Russia, and in Russia, it's OTC (or was, anyway).

DMP can be abused recreationally, just like Procodin and when abused, it too has withdrawal symptoms(albeit, of a different form).

Unless you're abusing Procodin(which I must admit, is ALWAYS very tempting because the damn thereauptic dose always feels like it doesn't work after a mere 5 min), the risks of dependence isn't that high.

Yes, DXM can be abused, but...it can't be cooked into fucking desomorphine.

[Broomstick]

The desomorphine isn't the problem. The pure stuff isn't any more toxic than the other opiates.

What makes krokodil so hideous is the shit in addition to to the desomorphine.

[Purple]

The desomorphine isn't the problem. The pure stuff isn't any more toxic than the other opiates.

What makes krokodil so hideous is the shit in addition to to the desomorphine.

Wait really? So like, how toxic are we talking about for the pure stuff?

[Terralthra]

The desomorphine isn't the problem. The pure stuff isn't any more toxic than the other opiates.

What makes krokodil so hideous is the shit in addition to to the desomorphine.

Wait really? So like, how toxic are we talking about for the pure stuff?

Not, really. It's a synthetic morphine, and has been used medically because it's relatively low on nausea and other side effects, and is like 8-10 times as powerful as morphine.

Broomstick is right, krokodil is horrible because the sequence involved in making krokodil involves taking codeine-containing medicine (which typically also has shit like caffeine, acetaminophen, diphenhydramine, etc. in it. Then those pills are crushed up and reduced with iodine and red phosphorus, paint thinner, and usually gasoline. Amateur chemists don't have the expertise to ensure that these reactions occur completely and without side reactions, nor are they able to purify the pills they buy, so they have all sorts of unintended reactions from the other active ingredients in their original pills. Then they inject this shit with unknown amounts of poison directly into a vein. And since it has only like an hour to an hour and a half of active effects, they frequently then begin to cook the next batch of it....while high.

And yes, Broomstick, I agree that the problem with krokodil is all the shit that's in the horrible injection besides desomorphine. But, if their OTC pain pills/cough syrup couldn't be cooked into desomorphine (as DXM can not, for example), it wouldn't matter how unclean and uncontrolled the backyard chemists are.

[Lord Relvenous]

Good lord. I've never been able to understand what drives someone to use it, though heroin addiction is something I luckily have never struggled with. It's terrible to see people damage themselves in such a way.

[Channel72]

It's not stupidity; it's desperation. Most krokodil addicts are heroin addicts who can't afford more heroin. Heroin is expensive and harder to come by than krokodil, which can be produced cheaply using over-the-counter materials.

Desperation still means taking the least-bad option available to you. Given the choice between withdrawal symptoms and withdrawal symptoms and melting the flesh off your bones, the latter is not the least-bad option.

And yet thousands of Russians choose to take krokodil, which is really a testament to how fucking difficult it is to withstand the withdrawal symptoms of heroin. Krokodil users probably don't give a shit whether they live or die; they'll just do anything to end the withdrawal pains. It usually requires professional intervention to stop taking heroin.

[SAMAS]

God.

Fucking.

DAMN.

Why did I open that spoiler?!

How the hell can people do that to themselves?

[Napoleon the Clown]

Addiction is a bitch, that's how.

[Broomstick]

And yet thousands of Russians choose to take krokodil, which is really a testament to how fucking difficult it is to withstand the withdrawal symptoms of heroin. Krokodil users probably don't give a shit whether they live or die; they'll just do anything to end the withdrawal pains. It usually requires professional intervention to stop taking heroin.

It's not just the misery of withdrawal at work. LOTS of people have made it through heroin withdrawal, some even cold turkey. Sure, it's awful but it's not unendurable.

A major factor is the psychological aspects of addiction. People who become physically dependent on opiates, usually after using them for a prolonged period for pain control, but who are not addicts can detox from them without too much trouble. Sure, the withdrawal is unpleasant but they don't go running for street drugs or worse and they don't have the pressing urge to use again. Addicts are a different category altogether. Some of them can't tolerate pain or discomfort on any level without getting high. There is an amazing self-destructive aspect to any addiction. Add in despair, the notion that the future will never get any better, no hope for a better life, and shooting up on such a corrosive chemical is less daunting. It's almost a form of suicide.

So they can't get heroin, so they make krododil and shoot that. Then there's the pain of dying flesh and despair over bodily harm which now must be soothed, so more krokodil. Rinse and repeat. That's the scenario in some of the isolated villages where this shit became "popular".

That doesn't explain people in more affluent areas (and it's not just the US, this shit has shown up in Europe as well as the more affluent parts of Russia) using this shit. Those people can get effective shit that doesn't dissolve flesh. So why use krokodil...? I just don't understand that leap. Sure, addicts can be highly specific in what they use but at some point the person has to choose to switch to krokodil and, with other stuff available that isn't so toxic it's puzzling why anyone would do that.

[Kitsune]

First thing I have seen that a long time Meth addict looks pleasant by comparison

[Darth Yoshi]

Not, really. It's a synthetic morphine, and has been used medically because it's relatively low on nausea and other side effects, and is like 8-10 times as powerful as morphine.

Broomstick is right, krokodil is horrible because the sequence involved in making krokodil involves taking codeine-containing medicine (which typically also has shit like caffeine, acetaminophen, diphenhydramine, etc. in it. Then those pills are crushed up and reduced with iodine and red phosphorus, paint thinner, and usually gasoline. Amateur chemists don't have the expertise to ensure that these reactions occur completely and without side reactions, nor are they able to purify the pills they buy, so they have all sorts of unintended reactions from the other active ingredients in their original pills. Then they inject this shit with unknown amounts of poison directly into a vein. And since it has only like an hour to an hour and a half of active effects, they frequently then begin to cook the next batch of it....while high.

And yes, Broomstick, I agree that the problem with krokodil is all the shit that's in the horrible injection besides desomorphine. But, if their OTC pain pills/cough syrup couldn't be cooked into desomorphine (as DXM can not, for example), it wouldn't matter how unclean and uncontrolled the backyard chemists are.

I read that one of the byproducts of the manufacturing process is hydrochloric acid. As in, stomach acid. Yeah, when you're basically digesting yourself a little bit every hour, of course your arm will look like that. Yeesh.

[Raw Shark]

I've got to wonder how somebody can get their arm to the point depicted in that first photo and not be dead from a massive infection. Is the state providing antibiotics but not methadone?