Krokodil (Desomorphine) Drug: History, Side Effects, & Treatment Options

What is Krokodil (Desomorphine)?

Krokodil (desomorphine) is a semi-synthetic opioid drug derived from codeine.¹ 

The drug was first used in Russia and Ukraine before spreading to other countries.

Russia and Ukraine are the most affected by Krokodil use because of the availability of codeine, a key ingredient for making this drug.

Research estimates that at least 100,000 people in Russia were confirmed to have injected Krokodil in 2011 alone.²

When injected, Krokodil results in a scaly black and green appearance at the injection site, resembling reptile or crocodile skin.

These toxic side effects are due to the harmful ingredients added to codeine when making Krokodil. 

These additives include:

Like other opioids such as heroin, Krokodil is both a sedative (creates a feeling of calm) and an analgesic (pain reliever). 

In many cases, Krokodil is used as a cheaper substitute for heroin.

Desomorphine (the active ingredient in Krokodil) is about ten times stronger than morphine, and its effects kick in much faster. However, unlike morphine, the euphoric effects of Krokodil last about two hours.

Krokodil was first used in 1935 to relieve pain and promote calmness before and after surgery.

However, Krokodil is no longer used and is classified as a Schedule I controlled drug in the United States due to its great potential for abuse and medical insignificance.³

How to Take Krokodil Correctly 

Most users take Krokodil via injection, although it may also be taken orally. Krokodil has a rapid onset of two to three minutes. 

Since the effects last only two hours, most Krokodil users tend to inject the drug more frequently. This leads to quick physical addiction.

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What are the Side Effects of Krokodil?

Short-term side effects include:

• Slow or shallow breathing
• Pain and swelling at the site of injection

Long-term side effects include:

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What are the Risks of Krokodil?

When Krokodil is injected, it may cause vein damage and localized infections. 

These infections have the potential to spread to other parts of the body and cause organ damage.⁵ 

If the limbs get infected, you may require an operation or amputation (removal of that part of the body).

Because Krokodil is a homemade opioid, the conditions under which it is prepared are a health risk to users.

Those preparing the drug are more likely to share preparation equipment, increasing the potential of contamination with other harmful substances.

In addition, users are likely to share needles, exposing themselves to the risk of infections such as HIV/AIDS and Hepatitis C.

The frequent use of Krokodil throughout the day may also contribute to non-sterile needle use and the potential for infections.

Even short-term Krokodil usage may result in serious health problems and death. Research estimates that most Krokodil users die within two years of addiction.⁶ The first use of Krokodil can lead to death in some cases.

Is Krokodil Addictive? What are the Symptoms?

Krokodil is very addictive. This, along with the side effects, makes it a hazardous drug. 

Krokodil is about ten times more powerful than morphine and three times more potent than heroin. It is also very cheap.

According to the DEA, repeated administration of desomorphine at short intervals in cancer patients demonstrated that the drug is potentially addictive.⁷

The urge to continue using krokodil to prevent withdrawal symptoms may keep users from seeking addiction treatment, leading to chronic drug abuse.

Suddenly stopping Krokodil use will lead to withdrawal symptoms. They include:

Although these withdrawal symptoms are very unpleasant, they are not life-threatening. However, the distress may be enough to keep someone stuck in an addictive lifestyle to avoid them.

Symptoms of Krokodil Addiction

• Experiencing withdrawal symptoms
• Inability to stop using
• Continued use of Krokodil despite the adverse effects on your health
• Isolating oneself from others to use the drug
• Depression and lack of motivation
• Neglecting personal responsibilities such as work or school

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Can You Overdose on Krokodil?

Yes. You can overdose on Krokodil. 

The symptoms of Krokodil overdose are similar to those of other opioids. They include:

• Extreme drowsiness
• Reduced or stopped breathing
• Pinpoint pupils
• Spasms or seizures
• Extreme nausea and vomiting
• Coma/unresponsiveness
• Poor muscle coordination

In most instances, if these symptoms are not treated properly, death will occur. 

Anyone experiencing these symptoms while using desomorphine or other opioids should seek emergency medical treatment.

4 Treatment Options for Krokodil Misuse & Addiction

Substance use treatment includes both psychological (mental) and physical healthcare.

Because of the significant physical harm caused by desomorphine addiction, most users should be treated in a supervised setting.

There are various treatment options for Krokodil addiction:

1. Medical Detox

If you’re experiencing Krokodil withdrawal symptoms due to your addiction, a medically assisted detox program may help you overcome your physical dependency. 

A Krokodil detox program offers treatment for Krokodil withdrawal symptoms, allowing you to feel secure, comfortable, and cared for. 

It also helps in the prevention of relapse by giving professional support in a therapeutic setting.

2. Rehabilitation

People who have a history of krokodil addiction may find it highly beneficial to enroll in a drug treatment program after Krokodil detox. 

Long-term addiction therapy may assist people in addressing the underlying causes of their addictive behaviors. 

Addiction therapy will also help establish a solid foundation in recovery and develop essential life skills that help addicts remain clean in the long run.

The National Institute on Drug Abuse (NIDA) affirms that long-term (at least 90 days) offers the best chance of long-term recovery and reduces the risk of relapse.

Depending on your financial ability and treatment needs, you may choose to enroll in either an inpatient recovery program or an outpatient recovery program.⁸

Inpatient programs require the patient to stay in the facility for the entire duration of their recovery. It’s most beneficial for severe addiction.

On the other hand, outpatient recovery centers allow patients to attend treatment while living their everyday lives. It’s most preferred in mild addiction cases.

If you’re thinking about Krokodil drug rehab, you should expect to work alongside addiction treatment experts and sober peers to accomplish the following goals:

• Learn about Krokodil addiction and the recovery process
• Learn how to cope with triggers and cravings
• Learn how to use a recovery program such as the 12-Step Program
• Attend group and individual counseling sessions to resolve underlying psychological issues

These addiction treatment goals are achieved through various evidence-based treatment approaches, including cognitive-behavioral therapy (CBT), lectures, family counseling, and peer support.

3. Sober Living Programs

It often takes time to adapt to a clean lifestyle after treatment. 

Most people need all the assistance and support they can receive, even after they complete their treatment.

A sober living program serves as a link between Krokodil treatment programs and independent sober living.

Sober living homes provide a secure, supportive, and sober living environment that fosters long-term recovery.

4. Aftercare Programs

Aftercare treatment consists of a series of outpatient group therapy sessions where recovered people may gather and discuss problems connected to addiction recovery.

Aftercare groups are a great way to build healthy connections, improve communication skills, discuss personal struggles, and support others in their recovery journey.

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