Krokodil Addiction

Krokodil, also known as the zombie drug, has effects similar to opiates, yet it can be more dangerous and deadly. 

Krokodil (or the “zombie drug”) is a street name for desomorphine. Krokodil drug abuse was relatively unheard of in the U.S. until fairly recently, but the drug has been problematic in Russia and other former Soviet countries since 2002–2003.

Krokodil is considered a cheap replacement for heroin. Compared to heroin, krokodil is inexpensive and often more accessible, and the effects are powerful. This injectable drug can also rot someone’s skin from the inside out.

What Is Krokodil?

Desomorphine, which is the generic name for krokodil, is a codeine derivative.

Like methamphetamine, krokodil is often made with other substances, making it especially dangerous. Some of the most toxic ingredients in illicitly manufactured krokodil include battery acid, paint thinner and gasoline. These substances are used to create reactions to synthesize the drug, and they aren’t usually removed before someone buys and injects it.

What Does Krokodil Look Like?

Many people wonder, “What does krokodil look like?” Krokodil looks like a clear or colored liquid. Krokodil can also look like heroin in many cases. However, because of the different substances in krokodil, the color may vary from batch to batch. Frequently, krokodil is a yellow liquid with an acidic odor.

How Is Krokodil Used?

Because krokodil is a liquid, the primary method of use is an intravenous injection. Krokodil can be injected into a vein in the same way that heroin can be injected. Eating, smoking or snorting krokodil may be possible, but most research suggests that krokodil is mainly injected intravenously.

Street Names for Krokodil

Along with krokodil, other street names include:

• Zombie drug
• Crocodile
• Russian magic
• Poor man’s heroin

Where Is Krokodil Found?

This synthetic opioid derivative was first synthesized in the U.S. in the 1930s. Desomorphine is an estimated 10 times more potent than morphine. There is currently no accepted medical use for desomorphine in the U.S., although it’s used medically in Switzerland, where it’s known under the trade name Permonid.

While desomorphine was initially synthesized decades ago, the abuse of krokodil didn’t start to appear internationally until around 2002. By 2010, the misuse of krokodil had become somewhat widespread in Russia, with about 100,000 Russians injecting the drug in 2011.

Illicit manufacturing of krokodile became increasingly common, particularly when Russia started cracking down on heroin use. Homemade versions of krokodil often include codeine and iodine from over-the-counter medications.

In the U.S., krokodil is much less common because codeine (required to synthesize krokodil) is a controlled substance. Even though low-dose codeine medications are available at most pharmacies, regulations and restrictions surrounding codeine use still exist.

How Is Krokodil Made?

While desomorphine is an opioid with effects similar to heroin, it’s not the most dangerous component of krokodil. Krokodil production is highly dangerous because of the highly toxic ingredients used.

With very little equipment and codeine, krokodil can be made in less than an hour. The codeine is extracted from medications and then combined with a solvent. A base is added, and then acid.

It is not advised for anyone to learn how to make krokodil. Krokodil ingredients can include harmful and potentially explosive substances like:

• Codeine
• Gasoline
• Hydrochloric acid
• Iodine

Depending on how it’s made, these toxic ingredients aren’t typically removed from the desomorphine before it’s sold and consumed.

Krokodil Addiction

Krokodil addiction is an emerging threat. Although little data are available on krokodil addiction in the U.S., experts know it is a highly potent and addictive drug. As such, research into krokodil addiction and its impact is ongoing.

Is Krokodil Addictive?

Krokodil is a Schedule I controlled substance in the U.S., indicating that it’s highly addictive with no approved medical uses. People may wonder, “Why is krokodil addictive?” As with other opioids, krokodil activates receptor sites in the brain. This activation triggers reward responses that can contribute to addiction.

The potency of krokodil and its short-lived high also contribute to its highly addictive nature.

People dependent on krokodil may also quickly develop a physical dependence on the drug and experience withdrawal symptoms if they try to stop using it.

The risks of krokodil addiction and dependence only add to the potentially life-threatening physical dangers to the skin, bones and organs.

How Krokodil Addiction Starts

Krokodil is a cheap alternative to heroin, and many krokodil users may not even know they are taking the drug, mistakenly believing they are taking heroin. As a Schedule I opioid, krokodil floods the brain’s reward system with feel-good chemicals, causing euphoria and a sense of well-being. Over time, this can pave the way to a krokodil addiction.

Effects of Krokodil Addiction 

Krokodil effects are similar to heroin and other opioids. Krokodil drug effects tend to occur within two to three minutes after administration. The effects are estimated to be 10 times stronger than morphine and sometimes as much as 15 times more powerful. People may feel a short-lived high like that of heroin. Krokodil drug effects can include not only the euphoric high but also respiratory depression and drowsiness.

Physical Effects of Krokodil 

Other krokodil side effects that can occur from the toxic ingredients used to manufacture the substance can include:

• Vein damage
• Infections of the soft tissue
• Necrosis and gangrene
• Ulcerations at injection sites and remote areas of the body
• Blood vessel damage
• Pneumonia
• Blood poisoning
• Meningitis
• Tooth decay or loss
• Rotting gums
• Transmission of blood-borne viruses
• Bone infections
• Memory loss
• Damage to the liver and kidneys

Krokodil is nicknamed the “zombie drug” because of its flesh-eating effects at injection sites and elsewhere throughout the body. Krokodil effects can lead to the need for skin grafts, surgeries and limb amputations.

When injected, krokodil damages the vein and can lead to infections. The infections can spread throughout the body, causing organ damage. Living tissue can also die. Media reports have shown krokodil effects often in graphic detail. People may have dead patches of skin on their bodies. The skin can become black, green or grey and flake off, creating a reptile-like appearance.

Psychological Effects of Krokodil Addiction

Little is known about the psychological effects of krokodil addiction. However, opioid use disorder is often linked to mental health issues like depression and anxiety. For experts to learn more, additional research must be conducted into the psychological impact of krokodil addiction.

Treatment for Krokodil Addiction

While the use of krokodil isn’t yet widespread in the U.S., there is concern that it may become more pervasive. This is especially true as the opioid epidemic continues to affect millions of Americans, and increasingly strict laws and regulations attempt to crack down on opioid use. There is a growing concern that Americans may turn to cheap, illegal substances like krokodil, as was the case in Russia.

Krokodil drug treatment is available for someone who struggles with krokodil use. Krokodil treatment focuses on the opioid component of the drug but would also likely need to be specialized due to its physical effects.

Inpatient Rehab for Krokodil Addiction

Inpatient rehab is readily available and may be necessary for many individuals who use krokodil. The medical issues associated with krokodil use mean that primary care staff may need to be available for wound care. The tissue damage caused by krokodil is often profound, with visible scarring and the loss of skin even after injecting the drug only once. Patients may require hospitalization before they are cleared for inpatient rehab.

Inpatient rehab usually involves multiple treatment methods like medication, talk therapy and group therapy. Medication may include drugs for nausea, vomiting, tremors, cravings, sweating, seizures, diarrhea, body aches and hallucinations.

How Long Is Krokodil Rehab?

Rehab for krokodil may be longer than other drugs because of the complex medical issues the drug causes. However, after these medical issues stabilize, krokodil rehab can vary from a month to several months, just like other opioids. The length of rehab will vary greatly depending on the individual’s response and the severity of the addiction and symptoms coming into rehab. 

Ongoing Recovery From Krokodil Addiction

Long-term recovery depends on a strong social support system, follow-up medical and psychiatric care and positive opportunities like new employment or hobbies. Maintaining good social and medical support is crucial for maintaining sobriety in the long term. Support groups can help keep an individual tethered to supportive relationships that help guard against relapse. 
To learn more about krokodil treatment, contact us at The Recovery Village.

Editor – Theresa Valenzky

Theresa Valenzky graduated from the University of Akron with a Bachelor of Arts in News/Mass Media Communication and a certificate in psychology. She is passionate about providing genuine information to encourage and guide healing in all aspects of life. Read more

Medically Reviewed By – Dr. Jessica Pyhtila, PharmD

Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more