krokodil

Krokodil, commonly known as desomorphine in illicit use, is a street name for a potent, short-acting semi-synthetic opioid that has been abused via injection. The name "krokodil" reflects the severe tissue damage seen at injection sites, which can give the skin a green, scaly appearance.

Desomorphine was first synthesized in 1932 as a morphine-related compound. In the early 2000s, reports emerged of an injectable street drug in Russia and parts of Eastern Europe that produced rapid, intense euphoria but caused extensive tissue destruction. Because the drug is typically produced illicitly with a mix of cheap precursors and solvents, its content and potency vary widely, and the impurities contribute to health complications.

Desomorphine acts as a potent agonist at mu-opioid receptors, producing analgesia and euphoria. It has a rapid onset when injected and a relatively short duration, contributing to repeated injections. It is considerably more potent than morphine, increasing risks of overdose, respiratory depression, and dependence.

The most distinct hazard is severe tissue damage at injection sites, including necrosis, gangrene, and multiple amputations. Additional risks include severe infections, sepsis, liver and kidney damage, blood-borne disease transmission, and high mortality. The combination of impurities and delayed medical care often worsens outcomes.

Krokodil has been reported primarily in Russia and some neighboring countries; international spread is sporadic. Public health authorities warn against its use and emphasize harm reduction, addiction treatment, and access to medical care.