Desomorphine attracted attention in 2010 in Russia due to an increase in clandestine production, presumably due to its relatively simple synthesis from codeine. The drug is easily made from codeine, iodine and red phosphorus,[8] in a process similar to the manufacture of methamphetamine from pseudoephedrine; but desomorphine made this way is highly impure and is contaminated with various toxic and corrosive byproducts. The street name in Russia for home-made desomorphine is "krokodil" (крокодил, crocodile), reportedly due to the scale-like appearance of skin of its users and the derivation from chlorocodide.[9] Due to difficulties in procuring heroin, combined with easy and cheap access to over-the-counter pharmacy products containing codeine in Russia, use of "krokodil" has been on the increase. Since the home-made mix is routinely injected immediately with little or no further purification, "krokodil" has become notorious for producing severe tissue damage, phlebitis and gangrene, sometimes requiring limb amputation in long-term users.[10] The amount of tissue damage is so high that addicts' life expectancies are said to be as low as two to three years, especially as they are often highly susceptible to infections and gangrene due to widespread HIV infection among injecting drug users in Russia.[11][12][13][14]
