23536
Bluelight Crew
http://www.thepoisonreview.com/2013...ve-soft-tissue-injury-from-homemade-krokodil/
Unedited manuscript
Several days ago, a news story on KTVI-FOX2now in St. Louis suggested that local physicians had written up a case of skin damage from the use of krokodil, and that the case report had been accepted for imminent publication by the American Journal of Medicine.
An unedited manuscript of that article is now available. In it, the authors — from St. Mary’s Medical Center in Richmond Heights MO — describe a 30-year-old male who developed left upper extremity pain, swelling, and necrotic ulceration where he had been skin popping for several months. (There is a graphic photograph in the manuscript.) He also had developed swelling and necrosis of the left 5th finger which “auto amputated.” The patient told the medical team that because he could no longer afford his $300-a-day heroin habit, he had turned to “cheaper home-made heroin substitutes prepared from codeine.”
This story doesn’t quite make sense. As TPR has reported before, “krokodil” became heavily used in Russia where heroin is expensive and, until recently, codeine was cheap and available over-the-counter without a prescription. Heroin addicts who could no longer afford the drug attempted to make the injectable opiate desomorphine, using a process treating codeine with substances such as gasoline, paint thinner, hydrochloric acid, red phosphorous, and iodine. When the end-product was injected, it, not surprisingly, caused horrendous tissue damage.
Unlike heroin, desomorphine has a relatively short duration of action — approximately 90 to 120 minutes. Since it is very addicting, users in Russia would spend their entire time shooting up, then cooking another batch and repeating the injection.
In the United States, heroin is relatively inexpensive and codeine is regulated and available by prescription only. I’m not sure about how the economics of krokodil would work out in this country.
Recently, there were cases of possible “krokodil” use reported from Arizona, Oklahoma, Utah, and Illinois. Some of these reports have been debunked. Some experts have suggested that “krokodil” had not reached the U.S. at all.
Despite the sparse clinical information included in this case report — as well as errors in grammar, spelling, and science that I assume will be correct before official publication — it is worthwhile knowing that at least one drug user in this country sustained significant soft-tissue damage from injecting a mixture of chemicals contained in an internet recipe for desomorphine. I do wish the authors had been more specific about what chemicals the patient reported using in his attempt to make desomorphine. It is also unfortunate that the patient absconded and was lost to follow-up.
- See more at: http://www.thepoisonreview.com/2013...-from-homemade-krokodil/#sthash.PVVKpt2K.dpuf
Unedited manuscript
Several days ago, a news story on KTVI-FOX2now in St. Louis suggested that local physicians had written up a case of skin damage from the use of krokodil, and that the case report had been accepted for imminent publication by the American Journal of Medicine.
An unedited manuscript of that article is now available. In it, the authors — from St. Mary’s Medical Center in Richmond Heights MO — describe a 30-year-old male who developed left upper extremity pain, swelling, and necrotic ulceration where he had been skin popping for several months. (There is a graphic photograph in the manuscript.) He also had developed swelling and necrosis of the left 5th finger which “auto amputated.” The patient told the medical team that because he could no longer afford his $300-a-day heroin habit, he had turned to “cheaper home-made heroin substitutes prepared from codeine.”
This story doesn’t quite make sense. As TPR has reported before, “krokodil” became heavily used in Russia where heroin is expensive and, until recently, codeine was cheap and available over-the-counter without a prescription. Heroin addicts who could no longer afford the drug attempted to make the injectable opiate desomorphine, using a process treating codeine with substances such as gasoline, paint thinner, hydrochloric acid, red phosphorous, and iodine. When the end-product was injected, it, not surprisingly, caused horrendous tissue damage.
Unlike heroin, desomorphine has a relatively short duration of action — approximately 90 to 120 minutes. Since it is very addicting, users in Russia would spend their entire time shooting up, then cooking another batch and repeating the injection.
In the United States, heroin is relatively inexpensive and codeine is regulated and available by prescription only. I’m not sure about how the economics of krokodil would work out in this country.
Recently, there were cases of possible “krokodil” use reported from Arizona, Oklahoma, Utah, and Illinois. Some of these reports have been debunked. Some experts have suggested that “krokodil” had not reached the U.S. at all.
Despite the sparse clinical information included in this case report — as well as errors in grammar, spelling, and science that I assume will be correct before official publication — it is worthwhile knowing that at least one drug user in this country sustained significant soft-tissue damage from injecting a mixture of chemicals contained in an internet recipe for desomorphine. I do wish the authors had been more specific about what chemicals the patient reported using in his attempt to make desomorphine. It is also unfortunate that the patient absconded and was lost to follow-up.
- See more at: http://www.thepoisonreview.com/2013...-from-homemade-krokodil/#sthash.PVVKpt2K.dpuf
