Tianeptine (brand name Stablon in the US, Coaxil in Russia) is an SSRE (Selective Seratonin Reuptake Enhancer)- it does the 'opposite' of an SSRI; and unlike many typical anti-depressants, Tianeptine takes effect shortly after the first dose, rather than having to take it for a couple weeks before effects appear. Even in therapeutic dosages, it is a 'mood elevator'; its anti-depressant activity is more reminiscent (according to anecdotal reports) of a low dose of a recreational euphoriant than the empty mellowness of SSRI's/tricyclics/etc. In parts of the former USSR, injection of Tianeptine pills (Coaxil capsules) is popular. Similar to why people inject drugs like Zolpidem, Temazepam, etc, it increases the onset of effects considerably; and simultaneously feeds the habit of needle play. However, the mood elevating, positive aspects of Tianeptine decrease considerably with repeated usage, resulting in higher and higher dosages needed to achieve the same effect (and even then people who have written anecdotal reports say that it is nothing like the 'good feelings' when they initially took it the first several times).
Here at BL the deleterious effects of pill injecting on the health of injecting drug users is so well known it barely needs to be mentioned. The amputations, etc from IV Coaxil abuse is from coldshaking (dropping the pill or powder into the syringe barrel with water and shaking it until it looks dissolved then shooting with no filtering) the powder emptied from pharmaceutical capsules and injecting them. Some media reports from Russia say that addicts use very large gauge needles because trying to shoot a dozen capsules worth of Coaxil powder clogs up smaller gauge needles normally used for heroin injection. Imagine taking amount of pill powder that would half a salt-shaker, getting a big 10cc oral syringe, dumping all that powder in and coldshaking it, and injecting that IV with a 23g needle on a regular basis.
Regarding Krokodil, the drug it contains is purported to be Desomorphine; there was a great thread on here awhile back that shed light onto the actual contents of the drug based on the method of manufacture (with some guessing it may contain no actual Desomorphine at all, but rather a myriad of opioid byproducts of side reactions and poor chemistry of cooking Codeine with a variety of household and industrial chemicals):
http://www.bluelight.ru/vb/threads/580958-Krokodil-Chemistry
Keep in mind that Krokodil as a phenomenon and all of the cultural aspects that go with it have a long precedent. The history of clandestine Methcathinone manufacture and abuse in the Soviet Union set the stage for this. Once the kitchen chemistry was complete, the entire liquid leftover from the cooking process would not be refined. In the US, when methamphetamine cooks finish, the liquid 'honey' is turned into a powder, cut, then sold. Instead of doing this, the liquid containing Methcathinone, side reactions, by products, leftover chemicals used in the clandestine manufacturing process, etc would be sucked into a huge syringe and sold by dosage unit. A dealer would give out liquid doses from the same syringe to addict/user customers- like every addict in a shooting gallery dumped their heroin into a bowl, added water, and everyone stuck their dirty needles into that water like kids bobbing for apples, sucked up their doses and injected it. This is also true of the homemade opioids from home sown poppy crops (shirka, etc).
This article talks about a lot of these social fixtures of the fSU drug scene, pre and post Glasnost and the fall of the breakup of the USSR (though it contains lots of chemical inaccuracies, the social history is what is important):
http://www.angelfire.com/linux/vorlin/
The West suffers from many of the same problems associated with Coaxil and Krokodil abuse; the clandestine crank culture in the US is just as toxic in parts of the rural Midwest/South (or was moreso in the '70s-'90s) as homemade Krokodil; the chronic IV use of Temazepam gelcaps in the UK and Austrailia is similarly harmful,dangerous and tragic as chronic IV Coaxil abuse. NZ Homebake and Polish Kompot are two examples of Krokodil precedents. We've seen this all before, even if the consequences and damage this time around are far worse given the lack of social resources (drug treatment programs, jobs, quality education, social safety net, etc) and the particularities of drug culture in the fSU.
It just goes to show you that the effects of drug prohibition are the same everywhere. That people everywhere will use drugs no matter the consequences. That lack of harm reduction programs, policies and education hurts and kills millions of people. I am worried though that drug users reading these stories coming from Russia/fSU mythologize the drugs, as though they have some kind of power or are somehow different from any other drug that users and addicts are willing to suffer such consequences, as though there is some kind of special high from shooting desomorphine or tianeptine that is totally different and more powerful than anything else on earth. The media hypes this aspect of it for sensationalism (that one articles lead line is 'Krokodil - the drug that eats addicts'). It would be very sad if the media barrage leads to a transplanting of this phenomenon on any level. When you take away the aura of sensationalism, you realize theres nothing special about either drug, particularly Krokodil. It's a toxic soup of Iodine, solvent(s), degraded/partially reacted/byproduct opioids and toxic reactions/byproducts created by the cooking process with the other ingredients all mixed together, and potentially (in the best case) a very small amount of Desomorphine and Morphine, though more likely, as the other thread indicated, active opioid byproducts from the reaction. Pharmaceutical grade Desomorphine, just like pharmaceutical Diacetylmorphine, is not sensational. Doesn't have an aura. These same addicts would look and act like everyone else if they got a Desomorphine Hcl 99.9% USP sterile injection every 6-8 hours (just like chronic heroin addicts in Switzerland do on Diamorphine maintenance- go from a scab covered, track marked, abscess scarred skeleton to just another swinging dick walking down the street indistinguishable from anyone else).
