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Tuesday, November 22, 2011

Zombies High On Krokodil

The effects of this drug 
make crystal meth look benign by comparison.

"The average user of krokodil
a dirty cousin of morphine that is spreading like a virus among Russian youth, 
does not live longer than two or three years, 
and the few who manage to quit usually come away disfigured."

(Simon Shuster, "The Curse of the Crocodile: Russia's Deadly Designer Drug," Time Magazine, June 20 2011)

Krokodil has roughly the same effect as heroin but is at least three times cheaper and extremely easy to make. The active component is codeine, a widely sold over-the-counter painkiller that is not toxic on its own. But to produce krokodil, whose medical name is desomorphine, addicts mix it with ingredients including gasoline, paint thinner, hydrochloric acid, iodine and red phosphorous, which they scrape from the striking pads on matchboxes.

In 2010, between a few hundred thousand and a million people, 
according to various official estimates, 
were injecting the resulting substance into their veins in Russia, 
so far the only country in the world to see the drug grow into an epidemic.

A Russian Appalachia: Does This Sound Familiar?
Shuster reports that Krokodil has spread the fastest in the poorest and most remote parts of Russia, like Vorkuta, a former Gulag prison camp about 100 miles (161 km) north of the Arctic Circle. The winters there last eight months of the year, and ...
(a) The young people there are in a constant state of boredom
(b) Most of them drink
(c) Few of them work, the same as in hundreds of towns and villages across Russia's frozen north.

The final product is often an impure, orange-colored liquid, with this impurity causing skin irritation, a scale-like look, and eventual destruction of the skin.This is likely due to the presence of hydrochloric acid still in the final liquid solution prior to injection, with the red phosphorous playing a role in furthering sickening the user.   
According to Shuster, "The 'rotting' (experienced by users of Krokodil) explains the drug's nickname. At the injection site, which can be anywhere from the feet to the forehead, the addict's skin becomes greenish and scaly, like a crocodile's, as blood vessels burst and the surrounding tissue dies. Gangrene and amputations are a common result, while porous bone tissue, especially in the lower jaw, often starts to dissipate, eaten up by the drug's acidity." (Simon Shuster, "The Curse of the Crocodile: Russia's Deadly Designer Drug," Time Magazine, June 20 2011)
Some Quick Krok Information
1. Desomorphine causes the strongest levels of addiction, and is the hardest to cure.

"With heroin withdrawal, the main symptoms last for five to 10 days. After that there is still a big danger of relapse but the physical pain will be gone. With krokodil, the pain can last up to a month, and it's unbearable. They have to be injected with extremely strong tranquilisers just to keep them from passing out from the pain."
(Shaun Walker, "Krokodil: The Drug That Eats Junkies,", June 22 2011)
Not everyone succumbs to the addiction, but those that manage to escape its clutch pay a high price. A former krokodil user named Zhenya says, “I managed to kick the habit, after spending weeks at a detox clinic, experiencing horrendous withdrawal symptoms that included seizures, a 40-degree temperature and vomiting. I lost 14 teeth after my gums rotted away, and I contracted hepatitis C.” (Will Wlizlo, "Tripping On Krokodil,", June 27 2011)
2. Krokodil users are instantly identifiable because of their iodine smell. 
It infuses all their clothes. There's no way to wash it out, all they can do is burn the clothes.
3. The key ingredient for krokodil – codeine pills.
There were plans to make codeine-based tablets available only on prescription, but that it was impossible to introduce the measure quickly. Opponents claim lobbying by pharmaceutical companies has caused the inaction.The tablets don't cost much but the profit margins are high. Some pharmacies make up to 25 per cent of their profits from the sale of these tablets. It's not in the interests of pharmaceutical companies or pharmacies themselves to stop this, so the Russian government needs to use its power to regulate their sale.

4. Unlike heroin, where the hit can last for several hours, a krokodil high only lasts between 90 minutes and two hours.

Given that the "cooking" process takes at least half an hour, being a krokodil addict is basically a full-time job.
The short time table causes addicts to be trapped in a full time, twenty-four hour a day cycle of cooking and injecting in order to avoid withdrawal. 

5. Most krokodil users inject the drug only when they run out of money for heroin. 

As soon as they earn or steal enough, they go back to heroin. In other more isolated regions of Russia, where heroin is more expensive and people are poorer, the problem is worse. People become full-time krokodil addicts, giving them a life expectancy of less than a year.

6. Users may have to use it for two or three weeks before becoming aware of the dangerous side-effects and thus realizing that what they were sold was something other than heroin.

Why Do People Choose to Become "Walking Zombies"?

Addiction is all-powerful and completely controlling. Also, consider that dual diagnosis is often found: mental illness and drug addiction often occur together. This condition of dual diagnosis presents a challenge to physicians. The patient has two brain diseases that influence one another, and which both need treatment. 
Dual diagnosis may stem from developmental changes in the amygdala, 
a walnut-shaped part of the brain linked to fear, anxiety and other emotions.

Dual diagnosis is common yet difficult to treat. Addiction of all types -- to nicotine, alcohol and drugs -- is often found in people with a wide variety of mental illnesses, including anxiety disorders, unipolar and bipolar depression, schizophrenia, and borderline and other personality disorders. 
In his studies on the subject, Andrew Chambers, MD, cites clinical reports that at least half the people who seek help with addiction or mental-health treatment have co-occurring disorders. Epidemiological data says that from two to five of every 10 anxious or depressed people, and from four to eight of every 10 people with schizophrenia, bipolar disorder, or antisocial personality, also have some type of addiction. (American Psychological Association. "Mental Illness And Drug Addiction May Co-occur Due To Disturbance In Part Of The Brain." ScienceDaily, December 3 2007) 
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