Breaking worse: The emergence of krokodil and excessive injuries among people who inject drugs in Eurasia

Grund, Jean‐Paul C.; Latypov, Alisher; Harris, Magdalena

doi:10.1016/j.drugpo.2013.04.007

Cited by 78 publications

(198 citation statements)

References 40 publications

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“…Krokodil has been spreading rapidly across Europe [1]. The presence of krokodil was confirmed in Poland, Germany, France, Belgium, Sweden and Norway [2].…”

mentioning

confidence: 86%

“…It also increases risk of HIV and HCV transmission. Other reported complications are thrombosis of major vessels, osteomyelitis, subcutaneous abscess, serious systemic damage, neurological damage including speech and motor skill impairment, endocrine damage due to iodine content, memory and concentration impairment, and personality changes [1].…”

Section: Discussionmentioning

confidence: 99%

“…Krokodil production requires minimal laboratory equipment and it takes up to 45 minutes to synthetize the drug. Due to the nature and variety of these additives, there is high potential for contamination [1].…”

Section: Discussionmentioning

confidence: 99%

“…It has faster onset of action, and shorter half-life compared to morphine [7]. The analgesia caused by krokodil causes users to seek medical attention much later, after a significant amount of necrosis has already begun [1,7,8]. The high likelihood of contamination with different toxic chemicals and byproducts from their chemical reactions with one another has been hypothesized to be the reason why krokodil is more often associated with gangrenous and necrotic tissue destruction than other intravenously injected illicit substances, including heroin [9,10].…”

Section: Discussionmentioning

confidence: 99%

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New case of krokodil (desomorphine) use

Caldararo¹,

Rad²,

Laborde³

et al. 2018

Int J Case Rep Images

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Introduction: Krokodil use was first reported in siberia in 2002. the drug derives its name from the harms associated with its use, such as ulcerations and discolored necrotic scaled skin which may resemble crocodile skin. It has also been described as "flesh eating", as it finally disrupts the skin leaving the bone and muscle exposed to infections. case report: A 27-year-old female with past medical history of intravenous opioid dependence for 5-6 years and gastroesophageal reflux disease who presented with ulcerations of the posterior aspects of her arms bilaterally. the patient reported injecting krokodil for the past 5-6 months. she had been observing blue and black discoloration of the skin 1-2 days after each injection for the past 4-5 months. the injection site scabbed after 2-3 days. the patient continued injecting in area next to the affected sites. Eventually the affected sites coalesced and evolved into a large scab containing black necrotic tissue. In the last 5-6 days the black necrotic tissue started peeling off made the underlying tissue visible with mild

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“…Krokodil has been spreading rapidly across Europe [1]. The presence of krokodil was confirmed in Poland, Germany, France, Belgium, Sweden and Norway [2].…”

mentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

New case of krokodil (desomorphine) use

Caldararo¹,

Rad²,

Laborde³

et al. 2018

Int J Case Rep Images

View full text Add to dashboard Cite

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“…Home-made labs represent atypical risk environments (Rhodes, 2009;Miovský et al 2015) with synthesis taking place in primitive settings, with substandard equipment and ingredients ). Equally concerning are the risks of contamination, absence of correct protocols and purification methods, and highly toxic reactants (Alves et al 2015;Caldicott et al 2005;Grund et al 2013;Martyny et al 2007;Ning Chiu et al 2011;). Hazards in production centre on the potential for life threatening injuries in places serving simultaneously as lab and home due to fires and explosions, and the exposure to toxic by-products of bystanders and children ( Acute effects reported were similar to those reported in the literature and centred on disinhibition, euphoria, decreased need for food and sleep, increased sociability, wellbeing and energy, and with a high probability of dependence (Sheridan et al 2006).…”

Section: Discussionmentioning

confidence: 99%

Shake ‘N Bake: the Migration of ‘Pervitin’ to Ireland

Hout

Hearne²

2016

Int J Ment Health Addiction

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Home manufactured methamphetamine known as 'Pervitin' has historically dominated the drug market in the Czech and Slovak Republics. Seizures and surveillance data indicate some displacement of 'Pervitin' across Europe to areas of low reported prevalence (Nordic countries, Germany, Cyprus, Greece and Portugal). We present the first single case study of clandestine production of 'Pervitin' to Ireland, a country with low reporting history of methamphetamine. Content analysis yielded three descriptive themes; 'Pervitin' use, Decisions to Use and Effects; Legality and Hazards; and 'Clandestine Manufacture.' The study yielded unique insight into migration of this culturally specific drug, and how continued cultural contexts for use and 'cooking' remain intact when residing in the host country. Given its unique cultural nature and national characteristics, continued migration of Eastern European citizens across Europe, diffusion of clandestine production warrants continued surveillance. Appropriate service responses require culturally appropriate information and outreach services to Eastern European service users.

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