Commentary on “A new drug with a nasty bite: A case of krokodil-induced skin necrosis in an intravenous drug user”

DARK Classics in Chemical Neuroscience: Heroin and Desomorphine

“…In North America, some cases have been reported in both Canada , and the US ,,− (in newspapers and scientific articles), most of which are heavily based on patient history and the admission of krokodil use by drug users . However, the absence of confirmed toxicological results make their veracity doubtful, as some authors have pointed out. , As a result, the true prevalence of krokodil use in the US is relatively unknown. , To date, there are no reliable reports of the use of the drug in Mexico or Central or South America.…”

“…219 However, the absence of confirmed toxicological results make their veracity doubtful, as some authors have pointed out. 220,221 As a result, the true prevalence of krokodil use in the US is relatively unknown. 4) is the common name for 4,5-α-epoxy-17methylmorphinan-3-ol (dihydrodesoxymorphine-D; CAS Registry Number 427-00-9).…”

Doubts about first report of krokodil use in Canada

“…1 Although the authors report that use of krokodil (desomorphine) has been increasing in North America, reports of krokodil harms in North America have not been toxicologically confirmed. 2 Claims of krokodil use have been circulating since 2013, all without toxicological evidence. Ghazawi and Beecker did not explain how their patient was able to access large quantities of codeine as a precursor and why the patient would favour this toxic homemade brew over more easily accessible heroin.…”