Consumo de krokodil por vía oral en España: a propósito de un caso

Abstract

The krokodil use disorder is an addictive pathology with quite severe organic effects, especially at the skin level, that causes severe and degenerative necrosis of blood and muscle tissue. Though this disorder has a low prevalence in Spain, compared to the large number of consumers in other countries such as Ukraine or Russia, its consumption is slowly but gradually expanding in countries of the European Union and America. The simplicity of the process of obtaining the substance from desomorphine, together with its high availability and low cost, contribute toward consumers' self-sufficiency.This article presents the case of a user of krokodil and reviews the clinical symptoms of oral ingestion.Keywords: Krokodil; Substance use; Oral ingestion; Desomorphine.El trastorno por uso de krokodil es una de las patologías adictivas con mayores repercusiones orgánicas, principalmente a nivel cutáneo, produciendo una grave y degenerativa necrosis del tejido sanguíneo y muscular. Se trata de un trastorno con escasa prevalencia en España, frente al elevado número de consumidores en otros países como Ucrania o Rusia, si bien se está produciendo una lenta aunque gradual expansión del consumo en países de la Unión Europea y del continente americano. El sencillo proceso de obtención de la sustancia desde la desomorfina, unido a la elevada disponibilidad y bajo coste, configura el proceso de autoabastecimiento de los consumidores. En este artículo revisamos un cuadro clínico, presentando el caso de un paciente que consume krokodil por vía oral.Palabras clave: Krokodil; Uso de sustancias; Vía oral; Desomorfina. Consumo de krokodil por vía oral en España: a propósito de un caso

Meth Mouth—A Growing Epidemic in Dentistry?

“…Concerning the influence on soft-tissues, Haskin et al, reported extended, non-healing, necrotic skin wounds on the legs after long-time desomorphine abuse [ 24 ]. Baquero Escribano et al, described also that desomorphin is able to induce skin wounds and skin necrosis and further necrosis of blood and muscle tissues [ 25 ]. This might lead to the assumption that methamphetamine-induced osteonecrosis of the jaws might be caused or triggered by methamphetamine’s influence on soft-tissues and vascularization.…”

DARK Classics in Chemical Neuroscience: Heroin and Desomorphine

“…Since its appearance in Russia, the drug quickly spread to other neighboring former Soviet republics, especially Ukraine (which had around 20 000 cases in 2011), , as well as Georgia, − Armenia, , and Kazakhstan. , The first western European country to report cases of krokodil use was Germany in 2011 . Subsequently, cases (both confirmed and suspected) have been reported in other European countries, such as France, Italy, Norway, Spain, and Poland, , with a significant part of them imported from Eastern Europe through immigrants from former Soviet republics . It is noteworthy that various reviews mention cases reported in the Czech Republic, Sweden, Belgium, and Portugal, ,,, but reliable information about these cases could not be found by the authors of the current review.…”

“…Just like heroin and many other opioids, desomorphine is administered intravenously (the most common route), intramuscularly, and subcutaneously, ,, although oral administration has also been reported . The reported harms caused by the drug’s administration can be local, systemic, and neurological (Table ).…”

“…172,177,178,186,208,210,223,224 Just like heroin and many other opioids, desomorphine is administered intravenously (the most common route), intramuscularly, and subcutaneously, 172,177,247 although oral administration has also been reported. 207 The reported harms caused by the drug's administration can be local, systemic, and neurological (Table 2). 172,177 It is noteworthy that the damage described seems to appear relatively soon after the consumption of krokodil begins, and that it is extreme and unprecedented, generally leading to death after 2−3 years.…”

Vasculitis asociada al consumo de cocaína adulterada con levamisol

“…La molécula del krokodil, muy similar a la de la morfina, es un potente µ-opioide con gran toxicidad y un poder analgésico 5 a 10 veces mayor que el de la morfina; se sintetiza a partir de la codeína combinada con otros aditivos de fácil obtención y bajo costo. El neologismo krokodil (del ruso cocodrilo) se originó a partir de la apariencia de piel de cocodrilo que pueden presentar los consumidores, con piel verdosa oscura y con descamación (4,5) . Con el diagnóstico clínico-patológico de vasculitis por consumo de cocaína adulterada, posiblemente con levamisol, se inició el tratamiento.…”