A powerful heroin-like drug that rots flesh and bone has made its first reported appearance in the United States, an Arizona health official says.

Known on the street as "krokodil," the caustic homemade opiate is made from over-the-counter codeine-based headache pills mixed with iodine, gasoline, paint thinner or alcohol. When it's injected, the concoction destroys a user's tissue, turning the skin scaly and green like a crocodile. Festering sores, abscesses and blood poisoning are common.

Frank LoVecchio, the co-medical director at the Banner Good Samaritan Poison & Drug Information Center, told KPHO-TV that Arizona health officials have seen two cases during the past week.

"As far as I know, these are the first cases in the United States that are reported," he said. "So we're extremely frightened."

LoVecchio did not say where in the state the patients were located or provide details about their conditions.

The drug — chemically called desomorphine — emerged around 2002 in Siberia and the Russian Far East but has swept across the country in just the past three years, according to a Time magazine investigation.

Krokodil became popular in Russia because heroin can be difficult to obtain and is expensive. Krokodil costs three times less, and the high is similar to heroin though much shorter, usually 90 minutes.

The average life expectancy among krokodil addicts in Russia is two to three years, according to Time, which called the narcotic "the most horrible drug in the world." Gangrene and amputations are common, and the toxic mix dissolves jawbones and teeth, much like the methamphetamine that Walter White cooks in Breaking Bad.

As with all intravenous drug addicts, krokodil users are susceptible to HIV, hepatitis C and other blood-borne diseases, and have compromised immune systems.

One recovering Russian krokodil addict, Irina Pavlova, told Time in 2011 that she injected the drug almost daily for six years. She has a speech impediment and impaired motor skills because of the resulting brain damage.

Her brother was among the dozen or so addicts she shot up with. "Practically all of them are dead now," she said. "For some, it led to pneumonia, some got blood poisoning, some had an artery burst in their heart, some got meningitis, others simply rot."

A Russian woman using krokodil in June 2011 told The Independent that a fellow junkie refused to go to the hospital.

"Her flesh is falling off and she can hardly move anymore," she said.

Oleg glances furtively around him and, confident that nobody is watching, slips inside the entrance to a decaying Soviet-era block of flats, where Sasha is waiting for him. Ensconced in the dingy kitchen of one of the apartments, they empty the contents of a blue carrier bag that Oleg has brought with him – painkillers, iodine, lighter fluid, industrial cleaning oil, and an array of vials, syringes, and cooking implements.

Half an hour later, after much boiling, distilling, mixing and shaking, what remains is a caramel-coloured gunge held in the end of a syringe, and the acrid smell of burnt iodine in the air. Sasha fixes a dirty needle to the syringe and looks for a vein in his bruised forearm. After some time, he finds a suitable place, and hands the syringe to Oleg, telling him to inject the fluid. He closes his eyes, and takes the hit.

Russia has more heroin users than any other country in the world – up to two million, according to unofficial estimates. For most, their lot is a life of crime, stints in prison, probable contraction of HIV and hepatitis C, and an early death. As efforts to stem the flow of Afghan heroin into Russia bring some limited success, and the street price of the drug goes up, for those addicts who can't afford their next hit, an even more terrifying spectre has raised its head.

The home-made drug that Oleg and Sasha inject is known as krokodil, or "crocodile". It is desomorphine, a synthetic opiate many times more powerful than heroin that is created from a complex chain of mixing and chemical reactions, which the addicts perform from memory several times a day. While heroin costs from £20 to £60 per dose, desomorphine can be "cooked" from codeine-based headache pills that cost £2 per pack, and other household ingredients available cheaply from the markets.

It is a drug for the poor, and its effects are horrific. It was given its reptilian name because its poisonous ingredients quickly turn the skin scaly. Worse follows. Oleg and Sasha have not been using for long, but Oleg has rotting sores on the back of his neck.

"If you miss the vein, that's an abscess straight away," says Sasha. Essentially, they are injecting poison directly into their flesh. One of their friends, in a neighbouring apartment block, is further down the line.

"She won't go to hospital, she just keeps injecting. Her flesh is falling off and she can hardly move anymore," says Sasha. Photographs of late-stage krokodil addicts are disturbing in the extreme. Flesh goes grey and peels away to leave bones exposed. People literally rot to death.

Russian heroin addicts first discovered how to make krokodil around four years ago, and there has been a steady rise in consumption, with a sudden peak in recent months. "Over the past five years, sales of codeine-based tablets have grown by dozens of times," says Viktor Ivanov, the head of Russia's Drug Control Agency. "It's pretty obvious that it's not because everyone has suddenly developed headaches."

Heroin addiction kills 30,000 people per year in Russia – a third of global deaths from the drug – but now there is the added problem of krokodil. Mr Ivanov recalled a recent visit to a drug-treatment centre in Western Siberia. "They told me that two years ago almost all their drug users used heroin," said the drugs tsar. "Now, more than half of them are on desomorphine."

He estimates that overall, around 5 per cent of Russian drug users are on krokodil and other home-made drugs, which works out at about 100,000 people. It's a huge, hidden epidemic – worse in the really isolated parts of Russia where supplies of heroin are patchy – but palpable even in cities such as Tver.

It has a population of half a million, and is a couple of hours by train from Moscow, en route to St Petersburg. Its city centre, sat on the River Volga, is lined with pretty, Tsarist-era buildings, but the suburbs are miserable. People sit on cracked wooden benches in a weed-infested "park", gulping cans of Jaguar, an alcoholic energy drink. In the background, there are rows of crumbling apartment blocks. The shops and restaurants of Moscow are a world away; for a treat, people take the bus to the McDonald's by the train station.

In the city's main drug treatment centre, Artyom Yegorov talks of the devastation that krokodil is causing. "Desomorphine causes the strongest levels of addiction, and is the hardest to cure," says the young doctor, sitting in a treatment room in the scruffy clinic, below a picture of Hugh Laurie as Dr House.

"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."

Dr Yegorov says krokodil users are instantly identifiable because of their smell. "It's that smell of iodine that infuses all their clothes," he says. "There's no way to wash it out, all you can do is burn the clothes. Any flat that has been used as a krokodil cooking house is best forgotten about as a place to live. You'll never get that smell out of the flat."

Addicts in Tver say they never have any problems buying the key ingredient for krokodil – codeine pills, which are sold without prescription. "Once I was trying to buy four packs, and the woman told me they could only sell two to any one person," recalls one, with a laugh. "So I bought two packs, then came back five minutes later and bought another two. Other than that, they never refuse to sell it to us, even though they know what we're going to do with it." The solution, to many, is obvious: ban the sale of codeine tablets, or at least make them prescription-only. But despite the authorities being aware of the problem for well over a year, nothing has been done.

President Dmitry Medvedev has called for websites which explain how to make krokodil to be closed down, but he has not ordered the banning of the pills. Last month, a spokesman for the ministry of health said that 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.

"A year ago we said that we need to introduce prescriptions," says Mr Ivanov. "These 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 government needs to use its power to regulate their sale."

In addition to krokodil, there are reports of drug users injecting other artificial mixes, and the latest street drug is tropicamide. Used as eye drops by ophthalmologists to dilate the pupils during eye examinations, Dr Yegorov says patients have no trouble getting hold of capsules of it for about £2 per vial. Injected, the drug has severe psychiatric effects and brings on suicidal feelings.

"Addicts are being sold drugs by normal Russian women working in pharmacies, who know exactly what they'll be used for," said Yevgeny Roizman, an anti-drugs activist who was one of the first to talk publicly about the krokodil issue earlier this year. "Selling them to boys the same age as their own sons. Russians are killing Russians."

Zhenya, quietly spoken and wearing dark glasses, agrees to tell his story while I sit in the back of his car in a lay-by on the outskirts of Tver. He 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. He lost 14 teeth after his gums rotted away, and contracted hepatitis C.

But his fate is essentially a miraculous escape – after all, he's still alive. Zhenya is from a small town outside Tver, and was a heroin addict for a decade before he moved onto krokodil a year ago. Of the ten friends he started injecting heroin with a decade ago, seven are dead.

Unlike heroin, where the hit can last for several hours, a krokodil high only lasts between 90 minutes and two hours, says Zhenya. Given that the "cooking" process takes at least half an hour, being a krokodil addict is basically a full-time job.

"I remember one day, we cooked for three days straight," says one of Zhenya's friends. "You don't sleep much when you're on krokodil, as you need to wake up every couple of hours for another hit. At the time we were cooking it at our place, and loads of people came round and pitched in. For three days we just kept on making it. By the end, we all staggered out yellow, exhausted and stinking of iodine."

In Tver, 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.

Zhenya says every single addict he knows in his town has moved from heroin to krokodil, because it's cheaper and easier to get hold of. "You can feel how disgusting it is when you're doing it," he recalls. "You're dreaming of heroin, of something that feels clean and not like poison. But you can't afford it, so you keep doing the krokodil. Until you die."

Some of the names in this story have been changed

 Gentleman_Jellyfish wrote:
Hell yea Krokodil!

We need a Breaking Bad version with that

 Alfndrate wrote:

 Gentleman_Jellyfish wrote:
Hell yea Krokodil!

We need a Breaking Bad version with that

Kracking Krokodil?

"She won't go to hospital, she just keeps injecting. Her flesh is falling off and she can hardly move anymore," says Sasha. Photographs of late-stage krokodil addicts are disturbing in the extreme. Flesh goes grey and peels away to leave bones exposed. People literally rot to death.

 Dreadclaw69 wrote:
If you know the risks, have seen people suffer and die from it, know that you're injecting lighter fluid/industrial cleaner/gasoline/etc. then my sympathy is 0

"She won't go to hospital, she just keeps injecting. Her flesh is falling off and she can hardly move anymore," says Sasha. Photographs of late-stage krokodil addicts are disturbing in the extreme. Flesh goes grey and peels away to leave bones exposed. People literally rot to death.

But the important question is; do they come back as zombies, or as Plaguebearers?

 timetowaste85 wrote:
Pretty much this. If you're stupid enough to willingly inject gasoline into your blood stream, you don't deserve to be part of the gene pool. Earn yourself a Darwin Award.

djones520 wrote:But but but... if we would just legalize heroin, people would stop injecting themselves with flesh eating drugs.

*rolls eyes*

 azazel the cat wrote:

djones520 wrote:But but but... if we would just legalize heroin, people would stop injecting themselves with flesh eating drugs.

*rolls eyes*

I don't understand the eyeroll. Your statement is generally correct. If heroin were legalized, then its cost would significantly decrease, and thus alternatives like krokodil would generally not be considered. There may be some moral debate about it, but that is a different discussion.

 djones520 wrote:
But but but... if we would just legalize heroin, people would stop injecting themselves with flesh eating drugs.

*rolls eyes*

 RatBot wrote:
I can't imagine anyone willing injecting themselves with a caustic gasoline mixture if a legal, cheaper, safer alternative was available. Of course, I can't imagine anyone willingly injecting themselves with gasoline under any circumstances, but, well.

 AlexHolker wrote:

 RatBot wrote:
I can't imagine anyone willing injecting themselves with a caustic gasoline mixture if a legal, cheaper, safer alternative was available. Of course, I can't imagine anyone willingly injecting themselves with gasoline under any circumstances, but, well.

The flaw in your logic is that heroin is what makes people stupid enough to willingly inject themselves with these caustic materials. In a way, heroin is even more dangerous than krokodil, because krokodil is so blatantly horrible that people will rightly avoid it like the plague if a more insidious drug doesn't pave the way.

 RatBot wrote:
Well, just to play devil's advocate, the heroin addicts are turning to Krokodil because it's much cheaper and much easier to obtain than herion. If given access to a reliable and inexpensive source of heroin, they likely wouldn't start using krokodil.

To say that heroin use will degenerate into krokodil use is like saying marijuana use will eventually degenerate into use of harder drugs. I know many people who smoke marijuana, exactly none of them have moved on to harder stuff.