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'Krokodil' Drug FAQ

Deadly Drug May Have Entered the U.S.
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Sept. 30, 2013 -- A deadly, homemade drug known as krokodil may have made its way from Russia to the U.S.

Two people in Arizona are suspected of using the heroin-like drug, which rots the skin from the inside out, says Frank LoVecchio, DO, MPH. He is the co-medical director at the Banner Good Samaritan Poison & Drug Information Center in Phoenix, Ariz.

In the last week, he and his team have consulted with doctors about the patients, but he can't confirm the injections were krokodil because the drugs have not been tested.

LoVecchio says at least two other U.S. cities have unconfirmed reports of krokodil use. It’s named for the crocodile-like look it gives users’ rotting skin.

So far, there are no confirmed U.S. cases, says Barbara Carreno, a spokeswoman for the Drug Enforcement Administration. "We've been following this drug overseas for several years," she says. "We are very concerned about the possibility of this drug coming to the U.S."

Here, the two address other questions about the drug.

What is krokodil?

Krokodil is a homemade drug. It combines codeine, lighter fluids, gasoline, paint thinner, alcohol, and other ingredients, Carreno and LoVecchio say.

When and where did it become popular?

Krokodil was first used in Russia in 2003, according to the Journal of Addictive Diseases.

LoVecchio suspects krokodil took off in Russia because it was difficult to smuggle in heroin. Its use spread quickly across the country.

How is it used?

Users inject the drug because it delivers a faster high than in tablet form, LoVecchio says. "If the onset [of effects] was an hour or 2 for pill form, it could be within 5 to 10 minutes if you shoot it IV."

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