Tests fail to find traces of krokodil

October 28, 2013, 6:17 pm

Tests fail to identify krokodil: The Chicago Tribune reports that recent tests of drug samples have failed to find “krokodil“, the so-called “flesh-eating drug” that causes horrific soft tissue injuries when injected. “Krokodil” originated from — and has largely been confined to Russia — where desperate addicts faced with a shortage of heroin and corresponding high prices made their own home-brewed injectable opiate.

Until recently, codeine was inexpensive and available without prescription in Russia. Recipes detailing how to make injectable desomorphine from codeine were readily available. Unfortunately, the process involved using caustic and destructive reagents such as gasoline, paint thinner, hydrochloric acid, red phosphorous, and iodine.

Several weeks ago, an addiction doctor in Joliet, Illinois reported treating 3 patients with evidence of krokodil use. This came shortly after the Poison Control Center in Phoenix announced that they had consulted on two such cases. TPR raised questions about these cases at the time, pointing out that since “krokodil” was more a concept than an actual drug, the entire idea of laboratory confirmation was somewhat vague.

In any case, the Tribune article reveals that Jack Riley, special agent in charge of the Chicago FDA office, reported that after his agents made multiple buys of drugs in Chicago and its suburbs, they all tested positive for heroin, not desomorphine. Apparently, the patients in Joliet had also thought they were purchasing heroin, and developed sores at the point of injection. This is not at all unusual with parenteral drug users. As one drug researcher pointed out in the article, “In California once, there were these outbreaks of sores . . . It was because the heroin was coming across the border stuck up the rear ends of cows.”

The cases in Arizona might be a different story. According to the Tribune, some of the patients there had manufacturer their own krokodil, following instructions found on the internet. To my knowledge, there has not yet been a confirmed case of desomorphine exposure diagnosed in the United States.

On the current episode of the Tox Talk podcast, Matt Zuckerman talks with German physician Dr. Maximilian Gahr, who has published several papers on krokodil but apparently never seen a case himself. In the end, they raise more questions than there are answers.

More toxicology on the web:

At Vice.com, Roc Monn takes us on a poisoner’s tour of New York’s Central Park.

In Ontario, two people have died after ingesting “Bodico Hand Sanitizer”, a product that contained undeclared methanol instead of ethanol. (HT @DavidJuurlink)

 

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