Desomorphine (dihydrodesoxymorphine, Permonid) is an opioid invented in 1932 in the United States that is a derivative of morphine, where the 6-hydroxyl group has been removed and the 7,8 double bond has been reduced.[1] It has sedative and analgesic effects, and is around 8-10 times more potent than morphine.It was used in Switzerland under the brand name Permonid, and was described as having a fast onset and a short duration of action, with relatively little nausea or respiratory depression compared to equivalent doses of morphine. The traditional synthesis of desomorphine starts from α-chlorocodide, which is itself obtained by reacting thionyl chloride with codeine. By catalytic reduction, α-chlorocodide gives dihydrodesoxycodeine, which yields desomorphine on demethylation. "Krokodil"
Desomorphine attracted attention in 2010 in Russia due to an increase in clandestine production, presumably due to its relatively simple synthesis from codeine. The drug is easily made from codeine, iodine and red phosphorus,[8] in a process similar to the manufacture of methamphetamine from pseudoephedrine; like methamphetamine, desomorphine made this way is often highly impure and is contaminated with various toxic and corrosive byproducts. The street name in Russia for home-made desomorphine is "krokodil" (крокодил, crocodile), reportedly due to the scale-like appearance of skin of its users and the derivation from chlorocodide.[9] Due to difficulties in procuring heroin, combined with easy and cheap access to over-the-counter pharmacy products containing codeine in Russia, use of "krokodil" has been on the increase. The high associated with krokodil is akin to that of heroin, but lasts a much shorter period. While the effects of heroin use can last four to eight hours, the effects of krokodil do not usually extend past one and one half hours, with the symptoms of withdrawal setting in soon after. Krokodil takes roughly 30 minutes to an hour to prepare with over-the-counter ingredients in a kitchen.[10] Since the home-made mix is routinely injected immediately with little or no further purification, "krokodil" has become notorious for producing severe tissue damage, phlebitis and gangrene, sometimes requiring limb amputation in long-term users.[11] The amount of tissue damage is so high that addicts' life expectancies are said to be as low as two to three years, especially as they are often highly susceptible to infections and gangrene due to widespread HIV infection among injecting drug users in Russia. [12][13][14]
Abuse of home-made desomorphine was first reported in middle and eastern Siberia in 2002, but has since spread throughout Russia and the neighboring former Soviet republics. In October 2011, indications of "krokodil" use were found in Germany, with some media outlets claiming several dead users.[15] One death in Poland in December 2011 was also believed to be caused by "krokodil" use, and its use has been confirmed among Russian expatriate communities in a number of other European countries.[16]
Even in lesser cases, users can lose motor skills from the brain damage that the drug can do.[17]
[edit] Other ingredients
While crude amateur attempts to make krokodil will almost invariably still contain some remaining codeine as well as other, "accidentally produced" synthetic opioids such as iodocodeine, some of the krokodil produced also contains other drugs. For example, the codeine pills sold in Russia may also contain ingredients such as caffeine, paracetamol, or diphenhydramine (coincidentally an opioid potentiator); while chemicals such as tropicamide, found in over the counter eyedrops, may also be added to the mixture in attempt to prolong or enhance the experience. [18]
