April 3, 2016

Health & Ed | March 15, 2012
Russia's lost generation is being eaten alive
The frightening, flesh-eating effects of the opium derivative Krokodil
Written by | Visual by Amina Batyreva

WARNING: This article contains potentially triggering content

Following the very first injection, skin starts to discolour, turning a scaly gray and green; it becomes scabrous and rots with continued use.  Emulating the skin of the reptile the drug is named after – and also the result of its bite – Krokodil leaves its user’s bone and muscle tissue exposed, rotting, and awaiting the onset of gangrene. Pictures of addicts are a vision akin to the body horror found in Cronenberg films.

Russia is home to the world’s highest ratio of heroin users – up to two and a half million, according to unofficial estimates. Krokodil, a synthetic opiate alternative to heroin seems to have first appeared in parts of Russia around 2002. Its rapid spread throughout the country is largely tied to the  2009 crackdown on Afghani heroin. Faced with limited supplies of the opiate and the resulting higher street prices, there has been a mass shift to Krokodil as a heroin-substitute.

The growth of narcotic drug use in Russia has occurred alongside the growth of a demographic known as “the Lost Generation.”  This cohort, which faces high levels of unemployment, violence, and drug addition, is made up of those whose developmental years coincided with the fall of the Soviet Union and the ensuing economic turmoil.

A 2010 report by the World Health Organization (WHO) quantifies the challenges faced by this group. “In the Russian Federation, in the period [between] 1985-1994, rates [of youth homicide] in the 10 to 24-year-old age bracket increased by over 150 per cent.” Contemporary data supports the notion that the lost generation faces increasing strife. In 2010, the Russian International News Agency (RIA Novosti) reported that, of the two and a half million Russian drug addicts, 20 per cent were school-aged children, 60 per cent were young people (aged 16 to 30) and 20 per cent are older people. Ria Novosti also reported that the number of users between the ages of six and 13 were increasing “dramatically.”

Krokodil delivers roughly the same high as heroin, but is three times cheaper: a single dose costs 5 euros, compared to 50 for heroin. Made from iodine, lighter fluid, gasoline, industrial cleaning oil and codeine, it can be cooked in 30 minutes in a users kitchen.

As simple as its creation process appears, Krokodil addicts spend their lives in a cycle of cooking and injecting, in continued attempts to avoid withdrawal. Compared to the four to eight hour-long high heroin promises, Krokodil delivers only about ninety minutes of euphoria, with intense withdrawal symptoms following soon after.

Another fact distinguishing opiates from synthetic-opiates: a Krokodil user’s death comes maximally two to three years from the first dose, and even a single dose may be lethal.

The chemical associated with Krokodil, desomorphine, was used as a morphine-substitute in the 1930s, and is eight to ten times more potent than morphine. Codeine can be turned into desomorphine in a series of chemical reactions, which – although easily achieved through a three-step synthesis in a legitimate lab holding all the relevant materials – is often impure when cooked in a dirty, ill-equipped kitchen. The resultant impurity has been determined as the cause of skin decay around injection time.

Why has Krokodil use become so widespread in Russia? The most significant reason seems to be the ease of accessing codeine-based analgesics – they’re sold over the counter nationwide.

According to a report by the Medical University of Silesia in Poland, there are currently an estimated 100 to 250 thousand confirmed Russian Krokodil addicts, and about 30 thousand deaths per year associated with the drug.

Its presence in Germany, the Czech Republic, Ukraine, France, Belgium, Sweden, and Norway was confirmed earlier this year, although an estimate of the numbers of users is not yet available for these regions.

As codeine is not as freely available in some of these countries, such as Germany, it is believed that Krokodil is currently cooked in Russia and transported along drug routes to Germany, often being sold as heroin. Because of the similar euphoria induced, users may often not realize that what they have consumed is anything but the more natural opiate – at least not till discoloration, scabs, and rotting set in.

Until recently, Russian authorities failed to recognize the drug as a major problem, making no moves to increase state-run rehabilitation facilities or limit over-the-counter sales of codeine-based analgesics.

Failure to do the latter can be ascribed to the huge profits pharmaceuticals have been reaping from over-the-counter codeine sales.

“Over the past five years, sales of codeine-based tablets have grown by dozens of times,” Viktor Ivanov, head of Russia’s Drug Control Agency, told UK’s the Independent last year.  “It’s pretty obvious that it’s not because everyone has suddenly developed headaches.”

“A year ago we said that we need to introduce prescriptions,” said 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 pharmaceuticals or pharmacies themselves to stop this.”

The country’s authorities have been loosely debating over the need to ban codeine or impose mandatory drug testing in schools, and President Dmitry Medvedev has called for websites detailing the recipe for Krokodil to be shut down. Banning codeine has been a harder measure to introduce, hindered by lobbying pharmaceutical companies in rigid opposition to it. Yet with this downward societal spiral in place, Russian authorities have announced plans to restrict sale of medicines containing codeine starting in June 2012.

The state now also has a working plan to create its first network of rehabilitation clinics over the coming years. Yet, in the short term, the Health Ministry currently runs only a few live-in rehab centers, with their capacity capped at about 2.5 million drug addicts. To fill this void, the majority of operational rehab clinics in the country at the moment are being run by religion-affiliated groups which border on fundamentalism.

The limited rehab facilities are just that: a void, and a pressing one. Withdrawal from Krokodil is a harrowing month-long endeavor, far more painful than the week it takes to overcome heroin withdrawal. Users are aware of this, and are often also aware of the flesh they will lose and the reality of imminent death, yet they return to it for its cheapness and ease of access.

“You can feel how disgusting it is when you’re doing it. You’re dreaming of heroin, of something that feels clean and not like poison,” Zhenzya, a recovered Krokodil addict, toldh Independent, “But you can’t afford it, so you keep doing the Krokodil. Until you die.”

While restricting over-the-counter sales of codeine-based pharmaceuticals is essential in tackling Krokodil use in the region, the need for assisted rehabilitation and more comprehensive social reforms focused on Russian youth is just as pressing. If a heroin habit is thought to be difficult to kick, addiction to and creation and trafficking of  “the drug that eats junkies” must be tackled just as firmly in an attempt to combat the self-imposed death sentence Krokodil junkies in Eastern Europe now face.


The Haps
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