Desomorphine is a semi-synthetic opioid, a potent derivative of morphine first created for medical use that has gained notoriety as a dangerous illicit substance. This powerful, fast-acting opioid produces sedation and pain relief, and its journey from a pharmaceutical to a street drug highlights a significant public health concern.
Medical Origins and Legitimate Use
Desomorphine was first synthesized in the United States in 1932. The goal was to develop a morphine alternative with potent pain relief, fewer side effects, a rapid onset, and a short duration of action. This made it suitable for specific medical situations like post-operative pain management.
The substance was commercialized and used medically in Europe under the brand name Permonid. It was recognized for its powerful analgesic properties. Medically, desomorphine is approximately eight to ten times more potent than morphine, meaning a smaller dose was required for similar pain relief.
Despite its effectiveness, the therapeutic use of desomorphine was short-lived due to its high potential for dependence. Concerns over its addictive nature and side effects, such as respiratory depression, led to its withdrawal from most markets by the mid-20th century.
Illicit Synthesis and the Rise of Krokodil
The modern infamy of desomorphine is tied to its illicit, homemade production, which results in a substance known as “Krokodil”. This name, Russian for crocodile, is believed to originate from the green, scaly appearance of users’ skin at injection sites. The use of homemade desomorphine was first reported in Siberia around 2003 and spread through Russia and neighboring countries when heroin availability decreased.
The illicit synthesis process is simple and dangerous, contributing to the drug’s severe health consequences. It begins with codeine, which is “cooked” with a hazardous mix of easily obtainable chemicals including:
- Iodine
- Gasoline
- Paint thinner
- Hydrochloric acid
- Red phosphorus from matchboxes
This crude manufacturing process results in a highly impure final product. The resulting liquid contains desomorphine and a cocktail of toxic and corrosive byproducts. These contaminants, rather than the desomorphine molecule itself, are responsible for many of the devastating physical effects associated with Krokodil.
Physiological Effects
The psychoactive effects of desomorphine are similar to other opioids, binding to mu-opioid receptors in the brain to produce euphoria and sedation. The drug has a fast onset and a short duration of action, often lasting only two to three hours. This encourages frequent injections to maintain the effect, which increases the risk of dependence.
The most severe consequences of Krokodil use stem from the toxic impurities left over from its synthesis. Injecting this contaminated mixture causes immediate damage to the body’s tissues. The corrosive solvents destroy blood vessels, leading to thrombophlebitis, which is severe vein inflammation and clotting that compromises blood flow.
This vascular damage initiates severe abscesses, and the tissue begins to die in a process called necrosis. This can progress to gangrene, where large areas of soft tissue rot away, sometimes exposing the underlying bone. The skin often takes on a greenish, scaly appearance from this damage, which is a reason for the drug’s moniker.
Neurological and Long-Term Consequences
The damage caused by Krokodil extends beyond the visible effects. The toxic chemicals in the illicitly produced drug circulate throughout the body, inflicting systemic harm. These substances are damaging to the central nervous system, leading to significant and often irreversible neurological problems.
Exposure to these toxins can cause a range of neurological impairments, including memory loss, difficulty concentrating, and cognitive decline. Motor skills can also be affected, resulting in speech impediments and impaired coordination. These symptoms are a direct result of brain damage.
The long-term outlook for individuals who use Krokodil is poor, with a high mortality rate. The contaminants cause widespread organ damage, particularly to the liver and kidneys. The combination of severe tissue necrosis, systemic infections, organ failure, and neurological damage often leads to permanent disability or death within a few years of starting use.