A poison control center in Phoenix has treated two people who apparently were using krokodil, KPHO reports. The homemade opiate is commonly used in Russia. If confirmed, the cases would be the first known instances of krokodil use in the United States.

The name of the drug, which means “crocodile” in Russian, apparently refers to the drug’s dramatic effect on its users. After sustained use, a person’s skin turns greenish and scaly and begins to fall away. Krokodil “regularly causes complications” such as rotting skin, burst veins and gangrene, according to a review in the Journal of Addictive Diseases.

The psychoactive agent in the drug is desomorphine, a more potent derivative of morphine that was first synthesized in the United States in 1932, according to a New York state agency. Krokodil can be prepared quickly and cheaply from codeine pills, as well as other ingredients such as gasoline, paint thinner and red phosphorus. In the last few years, it has become popular in Russia as an inexpensive alternative to heroin. In 2011, Time reported that seizures of krokodil by Russian authorities had increased 23-fold in the previous two years. The magazine also reported that addiction is usually fatal, and described one woman who survived:

The average user of krokodil, a dirty cousin of morphine that is spreading like a virus among Russian youth, does not live longer than two or three years, and the few who manage to quit usually come away disfigured. But [Irinia] Pavlova says she injected the drug nearly every day for six years, having learned to cook it in her brother’s kitchen. “God must have protected me,” she says. But the addiction still left some of its trademark scars. She developed a speech impediment, and her pale blue eyes have something of a lobotomy patient’s vacant gaze. “Her motor skills are shot from the brain damage,” says Andrei Yatsenko, the house manager, who was addicted to heroin for seven years. “She’ll try to walk forward and instead jolts back into something. So we try to be gentle with her.”


A spokeswoman for the Drug Enforcement Administration told Mother Jones that the agency had not yet confirmed the reported cases in Arizona, but, she added, “This concerns us very much.