People in Siberia shooting up krokodil, taken from the VICE film Krokodil Tears. Photo by Stuart Griffiths.
You remember when we first alerted you to the joys of krokodil, right? In case you’d forgotten, it’s a drug from Russia that is just like heroin, except that it eats your flesh alive (NSFW link) because it’s made of painkillers cut with things like gasoline and sulfur. In other words, it’s probably the worst drug in the world. Well, unfortunately, it seems to be spreading. It made headlines last week when reports came through that it was being used in Arizona. And in the UK, Dr. Allan Harris, a specialist in treating drug addicts and the homeless, has reported that "there are plenty of warning signs" that krokodil is being used in Gloucester, where his drug clinic is. In an article he wrote for the Independent, he also mentioned that he'd treated a man in his early 30s who he believed had injected krokodil.
I called Dr. Harris to discuss his findings. We tried to negotiate whether to call the drug “krokodil” (from the Russian) or to Anglicize it now that it had made its way over from the mainland and start referring to it as “crocodile.” (I've used the former here, but Dr. Harris was pretty adamant about using the latter.) More importantly, it was an illuminating insight into the UK’s depressing cutting-drugs-with-things-that-are-even-worse-for-you-than-drugs scene.
VICE: So is it just the one case of krokodil that you found?
Dr Alan Harris: Yeah, I mean, it’s a bit retrospective really because it was a few years ago now. At the time, I just thought it was the citric acid burns of a heroin user, but looking back the tissue destruction was far, far in excess [of what you'd expect from that]. When you get citric acid issues you usually get second-degree burns, but this actually took out a huge crater of all the forearm muscle. When you took out the dead tissue you could actually see the tendons moving at the base of this crater and the bones as well—so pretty much like these horrific pictures you see on the warning leaflets for krokodil. It actually got to a point where he couldn’t move his right hand any more because it weakened the muscle so much. He could roll a cigarette and that was about it.
So how did they treat it?
They put a free skin graft over the top, which all healed OK but it was horrendous. The muscles never grew back because they were completely gangrenous. Looking back, it didn’t fit at all with citric acid because that’s an irritant but no worse than a slight infection. This was actually very, very disproportionate. From one small injection he took out the area of about 12 by eight centimeters of tissue, and quite deep as well—skin down to bone. What’s this about citric acid?
You put your heroin powder on the spoon with a bit of citric acid—lemon juice is commonly used. Heroin addicts use that when they’re fixing up because diamorphine is an alkaline. So when you use citric acid, which is a weak acid, it makes the solution more readily.
I see. What happened to this guy?
He died recently, unfortunately. Sorry to hear that. Has it been confirmed that he died from krokodil use?
Investigations are ongoing. I couldn’t say for sure, I’m afraid. We’re still waiting on the toxicology results from the coroner. Do you think cutting drugs with weird stuff is becoming more widespread in this country?
Yeah, almost certainly. We’ve had problems with tetanus and anthrax being found in batches of heroin. Previously we'd worry about it being cut with strychnine. Anything with a bitter taste, the dealers will use it to cut heroin with. This stuff is readily available and only takes about half an hour for people to make themselves. All the toxic ingredients go straight into the vein and that’s what causes the horrific loss of tissue.
Our film Siberia: Krokodil Tears
Given the horrifying effects it has, why would anyone want to take this stuff?
Well, it’s very potent, highly addictive, more sedative and about ten times stronger than morphine, so from that point of view it has more addictive potential than regular morphine or diamorphine—i.e., heroin. And it has more of a damping down effect, as well. It was developed in the 1930s in America and it has a strong narcotic, sedative, anaesthetic, painkilling agent. Sadly, it retains its properties today. What’s driving this? Has there been a problem with the heroin supply?
There has been recently. We saw it historically; obviously we had the war efforts in Afghanistan, where they destroyed huge poppy fields. Throughout the year there was a dip in availability, so users were taking heroin that was cut with so much stuff they were getting detox symptoms, because it wasn’t strong enough. More recently there has been a decline in heroin—I think through better policing—though the availability of it seems to be on the up again now. Drug dealers are getting to supplies again and it will probably takes the onus off people making their own heroin substitutes, such as krokodil. And of course when it's been low the use of mephedrone has increased as well. They use a similar chemical process to fix that up—similar agents. Similar to krokodil?
Yeah, because they’re krokodilizing Mkat—you know, “meow meow”—to make it injectable and more potent so we’ve seen more intravenous mephedrone use recently to compensate for the reduction in heroin. It’s quite… gooey, the stuff they’re making up. Sometimes it even solidifies in the barrel of the syringe. It’s pretty unpleasant, is what I'm trying to say, and we’ve seen a few blood clots in users who have injected into the femoral vein at the top of the leg.
Another one is pregabalin. It’s usually used to treat epilepsy, pain, and anxiety. But it’s gotten street value and we’ve been seeing some of that being diverted [into recreational drug use] as well. The news of it getting out has been quite slow, really; I think there’s not been much publicity about it and I hope it doesn’t come out, but it’s so easily made I think it’s only a matter of time before people do start trying to make their own stuff.
Is there anything particular to Gloucester that made this take place there?
No, not really. Ironically, Gloucester is the cheapest place in the country for heroin. Usually in most places it’s $32 per quarter-pound bag and in Gloucester it's has always been about $16. I mean obviously the quality and amounts you get of the drug are variable. What should be done about it?
I think as far as krokodil use goes, it is incredibly bad news but I think you should avoid it at all costs. We should really be making more people aware and we’ve got lots of posters up in the clinic in Gloucester. I think it’s about raising awareness in the drug-user community that this stuff is incredibly bad for you and often shortens your lifespan dramatically as it is highly addictive.
Follow Simon on Twitter: @simonchilds13
More on horrible drugs:
WATCH - Siberia: Krokodil Tears
WATCH - Heroin Holiday
READ - Bath Salts in the Wound