Desomorphine (Krokodil): An overview of its chemistry, pharmacology, metabolism, toxicology and analysis

Florez, Diego Hernando Ângulo; Moreira, Ana Maria dos Santos; Silva, Pedro Rafael da; Brandão, Ricardo; Borges, Marcella Matos Cordeiro; Santana, Fernando José Malagueño de; Borges, Keyller Bastos

doi:10.1016/j.drugalcdep.2016.12.021

Cited by 20 publications

(33 citation statements)

References 59 publications

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“…Improved controls over heroin trafficking has led to the resurgence of novel psychoactive substances, of which desomorphine has re‐entered the illicit drug scene, originating in Siberia and spreading throughout Russia, Ukraine, Georgia and other former countries of the Soviet Republic . Desomorphine is a semi‐synthetic derivative of morphine and so has similar analgesic, sedative and euphoric activity by binding to mu opioid receptors . Its pharmacokinetic characteristics, including increased lipophilicity, faster onset of action and shorter half‐life compared to morphine, are thought to be responsible for its addictive and reinforcement properties .…”

Section: Opioids – Heroin and Methadonementioning

confidence: 99%

“…Desomorphine is a semi‐synthetic derivative of morphine and so has similar analgesic, sedative and euphoric activity by binding to mu opioid receptors . Its pharmacokinetic characteristics, including increased lipophilicity, faster onset of action and shorter half‐life compared to morphine, are thought to be responsible for its addictive and reinforcement properties . The homemade production of desomorphine by the combination of codeine‐containing products (analgesic or antitussive preparations) and other readily available ingredients such as iodine, soda, red phosphorus, gasoline and hydrochloric acid produces an injectable liquid.…”

Section: Opioids – Heroin and Methadonementioning

confidence: 99%

“…The route of administration is usually by either intramuscular or intravenous injection, making the user susceptible to the harmful effects of the other components . Desomorphine gained its moniker, ‘krokodil’, ‘crocodile’, ‘croc’ or ‘krok’ due to the adverse effect the injection produces, which is a black and green discoloured, flaking skin, similar to that of a crocodile …”

Section: Opioids – Heroin and Methadonementioning

confidence: 99%

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Oral manifestations of illicit drug use

Teoh

Moses

McCullough

2019

Australian Dental Journal

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The use of illicit and misuse of licit drugs is a global public health problem, with illicit drug use being responsible for 1.8% of the total disease burden in Australia in 2011. Oral adverse effects associated with illicit drug use are well-established, with aggressive caries, periodontitis, bruxism, poor oral hygiene and general neglect documented. Other factors such as a high cariogenic diet and lifestyle, social and psychological factors compound the poorer oral health in illicit drug users. Literature has shown that the oral health-related quality of life among injecting drug users is poorer compared with the Australian general population and the overall quality of life of addicted people correlates with caries experience. Thus, the role of the dentist is imperative in managing the oral health of these individuals. Given their widespread recreational use, it is likely that dental practitioners will encounter patients who are regular or past users of illicit drugs. The aim of this article is to describe the prevalence and mechanism of action of commonly used illicit drugs in Australia, including cannabis, methamphetamine, cocaine and heroin and to inform dentists about the common orofacial presentations of their side effects to help with patient management.Abbreviations and acronyms: CBD = cannabidiol; CNS = central nervous system; MA = methamphetamine; ONJ = osteonecrosis of the jaw; THC = delta-9 tetrahydrocannabinol.

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Section: Opioids – Heroin and Methadonementioning

confidence: 99%

Section: Opioids – Heroin and Methadonementioning

confidence: 99%

Section: Opioids – Heroin and Methadonementioning

confidence: 99%

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Oral manifestations of illicit drug use

Teoh

Moses

McCullough

2019

Australian Dental Journal

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“…Respiratory depression can manifest as cyanosis and have severe (neural damage caused by cerebral hypoxia) or even fatal consequences [ 10 ]. Paraesthesia (abnormal dermal sensations), urinary retention, and histamine-mediated reactions (emesis, flushing, itching, and nausea) have been also reported for opiate use [ 23 ]. Prolonged abuse results in physical and psychological dependence, the development of tolerance (possibly due to the desensitization and internalisation of µ receptors [ 24 ], and probable formation of opiate antibodies [ 25 ]), and is associated with the onset of withdrawal syndrome (symptoms include: agitation, diarrhoea, insomnia, muscle cramps, panic attacks, and sweating), when dosing is abruptly discontinued [ 26 , 27 ].…”

Section: Resultsmentioning

confidence: 99%

Pharmacological Aspects of Over-the-Counter Opioid Drugs Misuse

Sobczak

Goryński

2020

Molecules

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Several over-the-counter (OTC) drugs are known to be misused. Among them are opioids such as codeine, dihydrocodeine, and loperamide. This work elucidates their pharmacology, interactions, safety profiles, and how pharmacology is being manipulated to misuse these common medications, with the aim to expand on the subject outlined by the authors focusing on abuse prevention and prevalence rates. The reviewed literature was identified in several online databases through searches conducted with phrases created by combining the international non-proprietary names of the drugs with terms related to drug misuse. The results show that OTC opioids are misused as an alternative for illicit narcotics, or prescription-only opioids. The potency of codeine and loperamide is strongly dependent on the individual enzymatic activity of CYP2D6 and CYP3A4, as well as P-glycoprotein function. Codeine can also be utilized as a substrate for clandestine syntheses of more potent drugs of abuse, namely desomorphine (“Krokodil”), and morphine. The dangerous methods used to prepare these substances can result in poisoning from toxic chemicals and impurities originating from the synthesis procedure. OTC opioids are generally safe when consumed in accordance with medical guidelines. However, the intake of supratherapeutic amounts of these substances may reveal surprising traits of common medications.

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“…Drug monitoring agencies like the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) rely on analytical methods capable of screening and identifying forensic evidence relevant to "Krokodil" synthesis and distribution [9]. Current analytical methods typically involve the use of gas chromatography/mass spectrometry (GC/MS) or liquid chromatography/mass spectrometry (LC/MS) [10][11][12][13]. While being well-established analytical techniques, both are known to require extensive sample preparation and lengthy separation/analysis times and are primarily restricted to laboratory-based applications.…”

Section: Introductionmentioning

confidence: 99%

Trace-Level Screening of Chemicals Related to Clandestine Desomorphine Production with Ambient Sampling, Portable Mass Spectrometry

Hall

O'Leary

Lawton

et al. 2017

Journal of Chemistry

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Desomorphine is a semisynthetic opioid that is responsible for the psychoactive effects of a dangerous homemade injectable mixture that goes by street name "Krokodil." Desorption electrospray ionization (DESI) and paper spray ionization (PSI) are implemented on a portable mass spectrometer for the direct analysis of desomorphine and precursor reagent codeine from multiple substrates of potential relevance to clandestine drug laboratory synthesis and paraphernalia seizure. Minimal sample preparation required for analysis and portability of the instrument suggest the potential for rapid, on-site analysis of evidence, a highly desired benefit for forensic science and law enforcement practitioners. Both DESI-MS and PSI-MS can generate spectra consistent with preceding data obtained using traditional ionization methods, while demonstrating detection limits in the low-to sub-ng levels.

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Desomorphine (Krokodil): An overview of its chemistry, pharmacology, metabolism, toxicology and analysis

Cited by 20 publications

References 59 publications

Oral manifestations of illicit drug use

Oral manifestations of illicit drug use

Pharmacological Aspects of Over-the-Counter Opioid Drugs Misuse

Trace-Level Screening of Chemicals Related to Clandestine Desomorphine Production with Ambient Sampling, Portable Mass Spectrometry

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