‘Krokodil’—A Designer Drug from Across the Atlantic, with Serious Consequences

Thekkemuriyi, Dany V.; John, Santhosh; Pillai, Unnikrishnan

doi:10.1016/j.amjmed.2013.09.030

Cited by 36 publications

(34 citation statements)

References 2 publications

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“…It is used as a cheaper alternative to heroin. "Krokodil" is now widely spread in Russia, Ukraine and this drug is seen in European countries and USA [25,26]. Desomorphine was first captured by IBBS studies in 2009 and in 2012 and was mentioned as a most widespread injected drug [27].…”

Section: Discussionmentioning

confidence: 99%

Human immunodeficiency virus prevalence and risk determinants among people who inject drugs in the Republic of Georgia

Shengelia

Chikovani

Sulaberidze

2017

J Infect Dev Ctries

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Introduction: In Georgia as in most Eastern European countries, injecting drug use remains one of the leading transmission modes of HIV infection. This paper aims to identify HIV prevalence and risk determinants among people who inject drugs (PWID). Methodology: A cross -sectional, anonymous bio-behavioral survey of PWID was conducted in seven cities of Georgia in 2014-2015. Overall 2,022 PWID were investigated. Bivariate and multivariate regression analyses were performed to identify association of HIV positivity with other factors. Results: HIV prevalence among PWID was (2.2%, 95% CI 1.53-2.99). Significant associations were found between HIV positivity and history of drug injection (OR 1.03, p < 0.05), older age at first drug injection (OR 3.94, p < 0.01), safe sex behavior last year (OR 5.32, p < 0.01) and preventive program coverage (OR 2.0, p < 0.05). Conclusions: HIV prevalence among PWID is stable and remains at low level. Our study shows that preventive interventions influence the sexual behavior of HIV positive PWID, however, the majority of injecting drug users are still not reached with these interventions. A changing environment may present additional challenges for harm reduction and current safe practices may change unless continuously supported by innovative HIV prevention programming.

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Section: Discussionmentioning

confidence: 99%

Human immunodeficiency virus prevalence and risk determinants among people who inject drugs in the Republic of Georgia

Shengelia

Chikovani

Sulaberidze

2017

J Infect Dev Ctries

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“…The first confirmed report of krokodil use in Russia occurred in 2004. In 2012, reports of horrific krokodil-related injection injuries began to appear beyond Russia in Western Europe [1] and the United States [2]. We conducted this exploratory study to determine if several complementary data sources may provide insight into the relative scale and spatial patterns of behaviors consistent with an interest in the production and use of krokodil before and after the imposition of Russian federal restrictions on CCM sales in 2012.…”

Section: Introductionmentioning

confidence: 99%

Internet Search and Krokodil in the Russian Federation: An Infoveillance Study

Zheluk¹,

Quinn²,

Meylakhs³

2014

J Med Internet Res

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BackgroundKrokodil is an informal term for a cheap injectable illicit drug domestically prepared from codeine-containing medication (CCM). The method of krokodil preparation may produce desomorphine as well as toxic reactants that cause extensive tissue necrosis. The first confirmed report of krokodil use in Russia took place in 2004. In 2012, reports of krokodil-related injection injuries began to appear beyond Russia in Western Europe and the United States.ObjectiveThis exploratory study had two main objectives: (1) to determine if Internet search patterns could detect regularities in behavioral responses to Russian CCM policy at the population level, and (2) to determine if complementary data sources could explain the regularities we observed.MethodsFirst, we obtained krokodil-related search pattern data for each Russia subregion (oblast) between 2011 and 2012. Second, we analyzed several complementary data sources included krokodil-related court cases, and related search terms on both Google and Yandex to evaluate the characteristics of terms accompanying krokodil-related search queries.ResultsIn the 6 months preceding CCM sales restrictions, 21 of Russia's 83 oblasts had search rates higher than the national average (mean) of 16.67 searches per 100,000 population for terms associated with krokodil. In the 6 months following restrictions, mean national searches dropped to 9.65 per 100,000. Further, the number of oblasts recording a higher than average search rate dropped from 30 to 16. Second, we found krokodil-related court appearances were moderately positively correlated (Spearman correlation=.506, P≤.001) with behaviors consistent with an interest in the production and use of krokodil across Russia. Finally, Google Trends and Google and Yandex related terms suggested consistent public interest in the production and use of krokodil as well as for CCM as analgesic medication during the date range covered by this study.ConclusionsIllicit drug use data are generally regarded as difficult to obtain through traditional survey methods. Our analysis suggests it is plausible that Yandex search behavior served as a proxy for patterns of krokodil production and use during the date range we investigated. More generally, this study demonstrates the application of novel methods recently used by policy makers to both monitor illicit drug use and influence drug policy decision making.

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“…It has been first reported in the US in Arizona in 2013 [4]. Other cases have been reported in Saint Luis Missouri in 2014 [5], and Cleveland in 2015 [6]. Here we report a young woman who has been admitted with progressive bilateral necrotic arm ulcers after intravenous abuse of Krokodil.…”

mentioning

confidence: 88%

New case of krokodil (desomorphine) use

Caldararo¹,

Rad²,

Laborde³

et al. 2018

Int J Case Rep Images

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Introduction: Krokodil use was first reported in siberia in 2002. the drug derives its name from the harms associated with its use, such as ulcerations and discolored necrotic scaled skin which may resemble crocodile skin. It has also been described as "flesh eating", as it finally disrupts the skin leaving the bone and muscle exposed to infections. case report: A 27-year-old female with past medical history of intravenous opioid dependence for 5-6 years and gastroesophageal reflux disease who presented with ulcerations of the posterior aspects of her arms bilaterally. the patient reported injecting krokodil for the past 5-6 months. she had been observing blue and black discoloration of the skin 1-2 days after each injection for the past 4-5 months. the injection site scabbed after 2-3 days. the patient continued injecting in area next to the affected sites. Eventually the affected sites coalesced and evolved into a large scab containing black necrotic tissue. In the last 5-6 days the black necrotic tissue started peeling off made the underlying tissue visible with mild

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‘Krokodil’—A Designer Drug from Across the Atlantic, with Serious Consequences

Cited by 36 publications

References 2 publications

Human immunodeficiency virus prevalence and risk determinants among people who inject drugs in the Republic of Georgia

Human immunodeficiency virus prevalence and risk determinants among people who inject drugs in the Republic of Georgia

Internet Search and Krokodil in the Russian Federation: An Infoveillance Study

New case of krokodil (desomorphine) use

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