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Notable Notes
January 2015

Krokodil: From Russia With Love

Author Affiliations
  • 1Department of Dermatology, University of Texas at Houston, Houston
  • 2Department of Dermatology, Tufts Medical Center, Boston, Massachusetts
  • 3Department of Dermatology, Brown University, Providence, Rhode Island
  • 4Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
JAMA Dermatol. 2015;151(1):32. doi:10.1001/jamadermatol.2014.1025

Krokodil (from the Russian кpoкoдил, or “crocodile”), which became popular in Russia around 2003, is a homemade opioid injectable drug synthesized from codeine (which is available over the counter in Russia) and other easily obtained materials. Over the years, krokodil has slowly spread across Europe, and has been sensationalized in various media reports as a drug that allegedly “turns people into zombies” and “eats junkies alive.”1 Indeed, krokodil can leave abusers disfigured, with scaling and green-black skin discoloration secondary to cutaneous infection, necrosis, and gangrene.1

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