A flesh-eating drug has appeared in the United States after first being discovered in Russia a decade ago.
Krokodil, Russian for "crocodile," is a street drug used as a cheap substitute for heroin. The drug is referred to as "krokodil" because it causes sores, tissue damage and rough, scale-like appearance on the skin.
Two cases involving the drug that surfaced at the Banner Good Samaritan Medical Center in Phoenix are alarming anti-drug advocates and medical personnel who fear use of krokodil might spread.
When the facility warned other poison centers around the country about krokodil, some revealed they also had patients suffering from its apparent use, according to Dr. Frank LoVecchio, co-medical director at Banner Poison, Drug and Information Center.
"This is up there as one of the craziest new trends I've seen," he said. "We've known about it in Russia, and we've known what it has done there. It's really decimated whole cities there."
Krokodil is made up of several ingredients easily accessed at home improvement stores and pharmacies. The base of the drug is usually codeine. Pure codeine is extracted from its pill form and adulterated with chemicals to create a liquid substance that is later injected into the veins. The types of chemicals used by manufacturers vary.
"Some of the chemicals they've used are very dangerous," LoVecchio said. "They've used things like hydrochloric acid. Some have used paint thinners, gasoline and other stuff that includes phosphorous."
The acidity of the chemicals causes the body's fat and skin to "burn off and die," LoVecchio said.
The presence of chemicals also makes the body more prone to infection. Immediate effects include visible scarring on the skin. Long-term effects are much worse.
"Once you start using this drug on a daily basis, you could die within two years," he said. "Other reports are that death is probably due to overwhelming infection. Your body can't fight the infection."
Leslie Bloom, CEO of DrugFreeAZ.org, said that despite the drug's dire consequences, krokodil use is not an outbreak to be fearful of.
"We don't want the public to be alarmed," she said. "What we want them to be is aware that this is a trend. There are other drug trends, too, that we see from time to time, especially with the synthetic drugs. This is a good reminder and a teaching moment."
According to Tommy Thompson, public information officer for the Phoenix Police Department, there are currently no existing arrests or law enforcement cases involving krokodil.