Krokodil addiction is one of the most devastating patterns in opioid misuse. Krokodil (homemade desomorphine) is a fast-acting opioid that can be mixed with toxic chemicals and injected, causing severe tissue damage, infections, and medical emergencies. During past regional surges abroad, reports counted tens of thousands of people harmed by krokodil; many presented with gangrene, bone exposure, and life-threatening infections. Desomorphine abuse is especially dangerous because batches are unpredictable, often contaminated, and far more potent than many people expect—raising the odds of overdose, amputations, and death.
Krokodil (Desomorphine) at a Glance: Signs & Symptoms, Risks, Overdose
What it is. Desomorphine is a potent opioid. “Krokodil” refers to home-brewed versions made from codeine or other inputs plus corrosive solvents, acids, and red-phosphorus. These batches destroy veins and surrounding tissue and can seed deep infections.
Street names. krokodil, crocodile, “kroc,” “Russian magic,” “homebake,” “pervitin opiate mix” (regional slang varies).
Common signs & symptoms of problematic use
- Injection marks that don’t heal; dark, scaly, or green-tinged skin around sites
- Rapid weight loss, exhaustion, foul-smelling wounds, fever or chills
- Using more often than planned; needing a shot to avoid feeling sick
- Hiding supplies, missing work or school, neglecting hygiene or meals
- Mixing with alcohol, benzodiazepines, or fentanyl-adulterated drugs
- Cravings, irritability, or sweating and body aches between doses
By the numbers (context you can use)
- In prior regional outbreaks, tens of thousands were estimated to be affected.
- Among people who inject drugs, skin and soft-tissue infections are common in a given year, and hospitalizations for abscesses and sepsis are frequent.
- Opioids remain involved in the majority of drug overdose deaths, with synthetic opioids a leading driver—making any injected opioid, especially contaminated batches, high risk.
Key risks to know
- Tissue destruction & infections: Chemical burns, necrosis, cellulitis, abscesses, bone infections (osteomyelitis), and sepsis
- Vascular damage: Collapsed veins, blood clots, and impaired circulation leading to ulcers and amputations
- Toxic exposure: Residual acids/solvents injure skin, muscle, nerves, and organs
- Polysubstance danger: Alcohol, benzos, and other depressants multiply overdose risk
- Blood-borne disease: Sharing equipment increases HIV, hepatitis B/C transmission
- Legal & social fallout: Arrests, homelessness, job loss, and family breakdown
- Slow or stopped breathing; blue or gray lips and fingertips
- Pinpoint pupils, limp body, unresponsiveness, gurgling or snoring sounds
- Pale, clammy skin, weak pulse, or sudden collapse
Call 911 immediately. If you have naloxone, use it and repeat doses as directed until help arrives. Even if the person wakes up, medical care is still needed—krokodil batches can cause delayed complications.
Withdrawals, Detox & Safety for Desomorphine Abuse
What withdrawals feel like. Like other strong opioids, krokodil triggers withdrawals when it leaves the body: intense body aches, cramps, nausea, vomiting, diarrhea, sweating, gooseflesh, anxiety, insomnia, and powerful cravings. On top of these, people face painful wounds, fever, and dehydration from infections.
Why home quitting is dangerous. White-knuckling through krokodil withdrawal at home can be life-threatening. Wounds can worsen rapidly, and dehydration, sepsis, or overdose (from relapse) is common. A medical detox is the safer path.
- Medical evaluation: Check breathing, heart rate, temperature, and oxygen; evaluate wounds; screen for sepsis and blood-borne infections.
- Medication for Opioid Use Disorder (MOUD): Buprenorphine or methadone reduces withdrawals and cravings and lowers overdose risk.
- Wound care: Debridement, antibiotics when indicated, tetanus update, and dressing changes; surgical consult for deep infections or suspected bone involvement.
- Hydration & nutrition: IV fluids if needed; pain control that does not undermine recovery.
- Harm-reduction support: Naloxone kit, safer-use education, and connection to syringe-service programs where legal.
- Stabilization timeline: Many feel better in 3–7 days with MOUD; wound healing takes longer and needs follow-up.
Treatment That Works (and Insurance Accepted Rehab)
Long-term recovery needs both treatment for opioid use disorder and care for the medical injuries krokodil leaves behind. An integrated plan improves survival and quality of life.
1) Medical & psychiatric care
- Start or continue buprenorphine or methadone to protect against relapse and overdose
- Treat infections (antibiotics, wound care, possible surgery) and manage pain safely
- Test for and treat hepatitis C, HIV, and other complications
- Address depression, anxiety, PTSD, or trauma that often fuels use
2) Levels of care (matched to your needs)
- Outpatient / IOP: Multiple therapy sessions weekly while you live at home—works well once wounds and withdrawals are under control
- Partial Hospitalization (PHP): Daytime structure for complex needs without an overnight stay
- Residential/Inpatient rehab: 24/7 support when safety, housing, or medical issues make outpatient too hard right now
Many programs are insurance accepted rehab and can verify benefits quickly for evaluation, detox, wound care coordination, MOUD, therapy, and aftercare.
3) Evidence-based therapies
- Cognitive Behavioral Therapy (CBT): Identify triggers, build coping skills, and rewrite “I can’t get through the day without a shot” beliefs
- Dialectical Behavior Therapy (DBT): Skills for distress tolerance, emotion regulation, and safer choices under stress
- Motivational Interviewing (MI): Strengthen your reasons for change and keep momentum through setbacks
- Trauma-informed care: Treat trauma that often drives substance abuse, nightmares, and hypervigilance
- Family therapy: Improve communication, set boundaries, and create a stable home plan
4) Practical supports that protect recovery
- Case management: IDs, insurance, wound-care appointments, transportation, and housing resources
- Peer recovery groups: SMART Recovery, 12-Step, or medication-friendly groups focused on opioid recovery
- Relapse prevention: Written plan listing your top triggers, early warning signs & symptoms, and exactly who to call, plus naloxone access for you and loved ones
5) Aftercare that sticks
- Follow-up with MOUD provider and wound clinic
- Weekly therapy or peer group for 6–12 months
- Structured evenings/weekends when risk is highest (meetings, gym, classes, family time)
Why act now. People on MOUD have much lower overdose risk and better odds of staying in care. Addressing wounds early prevents amputations and chronic disability. Waiting lets infections and cravings get worse; making a plan today saves lives.
True Stories of Addiction (Video) + How to Get Help Now
Cooper grew up feeling as though he didn’t truly belong anywhere. He found some solace in drinking Alcohol and abusing a variety of drugs. After becoming homeless for a period of time while abusing drugs, he went to a couple different halfway house before figuring out that his substance abuse problem was more serious than he had previously thought. He dove headfirst into a program in order to find his sobriety.
Your next step—today
- Search our directory to find programs that understand injection-related wounds, MOUD, and co-occurring mental health needs.
- Or call our confidential hotline at (866) 578-7471 right now. We’ll help you compare levels of rehab, verify insurance accepted rehab options, and schedule the first appointment for detox, wound care, and ongoing support.
Krokodil addiction is medical, urgent, and treatable. With MOUD, strong wound care, and a recovery plan you can actually live with, you can survive the immediate crisis and build a safer, healthier future. Reach out—real help is available today.
