Krokodil — a deadly opiate known as the zombie drug because it eats holes in the flesh of users — has raised its scaly head in South Africa.
Cooked from codeine tablets available across the counter from pharmacies, the drug, desomorphine, has killed two addicts in Port Elizabeth.
Its use as a recreational drug was first recorded in Russia about 10 years ago, where, in six years, usage ballooned to more than a million.
Krokodil’s attraction is that it offers a heroin-like high for as little as R20 — about 20% of heroin’s street price.
The mother of one of the Port Elizabeth victims accused the authorities of being in denial about krokodil.
“In Port Elizabeth there are technically no krokodil addicts because of the denial factor. It is not spoken of but is silently consumed and abused,” said Martha Dean.
Asked about its prevalence, and how the department of health is responding to it, ministry spokes- person Joe Maila said: “I don’t even know what you talking about.”
Krokodil made local headlines in July last year when Port Elizabeth’s Herald newspaper reported that Dean staged a protest outside the magistrate’s court where her 25-year- old daughter was appearing on a charge of possessing the drug.
‘The drug changed her from a good Christian girl into one of Port Elizabeth’s highest-paid prostitutes’
“Mr Magistrate please don’t ‘free’ my daughter to die on the streets,” read the placard she was carrying.
The court ordered Bonita Dean to be sent to the nearby Noupoort Rehabilitation Centre. She escaped in June this year, made her way back to Port Elizabeth and, four months later, was dead.
Her mother said: “I didn’t know who she was anymore. The drug changed her from a good Christian girl into one of Port Elizabeth’s highest-paid prostitutes.”
Regarded as more addictive than heroin, krokodil can kill users in two years. It is cooked with a range of substances including paint thinners, petrol, hydrochloric acid, lighter fluid and red phosphorus scraped from the sides of matchboxes, making those who mainline it — injecting it straight into a vein — prone to sepsis.
The cooked codeine is a murky yellow liquid with an acrid smell. It takes about 30 minutes to prepare. Dean said her daughter, before her death, had been “full of holes”.
The Herald quoted doctors at Livingstone Hospital as saying they were seeing an increasing number of sepsis cases, ostensibly caused by krokodil.
A South African National Council on Alcoholism and Drug Dependence (Sanca) official, Adrie Vermeulen, said the organisation had encountered four users in little over a year in their 33 centres nationally.
“Three new cases have been reported in Emalahleni and two in Port Elizabeth. All three clients needed immediate medical attention due to the serious consequences of this drug,” Vermeulen said.
“It’s highly likely that krokodil will be produced in South Africa. Crystal meth [tik] and cat [methcathinone] are produced locally with chemicals that are easy to come by.”
“They start off like a cigarette burn that turns purple, starts to blister and rots away.”
The name krokodil is derived from the dark, scaly wounds resembling reptilian skin that develop on the bodies of regular users.
In Russia, where desomorphine abuse first surfaced, there have been hair-raising reports of users’ flesh falling off “in chunks”.
Vermeulen said staff at Emalahleni in Mpumalanga, who had treated a krokodil addict, reported “seeing the bones in his hands”.
A 22-year-old Port Elizabeth woman said she has been addicted to krokodil for about a year.
“It’s not a choice anymore,” said the woman, who asked to be referred to as Roxanne. “It’s taking away my will to live but I feel like if I’m not on it there’s no point in living.
“I know I have to stop but it’s physically painful when I try. I get very bad stomach and lower back pains. This drug fights you at your weakest point — if you have bad lungs it will attack your lungs; if you have bad kidneys, it will go there. I guess luck has kept me alive.
“I have holes in my legs where I inject. They start off like a cigarette burn that turns purple, starts to blister and rots away.”
Roxanne said she and her boyfriend Jason moved to Port Elizabeth from Cape Town last year, and that both were heroin addicts at the time.
“Neither of us could find work in PE and soon we couldn’t afford heroin. But we still needed to get high so a Nigerian drug dealer gave us krokodil to try. It was almost the same high as heroin, so we continued to use it.
“One night we were getting high and my boyfriend took a nap and never woke up,” she said, bursting into tears as she described Jason’s descent towards an agonising death.
‘Krokodil withdrawals “savage” and more severe than heroin’
After his death in July, Roxanne said she was no longer able to support herself. She started working as a prostitute for the same drug dealer who initially sold her krokodil.
“I live with the dealer now and he cooks krokodil for me when I need it … I inject about eight times a day. The dealers don’t buy the drug — they know how to cook it themselves.”
The international drug information website Narconon describes krokodil withdrawals as “savage” and more severe than heroin.
Heroin withdrawals usually last up to 10 days but those from krokodil continue for at least a month, with doctors being forced to use powerful sedatives to control the pain.
Dean said Bonita, like Roxanne, had fought various drug addictions since the age of 15.
Originally from Bloemfontein, Bonita ran away from home after a Nigerian drug dealer took her in as “his wife”, Dean said.
“It was only during her last four days alive that I saw glimpses of my daughter. Only when she was filled with sores and could barely talk did the slimgat [know-it-all] attitude disappear.
“When they eventually found her, she was screaming in pain.”
Dean said she had rubbed shoulders with drug dealers and prostitutes on the streets of Port Elizabeth for three years while searching for her daughter, and that krokodil abuse is far more widespread than officials would have one believe.
“Many of the law enforcement operators and support structures still say there are no reported cases of krokodil being sold,” she said.
‘Krokodil is highly physically addictive and very difficult to treat’
To counter the spread of the drug, Sanca is calling for an educational programme about its effects and tougher restrictions on the sale of codeine-based medications.
Codeine abuse accounted for 2.5% of roughly 20000 admissions to drug treatment centres in 2014, a South African Medical Research Council (SAMRC) study found (Mail & Guardian, “Codeine abuse is a habit but how should SA deal with it?”, June 1 2016).
This figure excludes krokodil.
Codeine (3-methylmorphine) is available in over-the-counter combination preparations for pain relief and coughs or as a prescription medicine.
About 42% of pharmacists believe restrictions are not high enough, another 2014 SAMRC study found.
In 2014 the Medicines Control Council gave notice of its intention to reduce the amount of codeine in a tablet and to up-schedule narcodeine and acetyl codeine.
Vermeulen said: “The stricter control of the sale of codeine is needed to ensure that it doesn’t fall into the wrong hands.
“Krokodil is highly physically addictive and very difficult to treat. Medical detoxification and long-term psychological counselling are needed to kick the habit.”
Addiction caused long-term, irreversible changes in the brain. “This is the reason for relapse years after a person has been clean,” she said.
The head of addiction services at Stikland Hospital in the Western Cape, Dr Lize Weich, said: “There has been a debate in South Africa around the regulation of codeine.
“I believe we can think innovatively about how we can make codeine available without a doctor’s prescription, but with more control and less risk of diversion and abuse.”
First made in Russia, it has jumped borders
Desomorphine, the chemical name for krokodil, was originally developed in Siberia in 1932 as a fast-acting medical alternative to morphine and reported to be up to eight times as potent.
The drug was banned as a painkiller in the early 1990s, according to the news website Time Lightbox.
The first documented reports of its use as a recreational drug in Russia surfaced in 2005.
Usage peaked at a million in 2011, when the country’s narcotics agency confiscated 65-million doses of the drug.
In June 2012, over-the-counter sales of codeine — krokodil’s primary constituent — were banned in Russia. According to Wikipedia, this led to a dramatic drop in usage.
But the ban resulted in krokodil jumping the border and infiltrating some of Russia’s poorest neighbours, including Kazakhstan and Ukraine.
Greece, Spain, Germany and Norway have also registered their first addicts.
In December 2012, krokodil crossed the Atlantic Ocean to the United States. Two years later krokodil arrived in South Africa. — Tremaine van Aardt