It is therefore subject to annual aggregate manufacturing quotas in the United States, and in the quota for desomorphine was 5 grams. Russia has a significant opiate addiction problem partially due to its close proximity to Afghanistan. Use in Russia is estimated as high as 1 million and use has spread to other European countries including Germany. It has maintained this status as a controlled substance in the United States since Like the opioid class in general, it has sedative and analgesic effects when used. The clandestine manufacturing process is similar to that of methamphetamine. Like methamphetamine, desomorphine made this way is often contaminated with various agents. Colloquially called the zombie drug  . It appears to be used quite extensively in Russia, especially when heroin becomes scarce or too expensive.
Russia has a significant opiate addiction problem partially due to its close proximity to Afghanistan. Medical[ edit ] Desomorphine was previously used in Switzerland and Russia for the treatment of severe pain; although for many years up to , when its use was terminated, it was being used to treat a single person in Bern, Switzerland with a rare illness. It is therefore subject to annual aggregate manufacturing quotas in the United States, and in the quota for desomorphine was 5 grams. Strong acids and bases such as hydrochloric acid and sodium hydroxide are also employed without measuring pH of the final solution and analysis of leftover solutions of "krokodil" in used syringes showed the pH was typically less than 3 i. Injecting any such mixture can cause serious damage to the skin , blood vessels , bone and muscles , sometimes requiring limb amputation in long-term users. Krokodil is made from codeine mixed with other substances. Desomorphine has attracted attention in Russia due to its simple production, utilizing codeine, iodine, gasoline, paint thinner, hydrochloric acid, lighter fluid and red phosphorus. The clandestine manufacturing process is similar to that of methamphetamine. Use in Russia is estimated as high as 1 million and use has spread to other European countries including Germany. There have been incidents reported where desomorphine had supposedly been present within either country,  but no incidents have been confirmed by any drug-testing or analytical results, and desomorphine use in North America is still considered unconfirmed. Colloquially called the zombie drug  . The street name in Russia for homemade desomorphine is krokodil Russian: It has maintained this status as a controlled substance in the United States since However, while codeine-containing drugs generally have been prescription products in Europe, in Russia they were sold freely over-the-counter until June The street name in Russia for home-made Desomorphine made in this way is "krokodil" crocodile , reportedly due to the scale-like appearance of skin of its users, and it is used as a cheaper alternative to heroin, as codeine tablets are available without a prescription in Russia. Abuse of homemade desomorphine was first reported in Siberia in when Russia started a major crackdown on heroin production and trafficking, but has since spread throughout Russia and the neighboring former Soviet republics. It was used in Switzerland under the brand name Permonid, where it was found to have a faster onset and shorter duration than morphine, with less nausea and respiratory depression. The codeine is retrieved from over-the-counter medicine and is then mixed with ethanol , gasoline , red phosphorus, iodine, hydrochloric acid and paint thinner. It appears to be used quite extensively in Russia, especially when heroin becomes scarce or too expensive. Addicts often use readily available but relatively toxic and impure solvents such as gasoline or paint thinner during the reaction scheme, without adequately removing them afterwards before injection. Like the opioid class in general, it has sedative and analgesic effects when used. The Russian government has considered some steps to curb this epidemic, including banning websites that explain how to make the opiate, placing codeine back into the prescription only category and increasing enforcement with escalated confiscation. The frequent occurrence of tissue damage and infection among illicit users are what gained the drug its nickname of the flesh-eating drug, or the zombie drug as homemade versions made under inadequate conditions contain multiple impurities and toxic substances that lead to severe tissue damage and subsequent infection as a direct consequence of use. Since the mix is routinely injected immediately with little or no further purification, "Krokodil" has become notorious for producing severe tissue damage including injury to the veins phlebitis and gangrene. Other consequences of use have included severe withdrawal, spread of HIV through the use of contaminated needles and death. The pure form of the drug itself does not cause this damage and, despite the severe health impacts and short survival times commonly reported, there are also rarer cases of krokodil users more skilled in the manufacturing process who have used the drug for many years without experiencing the tissue damage associated with the impure "street" product.
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