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psx:substance/desomorphine/claim/929a3bd6-ea49-43bd-98d1-3215cd5087da

claim2026-05-08recordsupported

derived from · upstream

feeds · downstream

Closure of psx:substance/desomorphine/claim/929a3bd6-ea49-43bd-98d1-3215cd5087da: 57 upstream, 86 downstream.

psx:substance/desomorphine/claim/929a3bd6-ea49-43bd-98d1-3215cd5087da
├─ used  src/doi:10.1016/j.jdcr.2016.02.007  A new drug with a nasty bite: A case of krokodil-induced skin necrosis in an intravenous drug user
  ├─ informed_by  claim/a87a5224-4f71-4bfb-bac5-c5e1c0dfe43c  Claim in clinical-evidence — supported
  ├─ informed_by  claim/1ebf04a6-3cb5-4aab-84c6-a1fe56bb7279  Claim in clinical-evidence — supported
  ├─ informed_by  claim/a905cd7e-f708-4932-b071-a6ce78f98a99  Claim in clinical-evidence — supported
    ├─ used  src/doi:10.1021/acschemneuro.0c00262  DARK Classics in Chemical Neuroscience: Heroin and Desomorphine
    ├─ used  src/url:61029579d152daea  Desomorphine (Krokodil) - California Poison Control System
    ├─ used  src/doi:10.1016/j.drugpo.2013.04.007  Breaking worse: the emergence of krokodil and excessive injuries among people who inject drugs in Eurasia
    ├─ used  src/doi:10.1002/jcph.1923  Clinical Pharmacology, Toxicity, and Abuse Potential of Opioids
    ├─ used  src/doi:10.1080/10550887.2012.735570  Desomorphine goes 'crocodile'
    ├─ used  src/doi:10.1016/j.lfs.2014.03.008  A 'krokodil' emerges from the murky waters of addiction. Abuse trends of an old drug
    ├─ used  src/doi:10.1016/j.forsciint.2015.02.001  The harmful chemistry behind krokodil (desomorphine) synthesis and mechanisms of toxicity
    ├─ used  src/url:eb844846aef4f488  Desomorphine - Krokodil: Current State and Social Perception (summary of pharmacology)
    ├─ used  src/url:00567bd08424f430  Single Convention on Narcotic Drugs 1961 - Schedule IV listing of desomorphine
    ├─ used  src/url:c843cbe335da96c8  DEA Orange Book: Controlled Substances - Alphabetical Order (Desomorphine, CSCN 9055, Schedule I)
    ├─ used  src/url:8e889d7d8596ec6c  Desomorphine - Misuse of Drugs Act 1971 Schedule 2 Part I (Class A)
    ├─ used  src/doi:10.2196/jmir.3203  Internet search and krokodil in the Russian Federation: an infoveillance study
    ├─ used  src/doi:10.3109/10826084.2012.669807  Krokodil: revival of an old drug with new problems
    ├─ used  src/url:6f7da99bc003e4ad  No Confirmed Reports of Desomorphine (Krocodil/Crocodile) in Canada (CCENDU Bulletin)
    ├─ used  src/doi:10.3390/molecules25173905  Pharmacological Aspects of Over-the-Counter Opioid Drugs Misuse
    ├─ used  src/doi:10.1016/j.drugalcdep.2016.12.021  Desomorphine (Krokodil): An overview of its chemistry, pharmacology, metabolism, toxicology and analysis
    ├─ used  src/doi:10.1016/j.jchromb.2018.12.022  Quantitative analysis of desomorphine in blood and urine using solid phase extraction and gas chromatography-mass spectrometry
    ├─ used  src/doi:10.1155/2017/8571928  Trace-Level Screening of Chemicals Related to Clandestine Desomorphine Production with Ambient Sampling, Portable Mass Spectrometry
    ├─ used  src/doi:10.1016/j.jcms.2014.05.005  Surgical treatment of jaw osteonecrosis in 'Krokodil' drug addicted patients
    ├─ used  src/doi:10.1007/s12024-018-9967-9  Lethal endomyocarditis caused by chronic 'Krokodil' intoxication
    ├─ used  src/doi:10.1007/s10006-017-0613-6  Spontaneous bone formation after mandible segmental resection in 'krokodil' drug-related jaw osteonecrosis patient: case report
    ├─ used  src/doi:10.1002/hup.2572  Repeated subcutaneous administrations of krokodil causes skin necrosis and internal organs toxicity in Wistar rats: putative human implications
    ├─ used  src/doi:10.1016/j.bjoms.2020.08.079  The role of illicit drugs in developing medication-related osteonecrosis (MRONJ): a systematic review
    ├─ used  src/doi:10.3390/dj11050108  Surgical Treatment in Patients with Toxic Phosphorus Osteonecrosis of Facial Skull Middle Zone
    ├─ used  src/doi:10.1111/scd.12807  Progression of primarily untreated desomorphine drug induced jaw osteonecrosis: A case report
    ├─ used  src/doi:10.1093/cid/civ689  Emerging and Underrecognized Complications of Illicit Drug Use
    ├─ derived_from  gen/881244f6-fda6-4d1a-a0b9-252988162239  Generation — pipeline-v5
    ├─ generated_by  pub/58081fc8-6aea-409d-b8e9-fc1dfe120c68  Publication — backfill
      ├─ used  search/fc017ac1-135e-42bc-abc9-0630ee7bba9c  Searched PubChem for "desomorphine"
      ├─ used  search/e2eee1b7-d332-4e48-b0a1-c12c56d5c9ad  Searched PubMed for "desomorphine pharmacology opioid receptor"
      ├─ used  search/3e91def8-e0d3-4298-86ea-e3bc56fb90f1  Searched PubMed for "desomorphine krokodil toxicity case report"
      ├─ used  search/f1293f0b-bc65-4cb4-ac1d-a827b43ee125  Searched OpenAlex for "desomorphine krokodil opioid"
      ├─ used  search/6f69c149-296f-44a6-b2cc-3128cb81b62f  Searched PubMed for "krokodil desomorphine Russia epidemic abuse prevalence"
      ├─ used  search/13908ba6-f4e4-4912-9fe3-3a0865a89e88  Searched ClinicalTrials.gov for "desomorphine krokodil"
      ├─ used  search/ac82f31a-7f19-43ea-9b2f-956b44510c10  Searched DEA Diversion Control Division for "desomorphine Schedule I CSCN 9055"
      ├─ used  search/a07d8afa-e369-4c2d-b3e5-98915fb9cf4f  Searched UK legislation.gov.uk for "desomorphine Misuse of Drugs Act Schedule 2"
      ├─ used  search/a599a307-5683-4488-ad6f-92fcddedaeff  Searched PubMed for "krokodil desomorphine United States case report emergence"
      ├─ used  search/2c38c9f4-3875-4d25-b745-a899754963bd  Searched PubMed for "krokodil desomorphine jaw osteonecrosis surgical treatment"
      ├─ used  search/2b1deae8-7679-4dc2-812a-4dd3d37705cc  Searched WebSearch for "desomorphine discovery 1932 synthesis Lyndon Small history first synthesized"
      ├─ used  search/bfc95f83-ec90-4cc7-82cb-8e2b55feaf33  Searched WebSearch for "desomorphine Permonid Roche 1940s trade name commercial clinical use Switzerland"
      ├─ used  search/d1a78ab1-8729-4aa1-9b63-bc8dde0b5c7e  Searched WebSearch for "desomorphine DEA Schedule I CSCN 9055"
      ├─ used  search/7ebc649c-ae24-426c-8b48-3d6fb3bef7c2  Searched UK legislation.gov.uk
      ├─ used  search/19e43815-58e0-4094-83e0-8964e31519ff  Searched WebSearch for "desomorphine Canada CCSA CCENDU no confirmed reports"
      ├─ used  search/ef2fecf2-0adf-473c-b193-be56a19262ab  Searched WebSearch for "desomorphine Russia 2012 codeine prescription-only policy effect krokodil use decline"
      ├─ used  search/3e150871-f432-48ba-b041-7ce420e4c61b  Searched WebSearch for "desomorphine EU Germany France scheduling narcotic 1961 Single Convention"
      ├─ used  search/50bd3e87-db47-466f-9c8d-4460a2ea569c  Searched WebSearch for "desomorphine krokodil United States 2013 Arizona reported cases confirmed toxicology"
      ├─ used  search/91dba394-9bdf-4afa-875d-d77d8e4bf382  Searched California Poison Control System
      ├─ used  search/6f2b878f-d90f-4c0e-a5fa-e60a7961903e  Searched OpenAlex for "krokodil desomorphine toxicity tissue necrosis case report clinical"
      ├─ used  search/4a7fc8b6-8fbe-4252-8097-423d947fa881  Searched PubMed for "desomorphine krokodil overview chemistry pharmacology metabolism toxicology analysis"
      ├─ used  search/59195718-8c6c-4616-82c1-c906916cf969  Searched PubMed for "quantitative analysis desomorphine blood urine GC-MS SPE forensic"
      ├─ used  search/5e7b6993-19bd-41b3-909a-9c352a3969ab  Searched OpenAlex for "desomorphine pharmacology receptor binding potency analgesic"
      ├─ used  search/98ef7fdf-e490-42ed-b5f0-462c577db7ea  Searched ClinicalTrials.gov for "desomorphine krokodil"
      └─ used  search/945c4c02-2d1b-44f5-9310-c004c8bd9c3e  Searched PubChem API for "desomorphine CID 5362456"
├─ informed_by  section/clinical-evidence.full@1
  ├─ used  version/1  Revision 1
  ├─ used  claim/74d92889-3b0d-4e99-aa5b-2a1f6cc723c3  Claim in safety — supported
  ├─ used  claim/602bc4a4-76e0-4b94-9756-b25c3d419505  Claim in safety — supported
    ├─ derived_from  issue/notice@0d22ad4e2c06  Issued notice
    ├─ derived_from  issue/info_card@725eeba8165f  Issued info_card
    ├─ derived_from  issue/emergency@f85b2d2362c9  Issued emergency
    ├─ derived_from  issue/info_card@ed7cda12aedd  Issued info_card
    ├─ informed_by  section/safety.full@1
      ├─ used  claim/e2a1b365-0793-47e4-ab99-ad0c4332a97a  Claim in summary — supported
      ├─ used  claim/750625bf-3928-4975-8b2a-e352cbc0441e  Claim in summary — supported
      ├─ used  claim/6b124bb1-30c7-4ed9-9de5-39c26c43cce8  Claim in history — supported
      ├─ used  claim/0e69a06f-6c00-404c-a11b-61a71fe0fc90  Claim in pharmacology — supported
      ├─ used  claim/e0d37412-2384-413d-aa1b-fe8b9fff7864  Claim in pharmacology — supported
      ├─ used  claim/71bacfae-591d-437d-8422-e67ca4ca10cf  Claim in pharmacology — supported
      ├─ used  claim/657f6ef7-154b-4e22-aee1-65aba9002a21  Claim in safety — supported
      ├─ used  claim/057cccc9-1c8b-4515-9bd1-0d554649cfdb  Claim in history — supported
      ├─ used  claim/e237110d-ea68-4079-930c-bca87283d585  Claim in safety — supported
      ├─ used  claim/30e1d91d-85b9-4b37-a7a6-8322eda65f90  Claim in chemistry — supported
      ├─ used  claim/a1c715bd-392a-4525-9ce8-267fe7fecf4b  Claim in chemistry — supported
      ├─ used  claim/05128967-8a44-432d-b10b-d1338946de8c  Claim in chemistry — supported
      ├─ used  claim/ffa8f6a0-e063-4dc3-94a0-47516b3ec706  Claim in receptor-pharmacology — supported
      ├─ used  claim/39008301-b56a-4b63-857a-b50eb8d3c160  Claim in neuroscience — supported
      ├─ used  claim/8857963e-e9bc-4ed0-b2f3-77473f326e47  Claim in summary — supported
      ├─ used  claim/8894615b-1486-413e-a6aa-1478e5951cf5  Claim in pharmacology — supported
      ├─ used  claim/00c49f83-a82e-48b3-8fa5-c134a76af366  Claim in pharmacology — supported
      ├─ used  claim/539a26ab-c17e-4564-80e1-80c3a1b3b5f6  Claim in safety — supported
      ├─ used  claim/e2168e5a-dd73-4cdb-9b63-1845ef4073d3  Claim in safety — supported
      ├─ used  claim/f5851e80-4eda-42f8-8084-02cca411e0ca  Claim in safety — supported
      ├─ used  claim/e1ee2811-e4b8-4193-be9f-84a765763516  Claim in safety — supported
      ├─ used  claim/e97d5bac-eb5f-44ed-a678-ab39d1faa5d7  Claim in safety — supported
      ├─ used  claim/3ff2c341-2155-4c80-a80c-64240053c898  Claim in history — supported
      ├─ used  claim/35ed33ee-f823-4bee-9ae9-8e8403e2a4a0  Claim in history — supported
      ├─ used  claim/b560c340-5cc3-4bac-931e-18546112ba1d  Claim in comparative-pharmacology — supported
      ├─ used  claim/5d10fba1-afd4-4d48-acf0-37a4447a68fe  Claim in comparative-pharmacology — supported
      ├─ used  claim/64d02618-cfbb-464a-af45-6cac238e8112  Claim in summary — supported
      ├─ used  claim/f1bc04ce-14ac-48c9-aba7-f521792e77ba  Claim in pharmacology — supported
      ├─ used  claim/bdf47995-09a5-4179-99a4-8bf999cf1a46  Claim in pharmacology — supported
      ├─ used  claim/6a8d2df5-99b8-47a3-a984-bb8564dd508d  Claim in neuroscience — supported
      ├─ used  claim/ccbfcec8-c7b4-42b6-b7e6-bfed52bc51ce  Claim in neuroscience — supported
      ├─ used  claim/20f06db7-d1fa-419f-86b0-bf247af21a2e  Claim in neuroscience — supported
      ├─ used  claim/6662dbe4-ee1a-4de6-8d80-1646dcf54be4  Claim in pharmacology — supported
      ├─ used  claim/368abd9b-f2d0-4e28-aac7-ef1a89c7763a  Claim in summary — inconclusive  working
      ├─ used  claim/906cf3aa-eb14-49cb-8b2e-4e6faad879d6  Claim in pharmacology — inconclusive  working
      ├─ used  claim/587abf41-30b3-4c0e-97b5-2556738143ea  Claim in safety — supported
      ├─ used  claim/8cd4c69c-7f86-4444-9480-9d912bc7771b  Claim in safety — supported
      ├─ used  claim/3e2a6a1c-2dee-4942-b186-80a8ed6d5544  Claim in safety — inconclusive  working
      ├─ used  claim/7306555c-7d15-444a-9dcc-3fcba6b92cba  Claim in safety — inconclusive  working
      ├─ used  claim/87d28c59-cc6a-4fca-8a91-48131026f682  Claim in history — supported
      ├─ used  claim/18999292-5843-4192-ba81-bdd7a02d89ef  Claim in comparative-pharmacology — inconclusive  working
      ├─ used  claim/c1b86709-df91-4278-8594-8b3ab0bab06f  Claim in safety — supported
      ├─ used  claim/b9a88497-9abe-4e07-9a66-7afe9cf93412  Claim in summary — supported
      ├─ used  claim/cdeb9cc3-02cd-4e9b-ac48-2a07959bd612  Claim in pharmacology — supported
      ├─ used  claim/f1728ad3-ac82-4e99-bced-31b70f598323  Claim in pharmacology — supported
      ├─ used  claim/90150abc-3757-4479-83be-85df66497beb  Claim in receptor-pharmacology — supported
      ├─ used  claim/37cb5531-e260-4a8c-957c-8bf94f06dd05  Claim in effects-overview — supported
      ├─ used  claim/c833db72-4424-46f5-9ed9-4a2940613211  Claim in summary — supported
      ├─ used  claim/556b7d51-fb58-4809-8795-538cf9cd02a0  Claim in pharmacology — supported
      ├─ used  claim/4fdee290-5a68-486e-9070-042dfabf25bb  Claim in pharmacology — supported
      ├─ used  claim/bbae9445-e2e3-4a85-8dc5-e620d574a762  Claim in safety — supported
      ├─ used  claim/707fad28-bae2-41a8-ae75-df0c417358d3  Claim in safety — supported
      ├─ used  claim/7a8eafb0-7021-49a0-8cb2-4aabc5372fc2  Claim in safety — supported
      ├─ used  claim/8443914a-b6fe-4360-9b89-6118dbd55ad1  Claim in chemistry — supported
      ├─ used  claim/fbdd4445-8e10-419a-bb08-a3f23ee91d0d  Claim in chemistry — supported
      ├─ used  claim/237d53c0-be92-467b-adbd-560f4a06752f  Claim in receptor-pharmacology — supported
      ├─ used  claim/6396ea89-87fd-4005-b12d-350f7a3f3d8c  Claim in history — supported
      ├─ used  claim/daa9b764-fe5c-4d67-abad-6d4e32ef9d0c  Claim in history — supported
      ├─ used  claim/0b46e7d3-9a86-4ee5-a59d-50f642d64482  Claim in safety — supported
      ├─ used  claim/85ef1c72-1fa4-4af4-8670-4add34a76485  Claim in history — supported
      ├─ used  claim/fe567adf-a11e-4c45-a88e-165e9994a38d  Claim in pharmacology — supported
      ├─ used  claim/574d9c5d-780a-4750-a716-e27eac331bc1  Claim in pharmacokinetic-detail — inconclusive  working
      ├─ used  claim/8ad825b0-b7bb-4c79-b189-94a24e2365a1  Claim in pharmacokinetic-detail — inconclusive  working
      ├─ used  claim/fa475c5f-8cbb-42c0-bd96-42656ced7dae  Claim in pharmacology — supported
      ├─ used  claim/6bd306b0-1f3d-494a-b830-ff09e76b2cce  Claim in pharmacokinetic-detail — supported
      ├─ used  claim/27ccbc91-af08-4e35-9a01-4cb9d5be8e38  Claim in pharmacokinetic-detail — supported
      ├─ used  claim/c04853e2-2888-41d4-bbe8-3cb0bcd7c87b  Claim in safety — supported
      ├─ used  claim/1fdb5857-d170-4a36-ab26-9cfeeda98bd5  Claim in safety — inconclusive  working
      ├─ used  claim/bfb84c31-fabf-46c6-afec-2ab56ef1ec77  Claim in safety — supported
      ├─ used  claim/614809fb-8f44-435b-a6a4-be34aae3c061  Claim in safety — supported
      ├─ used  claim/3c3b9ae0-0118-493e-892a-4d3617fc84b4  Claim in safety — inconclusive  working
      ├─ used  claim/7eb45d33-8a39-48be-9003-27193af63010  Claim in neuroscience — supported
      ├─ used  claim/e2e2af22-76af-4965-a595-d8c0aec2c1b8  Claim in safety — supported
      ├─ used  claim/ad8e45f7-e45f-4230-8b22-602657e5daeb  Claim in safety — supported
      ├─ used  claim/96f8ccaf-aee3-49cd-acad-ffd8900f6c73  Claim in safety — supported
      ├─ used  claim/eabff87e-f12c-4a08-a4a8-51d5fe870a44  Claim in safety — inconclusive  working
      └─ used  claim/edefd2f3-2c5a-46a9-ab49-cb76b44985e3  Claim in safety — supported
… closure truncated at 200 nodes

indented by distance from this node, not by parentage

1Provenance card

the boundary, as counts

Sources

2721 with DOI

11 strong · 5 moderate · 11 weak

Compilations

12026-05-08T12:15:46.300Z

pipeline-v5 · prompt hash not recorded — run predates 2026-09

Decisions

26last ruled 2026-06-04

1 awaiting a ruling

Issued documents

42026-10-19T20:31:22.985Z

notice · info card · emergency

Searches

252 with no results

queries and counts on the build

Claims checked

8373 supported

73 supported · 10 not

Correspondence

0received

consent field ships in Phase 4

Edges

256

derivations recorded for this entity

Complete over 27 sources, 1 compilation, and 26 decisions.Not here: the private journal (never); 1 proposal awaiting a ruling (listed as pending only).Working material — drafts, discards, unsupported claims — is listed below and readable on the working page.Cite: psychedex.org/substances/desomorphine/archive

2Build

one panel per compilation run

generation run 2026-05-08

74 min completedmodel pipeline-v5plan not recordedrun/3b6ac8dd…

Selection

results seen111
selected by the model25
consumed as sources27

Verification

claims checked83
supported73
partially supported0
not supported0
inconclusive10
  • record
  • seen / partial
  • working

The model's own caveats

  • structural_inference
  • safety_data_unverified
  • sparse_evidence

Reproduce

inputs
27 source keys (listed under Sources)
plan
not recorded — template version, prompt hash and git SHA are written from 2026-09 onward
model
pipeline-v5
streams
none — agent transcripts are persisted from 2026-09 onward
25 searches — query, source, results, what was kept and why
25 searches for this run
#sourcequeryseenkeptrationale
1ClinicalTrials.gov · absencedesomorphine krokodil0—No trials registered — desomorphine has no current therapeutic development
2PubMedkrokodil desomorphine jaw osteonecrosis surgical treatment22Clinical case series on jaw osteonecrosis treatment
3PubMeddesomorphine krokodil toxicity case report22Clinical case reports of krokodil-induced jaw osteonecrosis
4PubMedkrokodil desomorphine Russia epidemic abuse prevalence62Key reviews on krokodil emergence and abuse trends
5UK legislation.gov.ukdesomorphine Misuse of Drugs Act Schedule 211Official UK classification
6PubMedkrokodil desomorphine United States case report emergence11Case report of fatal cardiac complications
7DEA Diversion Control Divisiondesomorphine Schedule I CSCN 905511Confirmed US federal scheduling
8PubMeddesomorphine pharmacology opioid receptor11Comprehensive review covering pharmacology, synthesis, and history
9OpenAlexdesomorphine krokodil opioid155Top-cited papers on krokodil epidemiology, toxicity, and chemistry
10PubChemdesomorphine11Primary chemical identity record — confirms formula, weight, InChIKey absent from seed data
11WebSearchdesomorphine Canada CCSA CCENDU no confirmed reports5—Canadian legal/epidemiological status
12WebSearchdesomorphine discovery 1932 synthesis Lyndon Small history first synthesized102Key historical and pharmacological data
13WebSearchdesomorphine EU Germany France scheduling narcotic 1961 Single Convention10—International legal status
14WebSearchdesomorphine krokodil United States 2013 Arizona reported cases confirmed toxicology10—US epidemiology
15OpenAlexkrokodil desomorphine toxicity tissue necrosis case report clinical102Toxicology animal study and systematic review on osteonecrosis
16UK legislation.gov.uk—1—Official UK classification
17California Poison Control System—1—Pharmacological data summary
18WebSearchdesomorphine Permonid Roche 1940s trade name commercial clinical use Switzerland101Clinical history data
19WebSearchdesomorphine DEA Schedule I CSCN 905511Official US scheduling
20WebSearchdesomorphine Russia 2012 codeine prescription-only policy effect krokodil use decline10—Key policy/epidemiology data
21PubMeddesomorphine krokodil overview chemistry pharmacology metabolism toxicology analysis11Most comprehensive single reference for desomorphine chemistry/pharmacology overview
22PubMedquantitative analysis desomorphine blood urine GC-MS SPE forensic11Validated forensic analytical method; supports discussion of detection methodology
23OpenAlexdesomorphine pharmacology receptor binding potency analgesic10—No specific desomorphine Ki/EC50 papers in top-cited OpenAlex results
24PubChem APIdesomorphine CID 536245611Chemical identity verification; fills missing fields in seed data
25ClinicalTrials.gov · absencedesomorphine krokodil0—Confirms absence of therapeutic development pipeline
83 claims by section — every cited sentence, checked against its source
safety28 · 23 ok
  • Dependence liability is rated very high across multiple reviewssupported

    Reviews chemistry, synthesis, pharmacology, toxicology of krokodil/desomorphine. j.lfs.2014.03.008

  • As a compound 8–10 times more potent than morphine, the therapeutic window is extremely narrowsupported

    Reviews history, chemistry, synthesis, pharmacology, and societal impact of heroin and desomorphine. acschemneuro.0c00262

  • The severe tissue damage documented with krokodil use is attributed primarily to toxic synthesis byproducts, not to pharmacological-grade desomorphinesupported

    Reviews synthesis chemistry of krokodil, epidemiology, pharmacology, and toxic byproducts responsible for tissue necrosis. j.forsciint.2015.02.001

  • The severe tissue damage documented with krokodil use is attributed primarily to toxic synthesis byproducts, not to pharmacological-grade desomorphinesupported

    Systematic review identifying krokodil as a mixture; psychoactive core is desomorphine; injectable complications include abscess, thrombophlebitis, gangrene. 10550887.2012.735570

  • The clandestine synthesis produces a crude mixture contaminated with red phosphorus, iodine, organic solvents, alkali residues, and heavy metals — all injected directly intravenouslysupported

    Reviews synthesis chemistry of krokodil (starting materials: codeine tablets, alkali solutions, organic solvent, iodine, red phosphorus). j.forsciint.2015.02.001

  • Skin and soft tissue: Thrombophlebitis, abscess formation, ulceration, gangrene, and skin necrosis with green-gray discoloration — the "crocodile skin" appearance giving the drug its street name — are the most commonly reported complicationssupported

    discusses production, social context, and harms including ulcerations, amputations, discolored skin. j.drugpo.2013.04.007

  • Skin and soft tissue: Thrombophlebitis, abscess formation, ulceration, gangrene, and skin necrosis with green-gray discoloration — the "crocodile skin" appearance giving the drug its street name — are the most commonly reported complicationssupported

    First case report of krokodil cutaneous manifestations in dermatologic literature; extensive ulcerations after single use. j.jdcr.2016.02.007

  • Skin and soft tissue: Thrombophlebitis, abscess formation, ulceration, gangrene, and skin necrosis with green-gray discoloration — the "crocodile skin" appearance giving the drug its street name — are the most commonly reported complicationssupported

    injectable complications include abscess, thrombophlebitis, gangrene. 10550887.2012.735570

  • Limb amputations have been documentedsupported

    discusses production, social context, and harms including ulcerations, amputations, discolored skin. j.drugpo.2013.04.007

  • Skin necrosis has been reported after a single injection.supported

    First case report of krokodil cutaneous manifestations in dermatologic literature; extensive ulcerations after single use. j.jdcr.2016.02.007

  • Bone: Osteonecrosis of the jaw (ONJ) is the most frequently documented illicit drug-induced ONJ, with a systematic review identifying 101 cases across 30 studiessupported

    Systematic review of ONJ in recreational drug users; 101 patients; desomorphine (krokodil) most common illicit drug associated with ONJ, most common site maxilla; 30 eligible studies. j.bjoms.2020.08.079

  • A clinical series of 40 patients demonstrated mandibular involvement in 52.5%, maxillary in 27.5%, and both jaws in 20%supported

    Retrospective series of 40 krokodil-addicted patients (2009-2013) with jaw osteonecrosis; mandible 52.5%, maxilla 27.5%, both 20%; surgery main treatment. j.jcms.2014.05.005

  • The mechanism likely involves direct toxicity of phosphorus compounds producing chemical osteonecrosis and avascular necrosissupported

    Reviews synthesis chemistry of krokodil (starting materials: ...iodine, red phosphorus), epidemiology, pharmacology, and toxic byproducts responsible for tissue necrosis. j.forsciint.2015.02.001

  • The mechanism likely involves direct toxicity of phosphorus compounds producing chemical osteonecrosis and avascular necrosissupported

    Russian Federation case series; toxic phosphorus osteonecrosis of maxilla from desomorphine/pervitin use; surgical resection with reconstructive techniques. dj11050108

  • Claim in safety — inconclusiveinconclusiveworking →

  • Claim in safety — inconclusiveinconclusiveworking →

  • Cardiovascular: Lethal endomyocarditis with congestive heart failure has been documented in a 39-year-old male with chronic krokodil use; desomorphine metabolites were confirmed on post-mortem toxicology.supported

    First Italian case of lethal krokodil abuse; 39-year-old male died of congestive heart failure from endocarditis and myocarditis; toxicology confirmed desomorphine metabolite in urine. s12024-018-9967-9

  • Renal and cardiac (animal data): Repeated subcutaneous krokodil administration in Wistar rats produced elevated creatine kinase, CK-MB, and uric acid; oxidative stress in kidney and heart tissue; and cardiac congestion.supported

    Animal study in Wistar rats; krokodil causes skin necrosis at injection site, cardiac and renal biomarker changes (creatine kinase, CK-MB, uric acid), oxidative stress (glutathione); cardiac congestion most relevant finding. hup.2572

  • Claim in safety — inconclusiveinconclusiveworking →

  • Infectious complications: Krokodil injection is associated with high rates of bacterial endocarditis, HIV transmission, and hepatitis C co-infection through shared injection equipment and non-sterile technique.supported

    Review of medical complications from illicit drug use; includes krokodil/desomorphine-related tissue necrosis and infectious complications. civ689

  • Mortality: Deaths from chronic krokodil use have been documented in case reportssupported

    First Italian case of lethal krokodil abuse; 39-year-old male died of congestive heart failure. s12024-018-9967-9

  • Claim in safety — inconclusiveinconclusiveworking →

  • Compulsive redosing: The short duration of action drives a cycle of intoxication and early withdrawal that occurs multiple times daily, consuming the user's time and resources in continuous drug acquisition and preparation.supported

    Reviews krokodil use in Russia (100,000+ users in 2011) and Ukraine (~20,000); discusses production, social context, and harms. j.drugpo.2013.04.007

  • Social deterioration: The krokodil epidemic in Russia was associated with severe social marginalization, with users unable to maintain employment, housing, or social relationships.supported

    Reviews krokodil use in Russia (100,000+ users in 2011) and Ukraine (~20,000); discusses production, social context, and harms. j.drugpo.2013.04.007

  • Claim in safety — inconclusiveinconclusiveworking →

  • Users of krokodil were documented injecting multiple times per day due to the compound's short duration, and this dosing frequency accelerates tolerance development and physical dependence beyond what is observed with longer-acting opioids.supported

    Reviews krokodil use in Russia (100,000+ users in 2011) and Ukraine (~20,000); discusses production, social context, and harms. j.drugpo.2013.04.007

  • Dependence liability is rated very high across multiple reviewssupported

    Reviews history, chemistry, synthesis, pharmacology, and societal impact of heroin and desomorphine. acschemneuro.0c00262

  • Dependence liability is rated very high across multiple reviewssupported

    Systematic review noting krokodil first reported in Russia 2003; desomorphine is the core agent; high dependence potential. 10826084.2012.669807

pharmacology15 · 14 ok
  • Route of administration: All published reports of krokodil/desomorphine use describe intravenous injection as the primary and near-exclusive route of administrationsupported

    injectable complications include abscess, thrombophlebitis, gangrene. 10550887.2012.735570

  • Desomorphine is a potent full agonist at the mu-opioid receptor (MOR), with weaker agonist activity at kappa-opioid (KOR) and delta-opioid (DOR) receptorssupported

    Reviews synthesis chemistry of krokodil (starting materials: codeine tablets, alkali solutions, organic solvent, iodine, red phosphorus), epidemiology, pharmacology, and toxic byproducts responsible for tissue necrosis. j.forsciint.2015.02.001

  • Receptor activation produces three principal downstream effects: inhibition of adenylyl cyclase (reducing intracellular cAMP), opening of G protein-coupled inwardly rectifying potassium (GIRK) channels, and closure of voltage-gated calcium channelssupported

    Comprehensive review of opioid pharmacology, toxicity, and abuse potential; covers pharmacokinetics, dependence, and overdose management. jcph.1923

  • These mechanisms underlie the full spectrum of opioid effects: analgesia, sedation, euphoria, respiratory depression, gastrointestinal hypomotility, and miosis.supported

    Comprehensive review of opioid pharmacology, toxicity, and abuse potential; covers pharmacokinetics, dependence, and overdose management. jcph.1923

  • Potency estimates derive from comparative analgesic assays: desomorphine is approximately 8–10 times more potent than morphine as an analgesic in animal modelssupported

    Reviews history, chemistry, synthesis, pharmacology, and societal impact of heroin and desomorphine. acschemneuro.0c00262

  • Potency estimates derive from comparative analgesic assays: desomorphine is approximately 8–10 times more potent than morphine as an analgesic in animal modelssupported

    Reviews chemistry, synthesis, pharmacology, toxicology of krokodil/desomorphine. j.lfs.2014.03.008

  • This potency advantage is attributed to the compound's increased lipophilicity: the absence of the C-6 hydroxyl group facilitates more rapid and extensive blood-brain barrier penetration than morphine.supported

    Reviews history, chemistry, synthesis, pharmacology, and societal impact of heroin and desomorphine. Covers structural features, pharmacological class. acschemneuro.0c00262

  • Onset and distribution: Desomorphine has a faster onset of action than morphine, attributed to its higher lipophilicity and more rapid blood-brain barrier penetrationsupported

    Reviews history, chemistry, synthesis, pharmacology, and societal impact of heroin and desomorphine. Covers structural features, pharmacological class. acschemneuro.0c00262

  • Claim in pharmacology — inconclusiveinconclusiveworking →

  • The shorter half-life of desomorphine drives the pattern of frequent redosing observed among dependent krokodil users, who inject multiple times daily — contrasted with heroin users, who typically inject 1–3 times per daysupported

    Reviews krokodil use in Russia (100,000+ users in 2011) and Ukraine (~20,000); discusses production, social context, and harms. j.drugpo.2013.04.007

  • CYP450 involvement is plausible — CYP3A4 and CYP2D6 participate in morphinan N-demethylation for related compounds — but this is inferred from class pharmacology, not substance-specific data.supported

    Reviews misuse of OTC opioids including codeine; codeine can be used as substrate for clandestine synthesis of desomorphine; CYP2D6 and CYP3A4 involvement in codeine metabolism. molecules25173905

  • CYP450 involvement is plausible — CYP3A4 and CYP2D6 participate in morphinan N-demethylation for related compounds — but this is inferred from class pharmacology, not substance-specific data.supported

    Overview of krokodil as illegal homemade desomorphine drug obtained from codeine; covers chemistry, pharmacology, metabolism, toxicology, and analytical methods. j.drugalcdep.2016.12.021

  • Route of administration: All published reports of krokodil/desomorphine use describe intravenous injection as the primary and near-exclusive route of administrationsupported

    Reviews krokodil use in Russia (100,000+ users in 2011) and Ukraine (~20,000); discusses production, social context, and harms including ulcerations, amputations, discolored skin. j.drugpo.2013.04.007

  • Route of administration: All published reports of krokodil/desomorphine use describe intravenous injection as the primary and near-exclusive route of administrationsupported

    Reviews synthesis chemistry of krokodil, epidemiology, pharmacology, and toxic byproducts responsible for tissue necrosis. j.forsciint.2015.02.001

  • Route of administration: All published reports of krokodil/desomorphine use describe intravenous injection as the primary and near-exclusive route of administrationsupported

    Reviews chemistry, synthesis, pharmacology, toxicology of krokodil/desomorphine; covers case reports, fatalities, analytical methods for detection in biological samples, and legal status. j.lfs.2014.03.008

history8 · 8 ok
  • Earlier German synthetic work by Knoll AG (patent circa 1920) preceded Small's synthesis but was not widely recognized in the English-language literature.supported

    Reviews history, chemistry, synthesis, pharmacology, and societal impact of heroin and desomorphine. acschemneuro.0c00262

  • Desomorphine was first synthesized in 1932 by the American chemist Lyndon Frederick Small and colleagues at the University of Virginia, working under funding from the US National Research Councilsupported

    Reviews history, chemistry, synthesis, pharmacology, and societal impact of heroin and desomorphine. acschemneuro.0c00262

  • Street-synthesized desomorphine, known as "krokodil" (Russian: krokodil), first appeared in Russia around 2003–2004supported

    Systematic review identifying krokodil as a mixture; psychoactive core is desomorphine; first reported use in Russia 2003. 10550887.2012.735570

  • Street-synthesized desomorphine, known as "krokodil" (Russian: krokodil), first appeared in Russia around 2003–2004supported

    First confirmed report of krokodil use in Russia in 2004; infoveillance study showing internet search patterns track codeine-containing medication policy changes. jmir.3203

  • A slight discrepancy exists in the literature: one early review places the first reports in 2003, while infoveillance data identifies the first confirmed reports in 2004supported

    Systematic review noting krokodil first reported in Russia 2003; desomorphine is the core agent; high dependence potential. 10826084.2012.669807

  • A slight discrepancy exists in the literature: one early review places the first reports in 2003, while infoveillance data identifies the first confirmed reports in 2004supported

    First confirmed report of krokodil use in Russia in 2004; infoveillance study showing internet search patterns track codeine-containing medication policy changes. jmir.3203

  • The emergence was driven by three converging factors: disruptions to the heroin supply reaching Russia from Afghanistan, over-the-counter availability of codeine-containing tablets, and a dramatic cost differential — krokodil cost approximately three times less than heroin per dose.supported

    Reviews krokodil use in Russia (100,000+ users in 2011) and Ukraine (~20,000); discusses production, social context, and harms. j.drugpo.2013.04.007

  • By 2011, an estimated 100,000 or more people injected krokodil in Russia and approximately 20,000 in Ukrainesupported

    Reviews krokodil use in Russia (100,000+ users in 2011) and Ukraine (~20,000). j.drugpo.2013.04.007

summary7 · 6 ok
  • Desomorphine (dihydrodesoxymorphine, known by the street name "krokodil") is a semi-synthetic morphinan opioid and potent mu-opioid receptor (MOR) agonist approximately 8–10 times more potent than morphine as an analgesicsupported

    Reviews history, chemistry, synthesis, pharmacology, and societal impact of heroin and desomorphine. Covers structural features, pharmacological class, and epidemiological context in ex-Soviet republics. acschemneuro.0c00262

  • Desomorphine was first synthesized in 1932 by Lyndon Frederick Small at the University of Virginia and briefly marketed by Hoffmann-La Roche as Permonid in Switzerland beginning around 1940supported

    Reviews history, chemistry, synthesis, pharmacology, and societal impact of heroin and desomorphine. acschemneuro.0c00262

  • Desomorphine's modern significance derives from the "krokodil" epidemic — clandestine synthesis from codeine-containing tablets — that emerged in Russia around 2003–2004 and peaked circa 2010–2012, with an estimated 100,000 or more users in Russia alone.supported

    Reviews krokodil use in Russia (100,000+ users in 2011) and Ukraine (~20,000); discusses production, social context, and harms including ulcerations, amputations, discolored skin. j.drugpo.2013.04.007

  • Desomorphine acts as a full agonist at MOR via Gi/o protein-coupled signaling, producing neuronal hyperpolarization through inhibition of adenylyl cyclase, opening of inwardly rectifying K+ channels, and closure of voltage-gated Ca2+ channelssupported

    Comprehensive review of opioid pharmacology, toxicity, and abuse potential; covers pharmacokinetics, dependence, and overdose management. jcph.1923

  • Claim in summary — inconclusiveinconclusiveworking →

  • Very high dependence liability is reported consistently across reviews, with rapid tolerance development accelerated by the short half-life and frequent dosing requirementssupported

    Reviews chemistry, synthesis, pharmacology, toxicology of krokodil/desomorphine; covers case reports, fatalities, analytical methods for detection in biological samples, and legal status. j.lfs.2014.03.008

  • The severe tissue necrosis, jaw osteonecrosis, and organ damage documented in krokodil users is attributed primarily to toxic synthesis byproducts — phosphorus compounds, organic solvents, and iodine — rather than pure desomorphine itselfsupported

    Reviews synthesis chemistry of krokodil (starting materials: codeine tablets, alkali solutions, organic solvent, iodine, red phosphorus), epidemiology, pharmacology, and toxic byproducts responsible for tissue necrosis. j.forsciint.2015.02.001

chemistry5 · 5 ok
  • These modifications substantially increase lipophilicity relative to morphine, enhancing blood-brain barrier permeability and CNS distribution.supported

    Reviews history, chemistry, synthesis, pharmacology, and societal impact of heroin and desomorphine. Covers structural features, pharmacological class. acschemneuro.0c00262

  • The (minus)-isomer is the pharmacologically active form, structurally analogous to natural (minus)-morphine in the 4,5-epoxymorphinan classsupported

    Reviews history, chemistry, synthesis, pharmacology, and societal impact of heroin and desomorphine. Covers structural features, pharmacological class. acschemneuro.0c00262

  • Desomorphine is significantly more lipophilic than morphine due to the absence of the C-6 hydroxyl groupsupported

    Reviews history, chemistry, synthesis, pharmacology, and societal impact of heroin and desomorphine. Covers structural features. acschemneuro.0c00262

  • Clandestine production uses codeine-containing tablets as the starting material, with red phosphorus (from matchbox striker pads), iodine, organic solvents (lighter fluid, paint thinner), and alkali solutions (caustic soda) as reagentssupported

    Reviews synthesis chemistry of krokodil (starting materials: codeine tablets, alkali solutions, organic solvent, iodine, red phosphorus). j.forsciint.2015.02.001

  • The remainder consists of unreacted codeine, synthesis intermediates, residual phosphorus compounds, iodine, organic solvents, heavy metals, and tablet binders — all of which are injected intravenously when the mixture is used.supported

    Reviews synthesis chemistry of krokodil, epidemiology, pharmacology, and toxic byproducts responsible for tissue necrosis. j.forsciint.2015.02.001

neuroscience5 · 5 ok
  • Chronic administration of potent MOR agonists downregulates endogenous opioid tone, contributing to the dysphoric withdrawal state when the exogenous agonist is discontinued.supported

    Comprehensive review of opioid pharmacology, toxicity, and abuse potential; covers pharmacokinetics, dependence, and overdose management. jcph.1923

  • To what extent does the tissue and organ damage observed in krokodil users reflect desomorphine pharmacology versus synthesis contaminant toxicity? Animal data suggest systemic toxicity from crude krokodil mixtures, but the contribution of pure desomorphine to this toxicity remains unresolved.supported

    Animal study in Wistar rats; krokodil causes skin necrosis at injection site, cardiac and renal biomarker changes (creatine kinase, CK-MB, uric acid), oxidative stress (glutathione); cardiac congestion most relevant finding. hup.2572

  • MOR agonism disinhibits dopaminergic neurons in the ventral tegmental area (VTA) by suppressing GABAergic interneuron activity, increasing dopamine release in the nucleus accumbens (NAc)supported

    Comprehensive review of opioid pharmacology, toxicity, and abuse potential; covers pharmacokinetics, dependence, and overdose management. jcph.1923

  • Desomorphine's 8–10-fold potency advantage over morphine suggests more potent engagement of this system at lower absolute doses, though the dose-response relationship has not been directly measured.supported

    Reviews history, chemistry, synthesis, pharmacology, and societal impact of heroin and desomorphine. acschemneuro.0c00262

  • Opioid tolerance involves multiple molecular adaptations at the receptor and post-receptor level: MOR phosphorylation by G protein-coupled receptor kinases (GRKs), recruitment of beta-arrestin-2, receptor internalization via clathrin-coated pits, and compensatory upregulation of adenylyl cyclase (cAMP superactivation)supported

    Comprehensive review of opioid pharmacology, toxicity, and abuse potential; covers pharmacokinetics, dependence, and overdose management. jcph.1923

clinical-evidence4 · 4 ok
  • A fatal case of endomyocarditis in a 39-year-old male, with desomorphine metabolites confirmed on post-mortem toxicologysupported

    First Italian case of lethal krokodil abuse; 39-year-old male died of congestive heart failure from endocarditis and myocarditis; toxicology confirmed desomorphine metabolite in urine. s12024-018-9967-9

  • Clinical descriptions from this era note advantages over morphine: faster onset, shorter duration of action, and markedly less nausea and emetic activitysupported

    Reviews history, chemistry, synthesis, pharmacology, and societal impact of heroin and desomorphine. acschemneuro.0c00262

  • A clinical series of 40 patients with krokodil-related jaw osteonecrosis treated surgically in Armenia (52.5% mandibular involvement, 27.5% maxillary, 20% both jaws)supported

    Retrospective series of 40 krokodil-addicted patients (2009-2013) with jaw osteonecrosis; mandible 52.5%, maxilla 27.5%, both 20%; surgery main treatment. j.jcms.2014.05.005

  • Skin necrosis after a single krokodil injection documented in the dermatology literaturesupported

    First case report of krokodil cutaneous manifestations in dermatologic literature; extensive ulcerations after single use. j.jdcr.2016.02.007

pharmacokinetic-detail4 · 2 ok
  • Claim in pharmacokinetic-detail — inconclusiveinconclusiveworking →

  • Desomorphine lacks the C-6 hydroxyl group, so only C-3 glucuronidation would be predicted — potentially simplifying its metabolic profile relative to morphine.supported

    Overview of krokodil as illegal homemade desomorphine drug obtained from codeine; covers chemistry, pharmacology, metabolism, toxicology, and analytical methods. j.drugalcdep.2016.12.021

  • Claim in pharmacokinetic-detail — inconclusiveinconclusiveworking →

  • Gas chromatography-mass spectrometry (GC-MS) with solid-phase extraction achieves limits of quantification of 5 ng/mL in blood and 8 ng/mL in urinesupported

    SPE/GC-MS method for desomorphine detection in blood (LOQ 5 ng/mL) and urine (LOQ 8 ng/mL) using deuterated internal standard; validated for forensic use. j.jchromb.2018.12.022

comparative-pharmacology3 · 2 ok
  • Claim in comparative-pharmacology — inconclusiveinconclusiveworking →

  • Duration: Heroin (via its active metabolites) has a longer duration of action than desomorphine, permitting 1–3 daily injections in dependent users versus the multiple daily injections required with krokodil.supported

    Reviews krokodil use in Russia (100,000+ users in 2011) and Ukraine (~20,000); discusses production, social context, and harms. j.drugpo.2013.04.007

  • Cost and accessibility: During the peak krokodil epidemic, street krokodil cost approximately three times less per dose than heroin, and codeine precursors were available over the counter in Russia.supported

    Reviews krokodil use in Russia (100,000+ users in 2011) and Ukraine (~20,000); discusses production, social context, and harms. j.drugpo.2013.04.007

receptor-pharmacology3 · 3 ok
  • The available evidence characterizes desomorphine as a full agonist at MOR with substantially weaker activity at KOR and DORsupported

    Reviews synthesis chemistry of krokodil, epidemiology, pharmacology, and toxic byproducts responsible for tissue necrosis. j.forsciint.2015.02.001

  • The 8–10-fold potency advantage over morphine in analgesic assays is likely attributable to pharmacokinetic factors (faster CNS penetration due to lipophilicity) rather than substantially higher receptor affinity, though this cannot be confirmed without direct binding data.supported

    Reviews history, chemistry, synthesis, pharmacology, and societal impact of heroin and desomorphine. Covers structural features, pharmacological class. acschemneuro.0c00262

  • The 8–10-fold potency advantage over morphine in analgesic assays is likely attributable to pharmacokinetic factors (faster CNS penetration due to lipophilicity) rather than substantially higher receptor affinity, though this cannot be confirmed without direct binding data.supported

    Reviews chemistry, synthesis, pharmacology, toxicology of krokodil/desomorphine. j.lfs.2014.03.008

effects-overview1 · 1 ok
  • The rapid-onset, rapid-offset kinetic pattern generates stronger reinforcement signaling than longer-acting opioids, contributing to the compound's exceptionally high abuse liability.supported

    Reviews chemistry, synthesis, pharmacology, toxicology of krokodil/desomorphine; covers case reports, fatalities, analytical methods for detection in biological samples, and legal status. j.lfs.2014.03.008

3Sources

27 consumed · sorted by year · feeds = sections resting on it

Sources
yearsourcetierstatusfeeds
2024DEA Orange Book: Controlled Substances - Alphabetical Order (Desomorphine, CSCN 9055, Schedule I)US Drug Enforcement Administrationurl:c843cbe335da96c8weakconsumedcited only
2023Desomorphine - Krokodil: Current State and Social Perception (summary of pharmacology)Various (secondary source compilation)url:eb844846aef4f488weakconsumedcited only
2023Desomorphine - Misuse of Drugs Act 1971 Schedule 2 Part I (Class A)UK Governmenturl:8e889d7d8596ec6cweakconsumedcited only
2023Desomorphine (Krokodil) - California Poison Control SystemCalifornia Poison Control Systemurl:61029579d152daeaweakconsumedcited only
2023Progression of primarily untreated desomorphine drug induced jaw osteonecrosis: A case reportRamishvili N, Chachua I, Zurmukhtashvili M, Abiatari I, Marks L, Dugashvili G · Special Care in Dentistrydoi:10.1111/scd.12807weakconsumed1 section
2023Surgical Treatment in Patients with Toxic Phosphorus Osteonecrosis of Facial Skull Middle ZoneIspiryan DH, Hakobyan G, Li A, Diachkova E, Vasil'ev YL · Dentistry Journaldoi:10.3390/dj11050108moderateconsumed1 section
2021Clinical Pharmacology, Toxicity, and Abuse Potential of OpioidsVearrier D, Grundmann O · Journal of Clinical Pharmacologydoi:10.1002/jcph.1923strongconsumed3 sections
2021The role of illicit drugs in developing medication-related osteonecrosis (MRONJ): a systematic reviewSacco R, Ball R, Barry E, Akintola O · British Journal of Oral & Maxillofacial Surgerydoi:10.1016/j.bjoms.2020.08.079strongconsumed1 section
2020DARK Classics in Chemical Neuroscience: Heroin and DesomorphineMella-Raipán J, Romero-Parra J, Recabarren-Gajardo G · ACS Chemical Neurosciencedoi:10.1021/acschemneuro.0c00262strongconsumed8 sections
2020Pharmacological Aspects of Over-the-Counter Opioid Drugs MisuseSobczak Ł, Goryński K · Moleculesdoi:10.3390/molecules25173905strongconsumed2 sections
2019Quantitative analysis of desomorphine in blood and urine using solid phase extraction and gas chromatography-mass spectrometryWinborn J, Kerrigan S · Journal of Chromatography Bdoi:10.1016/j.jchromb.2018.12.022moderateconsumed1 section
2018Lethal endomyocarditis caused by chronic 'Krokodil' intoxicationSorrentino A, Trotta S, Colucci AP, Aventaggiato L, Marzullo A, Solarino B · Forensic Science, Medicine, and Pathologydoi:10.1007/s12024-018-9967-9weakconsumed2 sections
2017Desomorphine (Krokodil): An overview of its chemistry, pharmacology, metabolism, toxicology and analysisFlorez DH, Dos Santos Moreira AM, da Silva PR, Brandão R, Borges MMC, de Santana FJM, Borges KB · Drug and Alcohol Dependencedoi:10.1016/j.drugalcdep.2016.12.021strongconsumed2 sections
2017Repeated subcutaneous administrations of krokodil causes skin necrosis and internal organs toxicity in Wistar rats: putative human implicationsAlves EA, Brandão P, Neves JF, Cravo SM, Soares JX, Grund JC, Duarte JA, Afonso CMM, Pereira Netto AD, Carvalho F, Dinis-Oliveira RJ · Human Psychopharmacologydoi:10.1002/hup.2572moderateconsumed2 sections
2017Spontaneous bone formation after mandible segmental resection in 'krokodil' drug-related jaw osteonecrosis patient: case reportHakobyan K, Poghosyan Y · Oral and Maxillofacial Surgerydoi:10.1007/s10006-017-0613-6weakconsumed1 section
2017Trace-Level Screening of Chemicals Related to Clandestine Desomorphine Production with Ambient Sampling, Portable Mass SpectrometryHall SE, O'Leary AE, Lawton ZE, Bruno AM, Mulligan CC · Journal of Chemistrydoi:10.1155/2017/8571928weakconsumedcited only
2016A new drug with a nasty bite: A case of krokodil-induced skin necrosis in an intravenous drug userHaskin A, Kim N, Aguh C · JAAD Case Reportsdoi:10.1016/j.jdcr.2016.02.007weakconsumed2 sections
2015Emerging and Underrecognized Complications of Illicit Drug UseWurcel AG, Merchant EA, Clark RP, Stone DR · Clinical Infectious Diseasesdoi:10.1093/cid/civ689strongconsumed1 section
2015The harmful chemistry behind krokodil (desomorphine) synthesis and mechanisms of toxicityAlves EA, Grund JP, Afonso CM, Netto AD, Carvalho F, Dinis-Oliveira RJ · Forensic Science Internationaldoi:10.1016/j.forsciint.2015.02.001strongconsumed5 sections
2014A 'krokodil' emerges from the murky waters of addiction. Abuse trends of an old drugKatselou M, Papoutsis I, Nikolaou P, Spiliopoulou C, Athanaselis S · Life Sciencesdoi:10.1016/j.lfs.2014.03.008strongconsumed5 sections
2014Internet search and krokodil in the Russian Federation: an infoveillance studyZheluk A, Quinn C, Meylakhs P · Journal of Medical Internet Researchdoi:10.2196/jmir.3203moderateconsumed1 section
2014Surgical treatment of jaw osteonecrosis in 'Krokodil' drug addicted patientsPoghosyan YM, Hakobyan KA, Poghosyan AY, Avetisyan EK · Journal of Cranio-Maxillo-Facial Surgerydoi:10.1016/j.jcms.2014.05.005moderateconsumed2 sections
2013Breaking worse: the emergence of krokodil and excessive injuries among people who inject drugs in EurasiaGrund JP, Latypov A, Harris M · International Journal of Drug Policydoi:10.1016/j.drugpo.2013.04.007strongconsumed5 sections
2013No Confirmed Reports of Desomorphine (Krocodil/Crocodile) in Canada (CCENDU Bulletin)Canadian Centre on Substance Use and Addictionurl:6f7da99bc003e4adweakconsumedcited only
2012Desomorphine goes 'crocodile'Gahr M, Freudenmann RW, Hiemke C, Gunst IM, Connemann BJ, Schönfeldt-Lecuona C · Journal of Addictive Diseasesdoi:10.1080/10550887.2012.735570strongconsumed5 sections
2012Krokodil: revival of an old drug with new problemsGahr M, Freudenmann RW, Hiemke C, Gunst IM, Connemann BJ, Schönfeldt-Lecuona C · Substance Use & Misusedoi:10.3109/10826084.2012.669807strongconsumed2 sections
1961Single Convention on Narcotic Drugs 1961 - Schedule IV listing of desomorphineUnited Nationsurl:00567bd08424f430weakconsumedcited only
—Searched ClinicalTrials.gov for "desomorphine krokodil" — no resultsabsenceno results—
—Searched ClinicalTrials.gov for "desomorphine krokodil" — no resultsabsenceno results—

4Docket

one filing per activity — decisions, correspondence, reports

awaiting ruling — 1

  • dependence · taper2026-07-03
  1. 0012026-05-08revisionRevision 1

    Initial LLM generation (v5 pipeline, wiki, prose phase)

    psx:substance/desomorphine/version/1
  2. 0022026-06-04proposal23 value proposals approved together

    one review action inferred from a shared reviewer and instant — the graph records one activity per proposal

    23 items in this filing

    • contraindication · other
    • contraindication · other
    • contraindication · neurological
    • contraindication · other
    • contraindication · immunological
    • toxicity
    • dependence · full
    • withdrawal
    • tolerance
    • dosage · oral
    • dosage · intravenous
    • duration · oral · total
    • duration · intravenous · onset
    • duration · intravenous · total
    • dose_tier · threshold
    • dose_tier · light
    • dose_tier · common
    • dose_tier · strong
    • dose_tier · heavy
    • timeline · intravenous · onset
    • timeline · intravenous · peak
    • timeline · intravenous · resolution
    psx:substance/desomorphine/proposal/contraindication/53c516bd-d7ba-402b-b6ea-1b6d1430b7b0
  3. 0032026-06-04publicationPublication — backfill

5Issued documents

what the notice, info card and emergency page said, by hash

Issued documents
documentcontent hashissuedfrom versionsuperseded
info_carded7cda12aedd740d53a34cf1…2026-10-19 20:31Revision 1current
emergencyf85b2d2362c98030e2585598…2026-09-04 04:29Revision 1current
info_card725eeba8165f7cc7bebf689a…2026-09-04 04:29Revision 1superseded2026-10-19
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