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Desomorphine Facts

Opioid; Depressant; Substituted morphinan; Mu-opioid receptor agonist

Description

Desomorphine (dihydrodesoxymorphine) — krokodil — is a semi-synthetic opioid of the morphinan class. It activates opioid receptors in the brain and spinal cord, suppressing pain signaling and producing its characteristic sedation.

Subjective effects include euphoria, deep sedation, pain suppression, physical warmth, and rapid erasure of anxiety. The experience is defined by speed — an intense rush that crests and crashes quickly, pushing dependent users into a relentless redosing cycle.[1]

Desomorphine produces severe physical dependence, and the margin between an effective and fatal dose is presumed extremely narrow.[2] The short half-life demands multiple daily injections, accelerating tolerance; street krokodil injects toxic contaminants with each dose, causing catastrophic tissue and bone destruction.[3]

Dose and durationby route · individual sensitivity varies

Oral(mg)
Threshold< 10 mgLight10 – 15 mgCommon15 – 20 mgStrong20 – 30 mgHeavy30+ mg

No duration recorded for this route.

Body and dependence

Acute toxicity
Critical
Chronic toxicity
High
Physical dependence
High
Psychological dependence
High
Withdrawal
Severe · medical supervision
Compulsive redosing
High

Tolerance

Builds
Rapid
Fully resets after
14 days
Carries over to
opioids

Effectslikely at a common dose

Perception
none likely · 4 possible, including Visual acuity suppression, Visual haze / noise, Spatial disorientation
Body
Body high; Constipation; Muscle relaxation; Pain suppression; Physical fatigue; Pupil constriction; Respiratory depression; Sedation; +19 possible, including Insomnia, Motor control impairment, Muscle tension
Thinking
Cognitive impairment; Compulsive redosing urge; +14 possible, including Analysis suppression, Decision impairment, Information processing suppression
Feeling
Anxiety suppression; Euphoria; +7 possible, including Anxiety, Anhedonia, Depression
Self
Craving; +7 possible, including Communication suppression, Social disconnection, Depersonalization
Time
none likely · 2 possible, including Temporal disorientation

Who shouldn't take it

Absolute
Respiratory insufficiency (COPD, severe asthma, sleep apnea); Known hypersensitivity to morphinan opioids; Concurrent CNS depressants (benzodiazepines, alcohol, barbiturates, other opioids); MAOI co-administration (within 14 days)
Relative
Head injury or raised intracranial pressure; Paralytic ileus or bowel obstruction

Combinations60 recorded

Lethal (4)
Benzodiazepines, Barbiturates; GHB, Baclofen; GHB, GBL; Local anesthetics
Dangerous (39)
Antihistamines; Benzodiazepines; Buprenorphine, Kratom; Cannabis, THC; Gabapentin, Pregabalin; MDMA, Amphetamines; Naltrexone; NRIs; Stimulants; THC; 5-HTP, Tryptophan; Alpha-2 adrenergic receptor antagonist; Amphetamines; Anticholinergics; Antipsychotics; Atypical antipsychotics; Buspirone; Caffeine; Cannabis; CBD; Dopamine agonists; DXM; Ephedrine, Pseudoephedrine; Glutamate modulator; and 15 more, see full page
Caution (12)
See full page: psychedex.org/substances/desomorphine
Not graded (5)
Not listed never means safe.

Seek help immediately if

  • Unresponsive / can't be woken, even to a firm sternal rub
  • Slow, shallow, or stopped breathing
  • Pinpoint pupils
  • Blue/grey lips, fingertips, or skin (cyanosis)
  • Limp body; pale, clammy skin
  • Choking or gurgling sounds ("death rattle")
  • Slow, erratic, or absent pulse

What to do

  1. Try to wake them — shout their name, firm sternal rub
  2. Call emergency services immediately
  3. Administer naloxone if available
  4. Give rescue breaths (or CPR if there is no pulse)
  5. Place them in the recovery position
  6. Stay with them; re-dose naloxone every 2–3 minutes if there is no response
Reversal agent
Naloxone (Narcan) — opioid antagonist. May require repeated doses; its effect can wear off before the opioid does.

With prompt naloxone and rescue breathing, reversal is usually rapid. Because naloxone can wear off before the opioid — especially with long-acting opioids (methadone) or high-potency ones (fentanyl) — a period of monitoring is needed even after the person revives.

988 Suicide & Crisis LifelineFireside Project: 62-FIRESIDE

Version r1 · Not medical advice

References

  1. [1]
    ^Gahr M, Freudenmann RW, Hiemke C, Gunst IM, Connemann BJ, Schönfeldt-Lecuona C (2012) Desomorphine goes 'crocodile' — Journal of Addictive Diseases doi:10.1080/10550887.2012.735570
  2. [2]
    ^Katselou M, Papoutsis I, Nikolaou P, Spiliopoulou C, Athanaselis S (2014) A 'krokodil' emerges from the murky waters of addiction. Abuse trends of an old drug — Life Sciences doi:10.1016/j.lfs.2014.03.008
  3. [3]
    ^Alves EA, Grund JP, Afonso CM, Netto AD, Carvalho F, Dinis-Oliveira RJ (2015) The harmful chemistry behind krokodil (desomorphine) synthesis and mechanisms of toxicity — Forensic Science International doi:10.1016/j.forsciint.2015.02.001
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