The krokodil craze, my choice for the best drug scare of 2013, continues to sweep the country. Just to be clear: The craze is not, so far as anyone has been able to confirm, a pharmacological fashion among American drug users; rather, it is occurring inside the minds of yellow journalists and their enablers in the medical and law enforcement communities. Or is it the other way around? Sometimes it is hard to tell who is enabling whom as reckless claims by doctors and cops are picked up by the press, which encourages new reckless claims, which leads to more sensational coverage, and so on. The latest example (I think) is a report in The Prowers Journal, a Colorado newspaper, headlined "Local Law Officials Warn of Krokodil, Corrosive Drug Sold as Heroin." As usual, it features worried cops describing krokodil's horrifying side effects:
"It destroys tissue when it's injected into the body, and if you mainline it into a vein the long-term effects will see your body eaten away from the inside out," explained Detective Dave Reid during a press conference for local media this past Tuesday, January 7. Some of the ingredients include gasoline, iodine, red phosphorous from match striker plates, codeine and several other corrosive products….
The corrosive compounds begin to break down body tissue to the point of open bleeding through needle penetration….Reid added that studies from Russia indicate the long-term user's body develops gangrene, phlebitis or blood-clotting and green scaly skin, hence it being called Krokodil. "Amputation for habitual users can become common, whether they inject the drug into a vein or tissue. Those who survive the drug develop speech problems, erratic body movement or just appear dazed."
Sounds bad, but what makes Reid and Police Chief Gary McCrea (also quoted in the story) think krokodil, a homemade concoction that originated in Russia as a heroin substitute, has caught on in Lamar, a small town in southeastern Colorado? The Prowers Journal says "the Lamar Police Department has sources that indicate [krokodil] is now being introduced to the area." Not satisfied? There's more:
[McCrea] said the first report the department received was from a man in a local store who was bleeding profusely from a venous injection and the police were told he was using Krokodil, but there was no official confirmation. The Chief did say there have been more recent reports of its use, but still, nothing on an official level.
"No official confirmation"? What does that mean? It means that no drug user or drug sample has tested positive for desomorphine, the narcotic that Russian junkies aim to produce by mixing codeine with all those nasty chemicals. It seems there has been no such toxicological confirmation in Lamar, in Colorado, or anywhere else in the United States. "I'm not aware of any forensic laboratory that has come up with a desomorphine sample," says Joseph Moses, a spokesman for the Drug Enforcement Administration (DEA). None of the putative krokodil samples tested by the DEA have contained desomorphine, and the agency has not seen a single positive result from any state labs either. "A lot of people want to call it a trend," Moses says, "but we're not seeing it."
Maybe Moses should have a chat with his colleagues in Texas. The day before yesterday, WOAI, a radio station in San Antonio, cited "the Texas DEA" as the source for a story headlined "Scary New Drug 'Krokodil' Seen for First Time in Texas." WOAI reports that a "17 year old girl from Houston checked into a hospital in the Mexican state of Jalisco, where she had gone to visit relatives over the holidays. She was complaining of digestive problems, and doctors noticed the fresh skin lesions and diagnosed the drug use."
As Moses notes, skin lesions can be caused by unsanitary injection of any drug. So why did the doctors in Mexico, the DEA agents in Texas, and the editorial staff at WOAI settle on krokodil? "Officials say the girl told them that she obtained and ingested krokodil in Houston," the station says. Unless this girl is a chemist with a well-equipped lab, it seems safe to say she has no idea what she actually bought in Houston; such uncertainty is a familiar hazard of the black market. Nevertheless, "DEA agents are now keeping an eye on Texas emergency rooms, to see if any more cases pop up here." You can be pretty sure more will, since drug users, doctors, reporters, and cops have been primed by alarmist reports from major news outlets such as USA Today, CNN, and Time to see krokodil even when it isn't there.
Speaking of major news outlets, here is how the Associated Press covered the same story:
Health authorities in western Mexico said Thursday they have detected a probable case of flesh lesions due to the drug Krokodil, often referred to as "the poor man's heroin."…
[The 17-year-old's doctor] said a survey of rehab centers and clinics in Jalisco had revealed there were no other local cases. He said so far, Mexico has detected only two probable cases, the woman in Puerto Vallarta and another person in the border state of Baja California.
Diagnosis is usually based on the tell-tale lesions, because the body quickly metabolizes the drug's psychoactive agent, desomorphine.
So if you encounter a patient with lesions like those often seen in intravenous drug users and you don't detect desomorphine, you know you must be dealing with krokodil. The capper is the headline that The Christian Science Monitor put on the story: "Krokodil Drug Case Confirmed for US Patient in Mexico." Confirmed, unconfirmed—whatever.
Reporters covering this pseudo-story (with some honorable exceptions) not only have been unfazed by the total lack of toxicological evidence; they have not stopped to wonder why there would be a market for krokodil in the United States. Russian addicts turned to krokodil because heroin was scarce and codeine was available over the counter. Neither of those things is true in this country. "It's unlikely that we would see that shift," Moses observes, "when other substances are available."
As in the case of candy-flavored meth, the DEA (in Washington, anyway) has responded to the alleged krokodil menace by pointing out the lack of evidence to support what Moses calls "a lot of hype." It is a sad commentary on the state of American journalism when the federal agency in charge of waging the war on drugs sounds like the voice of calm reason in comparison to the anti-drug hysterics at leading news organizations.
Addendum: Moses says Steve Whipple, the DEA special agent interviewed by WOAI, did not intend to confirm the report of krokodil in Texas—only to say that it would be troubling if it were true.
[Thanks to Medicinal Colorado for the the Prowers Journal link.]