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Desomorphine–Permonid is an opioid invented in 1932 in the United States that is a derivative of morphine. It has sedative and analgesic effects, and is around 8-10 times more potent than morphine. It was used in Switzerland under the brand name Permonid, and was described as having a fast onset and a short duration of action, with relatively little nausea or respiratory depression compared to equivalent doses of morphine.

The drug’s sinister nickname — also known as Krokidil — refers to the greenish and scaly appearance of a user’s skin at the site of injection as blood vessels rupture and cause surrounding tissues to die. According to reports, the drug first appeared in Siberia and parts of Russia around 2002, but has spread throughout the country in recent years.

To produce the potentially deadly drug, which has a comparable effect to heroin but is much cheaper to make, users mix codeine with gasoline, paint thinner, iodine, hydrochloric acid and red phosphorous. Codeine, a controlled substance in the United States used to treat mild to moderate pain, is widely available over the counter in Russia.

The high associated with krokodil is akin to that of heroin, but last a much shorter period. While the affects of heroin use can last four to eight hours, krokodil users are lucky to get an hour and a half of bliss, with the symptoms of withdrawal setting in soon after. Krokodil takes roughly 30 minutes to an hour to prepare with over-the-counter ingredients in a kitchen.

The short time table causes addicts to be trapped in a full time, twenty-four hour a day cycle of cooking and injecting in order to avoid withdrawal. Once someone becomes addicted, it is common for the individual to die within two-three years of heavy use from exposure and associated health issues, with many dying within a year.