Professor Jenishbek Nazaraliev: Americans Should Not Fear the Russian Krokodil

Following the announcement of the World League Mind Free of Drugs’ new television reality project titled Doctor Life , more than 200 submissions were received from applicants all over the world. Over the next month, members of our selection committee deliberated on each applicant’s story of drug abuse factoring in the region/country where the applicant resided. The culmination of data was significant in the process of selecting the applicant(s) that exhibited to be the most hardened addicts. In the end, the selection committee chose 8 drug addicts – 6 from Russia, 1 from Germany and 1 from the United States. As soon as the list of participants was approved, our film crew boarded a plane destined for Seattle, WA to introduce our first participant – American race car driver, Gleb Antonov. Gleb first smoked marijuana at the age of 17, now 5 years later, he is addicted to heroin and frequently smokes crack. In a later episode filmed in MCN’s rehabilitation center in Bishkek, Kyrgyzstan, Gleb witnesses the dreadful difference between smoking hash and injecting krokodil. Krokodil devastates the flesh causing it to rot and exposes the bones. Users normally succumb to infection and quickly develop abscesses and gangrene. Next, our film crew traveled to Magadan, Russia to film another 2 participants. Magadan is a “Gulag” city tucked between hills facing the Sea of Okhotsk and is considered the gateway to the Kolyma region. It is one of the most isolated and coldest regions in Russia and a world away from anything. Our crew traveled on gravel roads to a crime-ridden sketchy part of the city filming blocks of depressing 2-story grey substandard housing units. Young people are hanging outside almost every stoop. Inside one of the apartments we find our participants, Anatoly Nesmiyanov and Ekaterina Antopiva. The apartment reeks of gasoline, the furniture is broken, and the flooring is partially damaged. Fortunately, our camera crew has arrived just as Anatoly and Ekaterina are cooking up a batch of krokodil. A large amount of codeine based pills are crushed and mixed with gasoline, then heated over a small fire. After the concoction is ready, it is filtered through a piece of fabric and then mixed with iodine and vodka. Due to ethical and legal reasons, our cameras did not broadcast every step in this “devil’s” kitchen. Finally, Anatoly and Ekaterina inject the cloudy yellowish liquid into their rotten gangrenous hands and legs that are covered with ulcers and abscesses. “This is how we live, “Ekaterina reveals, as the crew filmed in silent horror. The two narratives mentioned above were filmed in October 2012. Over the next three months, all of the participants undergo a complete treatment and rehabilitation course and return back to normal life. It was at this particular time that I realized that one of my long-term goals was finally becoming a reality – to gather people suffering from drug addiction from different parts of the world and treat them in real time in front of the eyes of the world. This idea was not created out of my personal ambitions; it was based on 25 years of hard practical work and the successful treatment of 17,000 patients. By investing my own personal capital and effort into such a large scale project, I personally wanted to demonstrate to the people of the world the sickness from the inside out. Moreover, I wanted to illuminate others how addiction can and must be treated and to sincerely express that hope should never be lost. There is always a way out! Three and one-half million viewers watched Dr. Life on-line. Our viewers learned the differences between heroin and alcohol addicted patients. They also learned that even people that were addicted to Desomorphine, a drug known in Russia as “krokodil” that causes human flesh to quickly decay, have a chance to survive. We tried very diligently not to create an environment of panic during the taping of the entire project. Just two weeks ago, the first two suspected cases of the drug-use in the United States were reported in Arizona shocking health authorities. My colleague, Dr. Frank LoVecchio, the co-medical director at Banner's Good Samaritan Poison and Drug Information Center expressed extreme concern. Soon after the first reports were published in the nationally syndicated USA Today, the story was picked up by The Independent, TLTV and several other French and Norwegian TV Channels. In the world news, the story began to circulate about a new, cheap and deadly drug from Russia. Further, the articles reported that within a month of starting to use it, human flesh as well as the brain and liver began to rot and a user’s average life expectancy did not exceed two to three years. When I first heard the reports, I was alarmed at how sensational the news was being reported. As a health professional who faces the evils of addiction on a daily basis, I felt it was my moral responsibility to issue a statement to the media outlets of the world in hopes of calming and reassuring the American public that no krokodil epidemic is on the way. Americans should not fear Russian Krokodil. First, Krokodil is a drug used in the most impoverished regions and countries in the world. Due to the simple fact that it is so easy to manufacture, drug dealers avoid distribution since there is essentially no profit to be made in the sale of krokodil. However, the drug is a threat to Latin America, Africa, and certain South East Asian countries. For example, in Magadan, addicts cook krokodil after stealing a TV from a neighbor; in Moscow and other large metropolitan cities around the world, no one has even heard of this drug before. It is by far, much easier to purchase heroin, cocaine, methamphetamines, or ecstasy, than risk buying a low quality, cheap drug. Desomorphine is a close substitute for heroin and is easily manufactured using codeine. In order to combat the rising number of krokodil addicts in Russia, the Russian Federation passed a law that limited the purchase of prescription drugs containing codeine. A year after the law was passed, the use of krocodil dropped drastically. Second, when manufacturing krocodil, the toxic odors emitted during the process are nauseous and unbearably noticeable. It would be impossible to manufacture it in an open and/or neighborhood area where law abiding citizens resided. It can only be prepared in isolated poor areas where ignorance and chaos rule. In the United States, as far as I'm concerned, there are not too many isolated and unnoticeable places. Further, it is very difficult for me to imagine that just one floor downstairs, upstairs, across the hall from or even across the street from, a neighbor manufacturing krocodil would go unnoticed. Third, one has to take into serious account the unattractiveness of this particular drug. An individual who injects a mixture of gasoline, dissolved codeine tablets and alcohol into his/her vein is someone addicted, desperate and broke. Gleb Antonov, a participant on “Doctor Life” from the United States, was openly disgusted when he saw the hands and legs of the participants addicted to desomorphine. Despite the fact that he himself was a junkie, he always tried to appear neat and clean. He was extremely baffled, searching for any reason as to why someone would inject poison and dirt into their veins. When filming of the project concluded, he remained dumbfounded to these questions. Perhaps it is safe to assume that even the average standard of living in America is still one of the highest in the world. In my opinion, I believe the social structure and atmosphere in America will never allow a synthetic drug like krokodil to become widespread. The United States government is able to control the supply of drugs containing codeine by limiting its sales. Finally, can you even imagine people lining up at gas stations across the United States filling up their plastic Coca-Cola bottles with gasoline in order to manufacture krokodil? Not a chance, but unfortunately, this is common in Russia. What we are seeing today in the United States mass media outlets reminds me of a story published on-line last year in the “Russian Reporter.” The author of the article explained how easy it was to purchase over-the-counter codeine-based pills in Russian pharmacies. In other words, young people did not even need a prescription to purchase one of the lethal components needed to manufacture krokodil. Next, the author went on to explain how to manufacture the drug by providing the “recipe” for krokodil. In response, the Federal Russian Bureau for Drug Control, an agency that restricts the rights of drug addicts and conducts thorough drug tests for every convicted criminal, strongly insisted the article be removed from the website. Their request was obeyed, yet journalists’ around the world vilified the government agency for violating their basic right to freedom of speech, even though the journalist openly and recklessly printed the recipe. Something very similar has occurred in the United States. The two cases in Arizona have created a scandalous situation and sparked interest in a new drug invented in Russia called krokodil. The power of the media creates and sustains certain prejudices, and just as the Russian readers were provided with a complete recipe to manufacture krokodil, thousands of addicts in the United States will become interested in this new and intriguing Russian drug. In this sense, the power and influence of mass media outlets does have its downsides. I personally do not support the panic-mongers from Arizona who speculate on given facts and spread groundless rumors that serve to create fear! As for the horrible abscesses, ulcers, bruises, sores and peeling flesh, the citizens of America and the world should know that all are treated by classical physical therapy and with a broad spectrum of fifth generation antibiotics. All of these severe and dreadful physical symptoms begin to heal following 20-30 days of intensive therapy. Unfortunately, however, addicts who exhibit stages of severe physical condition and extremely weakened immunity are almost impossible to save. During the project “Doctor Life,” we met with Anatoly and Ekaterina, both of whom had injected krokodil for the last three years. In addition, they had been addicted to drugs for 16 and 12 years respectively. Anatoly even boasted about his abilities to manufacture krokodil bragging his mixtures were as clear and transparent as a tear drop. Although both Anatoly and Ekaterina had used drugs extensively for more than a decade and exhibited signs of latent diseases, we were able to bring them to a normal state of life after 45 days of intensive therapy. The rough scarred tissue, caused from years of injected krokodil, remained visible on their hands and legs, serving as a painful and sad reminder that this "LEPROSY" can eventually be treated. I adamantly believe that the Americans should not fear krokodil; just the opposite, specialists should focus on providing the most effective treatments instead of spreading groundless fears. For all of the skeptics who still have doubts and want to see the “proof” of successfully treated patients addicted to krokodil, stay tuned. In November of this year (2013), together with my television crew, I will present the 20th episode Doctor Life. The episode catches up with all of our participants one year later and we continue to observe our patients getting back to a normal social life, after having undergone treatment from krokodil and other serious addictive substances.