PHOENIX -- It's a deadly drug with an exotic name. Krokodil is a potent substitute for heroin and it literally has been eating people alive. A homemade morphine derivative, krokodil (desomorphine) was first seen in Russia in 2003, although it didn't attract worldwide attention until 2010.
Although the Drug Enforcement Administration has not confirmed it, it looks like krokodil is now turning up in the U.S., including here in Arizona. In fact, there are concerns that Arizona could be the epicenter of krokodil's U.S. invasion.
The videos and photographs of people who have fallen victim to krokodil are horrifying.
It was a call to the Poison Control Center at Banner Good Samaritan Medical Center that touched off a national alert. "In this case someone called and said we have a patient or two that may have used krokodil," Dr. Frank Lovecchio said. "They claimed to have used krokodil."
After receiving another call -- a similar call -- Lovecchio sounded the alarm.
"When I heard of these cases, we did try to alert other physicians because we thought it was pretty serious -- you know, very life threatening," he said.
Those who have encountered krokodil describe is as a "flesh-eating" drug -- one that eats users alive.
"They usually die of overwhelming skin infection," Lovecchio explained. "They usually die because they lose their limbs or extremities."
The high from krokodil is 10 times more powerful than that of heroin. When you consider that the intense, albeit short-lived, high comes at a fraction of the price of heroin, it's clear that krokodil, which is fairly easy to make in a basic kitchen, is a toxic brew on every level.
"They take a drug like codeine, or a codeine-like drug, and they will try to get it out by using acids or turpentine or gasoline," Lovecchio said. "Unfortunately for the drug abuser, when they inject that, some of that gasoline and turpentine is left behind."
It looks like that is what drug users in Arizona, Utah, Oklahoma and Illinois have been injecting into their veins. The results are scaly green scars -- hence the name krokodil (Russian for crocodile) -- open sores, rotting flesh and amputations.
DEA Agent Ramona Sanchez says it's frightening enough to prompt an investigation.
"We start to monitor what chemicals are being used," she said. "We start to monitor who is doing it, and how it is being produced."
There's also an investigation right here at home.
"We are strictly a clinical lab. We service the poison control center and the emergency-room physicians," Phillip Gatewood said, describing the lab two stories below Banner Good Sam. That's where scientists are trying to determine how krokodil made its way to the U.S.
Gatewood is testing the two samples from Arizona patients in an effort to learn if what they took was actually krokodil. Patient privacy laws mean information is tightly guarded, but Gatewood was able to share some of his general findings.
"What we found was the patients had high levels of drugs that were not related to the new drug, the krokodil," he said.
Until investigators are able to get their hands on the drug the patients actually injected, there might not be much anybody can do.
"The average age of them living once they start using the drug daily is about one to two years," Lovecchio said.
Since these initial reports, both the Poison Control Center and the lab are getting more requests from doctors for information about krokodil and help identifying potential users.