Monday, April 29, 2013

Russian Nightmare

Russia is a country where tragedy and angst are guests that never leave.

That is not to say that Russia or Russians hold no amount of humor and light, I'm sure.  I've never been there, but I collect Soviet "anecdotii" (jokes), wickedly sarcastic and funny views of the burdens Russians and others endured throughout that era.

Now, it is not a Communist economy the people have to fear, but
another Russian tragedy, and it is the direct result of State[i] intervention....albeit intervention that is no doubt backed by a sincere wish to "help people."

A designer drug called "Krokodil", a sort of home-made desomorphine  is making the rounds in the slums of Siberia and Ukraine.  As far as I can see, "Krokodil" is suicide in a syringe.  It is made from codeine--available over the counter in Russia--iodine; and something called red phosphorous, right in the user(s)' home in a pot on the stove.  The high from  Krokodil lasts about an hour and a half, and supposedly painful withdrawal symptoms set in right away so the ability to avoid injecting more is probably nil.

(Before I go on, a couple of caveats.  A homemade drug, used in a country whose HIV population stems largely from used needles, has dangers that aren't necessarily associated with the commercial or medical variety.  The pharmacological variety was used safely for medical purposes in the early 20th century.  

Also, as I write it occurs to me that this   sounds a little like Reefer Madness and other anti-drug propaganda.  So  the information available to us about its manufacture and consequences may be exaggerated. Nevertheless, in the interest of erring on the side of caution, I feel an urgency to inform others.)

The cycle that seems to occur in most cases--cooking, injection, high, cooking, injection, high--causes permanent physical effects shortly after it begins, from skin lesions up to and including the loss of skin and muscle such that bones are bared.   Brain damage, and eventually death, occur  if the cycle isn't broken quickly (users are said to have a longevity of only 1-3 years after use begins).

Those who do want to break the cycle are subject to unbelievably painful withdrawal symptoms which last 2-4 times as long as that from heroin withdrawal;  and of course treatment of wounds and rotting limbs is painful in itself.  I would also guess that use of such a potent drug would render many pain killers ineffective.

Why  would people want to do something that is almost guaranteed to kill them, and definitely guaranteed to cause horrible disfigurement?  They assuredly don't; maybe many of them aren't educated about the effects before starting.  Certainly others, particularly young people who have thus far avoided any sense of not being invincible, see its use as an adventure.

But many  are people who used to use heroin, and who, because of their addiction and its scarcity, are willing to take the chance.

Russia is a nation with one of the highest rates of heroin abuse and dependence.  They would like to get rid of that title.  Politicians and concerned professionals got together and decided on what they thought was a way to dramatically reduce the incidence of heroin use:  tighten the border with Afghanistan to reduce the trafficking of opium. (See the second paragraph in this article)

Unfortunately, this crackdown has resulted in what always occurs when a vice is prohibited or made more difficult  to obtain.  People will find a way to replicate the effects of their drug or drink or habit.  Most of the time, if a homemade substance is used to stem the desire of a another drug, immediate personal injury isn't a risk.  Bathtub gin drinkers in the 1920s and window box pot gardeners of the 1970s were probably physically fine after indulging in their favorite drug, unless they drove into an accident or were beaten up during an arrest.  Krokodil has broken that barrier.

Ben Stone of has advised that when the State heightens restrictions or outright bans a substance, whatever replaces it will be 10 times as potent and 10 times as dangerous.  That is certainly the case with Krokodil, which is said to be exactly 10 times as potent as heroin and many more times as destructive to the human body.  It is also 10 times cheaper:  the usual dose of heroin costs about 62 Euros (probably around 100 dollars); the usual dose of Krokodil goes for 6.20 Euros.  This directly reverses the effect the State probably wanted in the first place:  reduced use.  Furthermore, the difference in price with heroin is directly due to heroin's current degree of scarcity.

Instead of restricting the availability of a product, it would be nice if education about the drug and treatment were more available.  I don't know what the availability of treatment in Russia is; I would predict that traditional stigmatism and denial regarding drug and alcohol use (the Soviet Union insisted it had no significant rate of alcoholism throughout its existence, even as  its citizens stepped over countless drunks in the streets and subways, for instance) serve to make treatment poor and scarce.  All tied up in that, of course, is the tendency for people all around the world to see substance abuse as a personal defect or weakness.  Who would want to tell their doctor they used this stuff?

Krokodil and the spread of its use are a direct result of the State's jackbooted assault on freedom and personal choice, however well-intended.  There are awful personal consequences of the use of heroin OR desomorphine; but the world should know by now that restriction and prohibition worsens those consequences instead of ameliorating them.

A Youtube video with more information is here, but do not watch if you don't have a strong stomach.  NSFW, although since my office provides substance abuse treatment, I went ahead and looked anyway.  Gruesome.  

About a month ago, scary headlines alerted the US public to "cases" of krokodil use in  Arizona and Oklahoma.  The Oklahoma deaths were found not to have been caused by the drug; other cases are questionable, and the DEA has not yet officially announced the existence of krokodil here.  According to Newsweek, the fact that codeine is not available over the counter may be slowing would by krokodil users down, making other synthetics preferable.--kln, 11/16/2013

[i] By State, I do not mean any one government or one of the different United States of America, Mexico or Brazil.  I mean the imaginary construct by which people have been encouraged to see their own government or any group of individuals as “authority” or “saviors”. The State can be a national government, a mob, or any combination of people who aim to control other groups of people.    My underlying assumption is that a human being’s natural state (no pun intended!) is free from the constraints of undesired government.   

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