The Homemade Russian Drug Krokodil: Is it Good or Evil?

Abstract ID 23123 Poster Board 61 “Krokodil” is the street name for the injectable mixture used as a cheap substitute for heroin. The main psychoactive compound in krokodil is desomorphine. Krokodil is usually prepared at home by the users themselves in a harsh uncontrolled reaction that starts with codeine tablets, alkali solutions, organic solvent, acidified water, iodine, and red phosphorus, all of which are easily available in retail outlets, such supermarkets, and drugstores. The resulting product is a light brown liquid that is called krokodil. Due to its peculiar manufacturing procedure, the krokodil solution produces a large and complex mixture of different substances. The goal of this work was to understand the chemistry behind the krokodil synthesis by assessing the chemical profile of the resulting mixture using different analytical techniques. A reaction mechanism was proposed, and its toxicity and the possible clinical applications of the products formed during krokodil preparation were discussed. A street-like synthesis was performed in the laboratory and an analytical GC-MS methodology for the detection of desomorphine and codeine was developed and validated. This method allowed the confirmation of the successful synthetic methodology that mimicked the synthesis performed by users. The chemical complexity of the krokodil mixture was studied by reverse-phase high-pressure liquid chromatography coupled to a photodiode array detector (RP-HPLC-DAD) and by liquid chromatography coupled to high-resolution mass spectrometry (LC-ESI-IT-Orbitrap-MS). The validated GC/MS method for the quantification of codeine and desomorphine proved to be selective. The regression analysis for the analytes was linear in the range of 0.62-10 μg/mL with correlation coefficients > 0.99. The coefficients of variation did not exceed 15%, the acceptance criteria according to the EMA Guideline. The lowest limit of detection and quantification for desomorphine and codeine were 0.150±0.002 μg/mL and 0.170±0.02 μg/mL, respectively. Considering codeine as the only morphinan precursor and the reaction conditions for the krokodil synthesis, a theoretical chemical set of 95 possible morphinans in krokodil was defined. The exact mass approach was applied, and the defined morphinan mass fragmentations patterns were used as a targeted identification approach. The proposed 95 morphinans were searched using the full scan chromatogram and findings were validated by mass fragmentation o