A Ghastly Price For Success: Krokodil

The war in Afghanistan (remember that one?) clearly is resulting in, at long last, a decrease in the opium poppy trade, and the concomitant decrease in the global supply of recreational heroin. Apparently, heroin has become next to impossible to obtain in Russia, not from law enforcement activity but rather because there just isn’t enough of the stuff making it out of Afghanistan.

This seems like it ought to be good news. After all, the (official) drug policy of Russia is like that of the United States: criminalization and interdiction, aimed at making the drug difficult for users to obtain. Law enforcement may not have succeeded in interdiction, but the goal of interdiction — reduced supply, keeping the heroin off the streets — has been realized.

But.

The invisible hand works in the illegal drug market in Russia the same way it works in markets for legitimate products in Western nations. Supply and demand are the drivers, and when demand is high and supply is low, the market will find a way to return to equilibrium. In the case of Russia’s heroin market, the void left by heroin’s sudden unavailability has led chemists to manufactue substitutes. To meet the void left in the illegal narcotics market, some genius in Russia has concocted “Krokodil:”

Desmorphine, a synthetic with similar effects of heroin made from house-held chemicals like codeine (available over the counter in Russia), iodine, lighter fluid, gasoline, and industrial cleaning oil, is street-named Krokodil for the way it literally devours its users (like the mean crocodile). Injection sites turn flesh grey, green and scaly until gangrene skin peels away and bone is exposed; it can lead to amputated limbs.

Photographs of addicts are shocking, to say the least. Exposed bone from wrist to elbow, arms look more like the half-devoured limbs of a zombie than a living human. … [¶] Once users have compiled enough codeine, lighter fluid, industrial cleaning product, and iodine, the thirty-minute cooking process creates enough Krokodil for about a 90-minute high. Most addicts thus spend all their time cooking and shooting, cooking and shooting, until enough skin falls away that they die.

I’m not going to link to any pictures. If you want to be really grossed out — and I mean really grossed out — you can find them yourself. The article is dead-on when it says that the victims look like zombies. Some have walked in to hospitals with bare bone exposed surrounded by patches of gray, flaky, necrotized flesh, requesting piano-wire amputations so they can go home and cook more of the drug for themselves. One of my paralegals tells me that you can find a YouTube video of a patient being given such a procedure without much difficulty.

Making the drug seems no more difficult for a Russian dealer than it is for an American dealer to cook meth from Sudafed. Coedine is available over the counter in Russia, and all you’ve gotta do is cook the psychoactive agents out with some other perfectly legal products. Boom, you’ve got Krokodil and you’ve just rendered moot all the heroin interdiction efforts of the combined powers of the entire industrialized world. Enjoy the drug-induced euphoria that accompanies the remaining eighteen months of your life as you literally turn in to a zombie before you die.

The lesson I take from this is that the last thing we should possibly want is for a supply-reduction antidrug strategy to succeed. No amount of interdiction will ever help alleviate the problem of addiction. If a person wants to use a substance to get high, that person is going to use a substance to get high. How much more of an extreme case does it take to demonstrate that than this? It’s not like heroin is a particularly life-affirming, healthy habit to begin with. But when the supply of that already-dangerous, already-destructive drug is taken away, this is the market’s alternative product.

Supply-side strategies of reducing drug use are doomed to failure. The appalling results of Krokodil replacing heroin in Russia are grisly proof of this. If we want to tailor our public policies to reduce drug use and drug addiction, demand-side strategies are the only way to go. Decriminalization can be part of an intelligent demand-reduction strategy. Portugal has shown us the way forward. Russia shows us the terrible price that may have to be paid if interdiction-like strategies succeed.