Last week, Time ran a photo essay about the dangers of krokodil, a flesh-eating drug that is popular in Russia and Eastern Europe. They titled it “The World’s Deadliest Drug: Inside a Krokodil Cookhouse.” Since heroin is hard to come by in this part of the world, krokodil acts as a heroin substitute, and it’s better than not having anything, at least for the drug addict. Although the fear of having a krokodil epidemic in the U.S. is inflated, there is a reason to believe that we are not exempt from this terrible, skin-devouring drug.

What is Krokodil?

Krokodil (pronounced crocodile) is an injectable opioid that is extremely addictive. The drug is very easy to make and uses tools and ingredients that come from hardware stores and pharmacies. Users mix the ingredients together to get a murky yellow liquid, and they inject the drug into the body to mimic the effects of heroin. Krokodil is far cheaper than heroin, and the fact that it can be made by a novice makes it more readily available.

Nevertheless, krokodil is a drug that carries a lot of risk for its users, and they greatly pay the price. The drug got its name because of the black and green scaly skin that results from chronic use. When the drug is injected into the body, it causes the blood vessels to burst and the surrounding tissue to die. The skin can even fall off in chunks, which is why the lifespan of a krokodil addict is just 2 to 3 years.

Krokodil has also earned itself the nickname “the zombie drug” because it kills people from the inside out. In the meantime, users can suffer from soft tissue infections, damage to the veins and gangrene.

Is Krokodil Found in the U.S.?

At this time, there are no confirmed cases of krokodil abuse in the U.S., but “confirmed” is the keyword. To receive an official confirmation, the DEA must have a sample of the drug. Right now, we don’t really know how widespread krokodil use is in America, but officials have reason to believe that it’s here.

In September, Arizona physicians told toxicologists that they spotted symptoms consistent with krokodil abuse in a patient at the Banner Good Samaritan Poison Control Center. Although this case has not yet been confirmed, it’s area physicians who see emerging drug habits first. And, news of krokodil hasn’t stopped there.

The following month, in October, the Time Newsfeed reported that the Oklahoma Bureau of Narcotics is investigating the deaths of two Oklahoma men who died last year. The men were reportedly krokodil users who had missing skin. The article also reported that the drug has been found in Utah and Illinois.

Illinois is of particular concern because the area already has a big problem with heroin use. It’s believed by some officials that the tolerance to heroin is so high in some users, something like krokodil can offer a different high for a fraction of the cost. This is what the appeal is. CNN confirmed that five people in the Chicagoland area were hospitalized in mid-October with symptoms similar to krokodil use. Like the case in Arizona, it’s area doctors that are seeing the signs first and reporting these findings to the local authorities for further investigation.

If There are No Confirmed Cases, Why Should I Worry?

There are many skeptics who believe that the risk of krokodil in the U.S. is blown out of proportion and that since we can’t confirm any cases at this point, the problem must not exist. We can’t stress how wrong this attitude is to have.

If the fear of krokodil is inflated, then that is fine by us. Better safe than sorry. If we continue to ignore the fact that his drug could be lurking in the streets and posing a risk to the ones we love, we could miss out on finding and arresting the people responsible for manufacturing the drugs, and more importantly, miss out on saving lives.

In the war against drugs, being ahead of the game is the most important piece to the puzzle. Unfortunately, it’s often law enforcement that is the last to know about drug trends, which is why we need to be better listeners when it comes to what area physicians are reporting in their patients.

Krokodil is not an epidemic here in America, but that doesn’t mean that it won’t be. Just because the drug sounds exceptionally dangerous to the general public doesn’t mean that a desperate heroin user won’t experiment with it. It’s important to be aware and open minded so that if you do come across the signs of a potential krokodil addiction, you know not to wait in seeking immediate, intensive treatment.