Krokodil: The drug that eats junkies

A heroin user prepares the drug in Zhukovsky, near Moscow

Several people shared this article from the Independent about krokodil (pronounced crocodile), the street name for a home cooked heroin alternative in Russia. Krokodil is made by processing codeine into desomorphine, which is stronger than heroin but doesn’t last as long. According to the article, “It was given its reptilian name because its poisonous ingredients quickly turn the skin scaly.” After that, the article says, their skin starts to literally rot off.
But how exactly is desomorphone turning people into lizards? I looked up desomorphine in Wikipedia and found this Time article on the same subject. The Time article says:

At the injection site, which can be anywhere from the feet to the forehead, the addict’s skin becomes greenish and scaly, like a crocodile’s, as blood vessels burst and the surrounding tissue dies. Gangrene and amputations are a common result, while porous bone tissue, especially in the lower jaw, often starts to dissipate, eaten up by the drug’s acidity.

Gangrene explains the “rotting,” but gangrene is caused by bacterial infection and is a potential side effect of any unsafe IV drug use. So what’s with the green, scaly skin that precedes the rotting? I couldn’t find anything. The Wikipedia entry and some commenters on the Independent article indicate that it’s not actually desomorphine (which was sold commercially under the name Permonid for some time), but the impurities of its extraction from codeine pills. According to Time, addicts use “gasoline, paint thinner, hydrochloric acid, iodine and red phosphorous, which they scrape from the striking pads on matchboxes” to make krokodil from codeine. As the Wikipedia entry points out, that sounds similar to one of the easiest ways of making methamphetamine from pseudoephedrine.
The Independent also mentions the frequency of administration, difficulties addicts face finding veins and the use of dirty needles. I suspect these details may help explain the damaging effects. Due to desomorphine’s short duration, users have to shoot up more frequently the users of other drugs. This leads to collapsed veins and injections that miss veins. Add dirty needles to the mix, and the risk for gangrene infection goes up. It’s also possible that impurities in krokidil lead to scaly skin before gangrene infection occurs.
Another note: perhaps the name doesn’t really derive from the effect it has on the skin. According to Wikipedia, desomorphine is derived from a chemical called a-chlorocodide. I don’t think it would be a stretch to suggest “chlorocodide” as the source of the street name.
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