Krokodil in the UK Special Report: No Need to Panic - for Now

It seems to be the case that whatever happens in America is adopted by Britain before long. Whether it's Disney, McDonald's or Levis, we are soon besotted with the fashions of our trans-Atlantic cousins.

Thankfully, with drugs this isn't always the case. Many readers will remember when crack cocaine was first mooted as the next big drug in Britain; police forces assembled crack squads in the face of DEA agent Bob Stutman relating his experiences and predicting the crack of doom. However many of the squads were quickly disbanded, and it took much longer for crack to really gain a foothold in Britain.

A similar pattern has been witnessed with krokodil, the latest drug to percolate America's nightmares. For those unfamiliar with krokodil, it is essentially the street name for desomorphine, a homemade opioid similar to heroin, and is capable of rotting human fresh - the name 'krokodil', Russian for crocodile, was coined in reference to the drug's corrosive properties, which leave users with scaly, leathery flesh at the site of injection.

Perhaps all those grisly pictures of rotting human flesh, churned out by US media and easily accessible via Google Images, coupled with a suggested 2-3 years' life expectancy, have been enough to put British users off. Whatever the reason, krokodil has yet to really get its teeth into the UK, despite the widespread panic it has caused in the States.

Some UK drug workers have reported cases of mephedrone being cut with krokodil (informally titled 'krokodilising') to convert it from snorting to injecting, but as yet there are no Home Office stats on the prevalence of this practice. One doctor in Gloucester, Dr Alan Harris, retrospectively reports encountering one patient using the stuff - a man, who has since died. But we're a long way from the scourge many publications have warned of.

Yet at the same time we cannot afford to be complacent. In 2011 Russia's Federal Drug Control Services confiscated approximately 65 million doses of krokodil. Meanwhile, here in the UK, the drugs charity Release claims krokodil is increasingly acting as a substitute for heroin, which is currently said to be in short supply. This has some technical validity, in that krokodil is an opiate. If Release are correct in their assumption, then the future is worrying.

Krokodil's addictive properties pose an obvious danger. One only has to look at the behaviour of those hooked on methadone, another synthetic opioid, to see how potent its addictive properties could be. Some attendees at methadone clinics which require the addict to drink the methadone in front of the clinic staff will then nip into the loo, make themselves throw up into a plastic bag and then sell the contents to another user in return for money to buy their drug of choice. Whether the use of krokodil, despite its attendant bodily damage, could expand in addiction to epidemic levels is, at present, anybody's guess.

In combating the problem and minimising its spread, one hesitates to suggest the government's information agencies can do much, when, frankly, they can't even get their information on cannabis right. However formal and informal information would be one obvious target for increased resources. The government could also channel funds into street agencies and outreach services, to help get the word out on the street. And the message would be clear: 'Don't touch this stuff, even with two bargepoles tied together'.

In reality, of course, users' information networks often exceed those of any intervention agency. This leaves us with prevention, i.e. to change the culture of society in general and potential users in particular, so as to pre-empt any drug misuse. Given the present pathetic level of worthwhile prevention in the UK, largely assuming, quite wrongly, that information-giving is all you need, the short term prognosis of prevention as a cure is bleak and black. Prevention remains the 'Cinderella service'. And krokodil is but one of her ugly sisters.

Peter Stoker is director of the National Drug Prevention Alliance, a charity which strives to promote best practice in drug prevention. For more information about the NDPA, click here.