WARNINGDANGER OF DEATH
High doses alone or ordinary doses in combination with other depressants can fatally stop breathing.
Desomorphine
Desomorphine is a semi-synthetic opioid of the morphinan class, first synthesized in the early 1930s and marketed by Roche under the trade name Permonid.citation needed Characterized by a fast onset, short duration, and analgesic potency roughly ten times that of morphine intravenously, its significant dependence potential led to withdrawal from clinical use. It is the psychoactive component of the crude street preparation known as krokodil,1 notorious for causing severe tissue necrosis at injection sites due to toxic impurities and is highly disadvised to use.citation needed
Dosage & Duration
Dosage
Doses are population estimates that vary widely between individuals.
Duration
Subjective Effects
Legacy content. A statistically backed ontology from Mindstate Design Labs is coming soon.
The experience is broadly comparable to that of heroin or oxycodone, dominated by euphoria, sedation, and powerful pain relief. Owing to its structural differences from morphine, the onset is notably rapid and the duration of action considerably shorter, producing a fast-arriving but relatively brief opioid state. At equianalgesic doses, respiratory depression is more severe than that of morphine.
Physical
The body experience combines heavy sedation and analgesia with characteristic opioid side effects, including constipation, nausea and vomiting, itching, urinary retention, and suppression of the drive to breathe. Pupil constriction, skin flushing, and pins-and-needles sensations (paresthesia) commonly accompany the experience, and drops in blood pressure have been noted.
Cognitive
The headspace centers on opioid euphoria alongside a sedated, pain-free mental state. Decreased libido is also reported.
Pharmacology
Pharmacodynamics
Desomorphine is a potent morphine-like opioid that acts as an agonist at the μ-opioid receptor, functionally mimicking the activity of endogenous endorphins. Historical clinical comparisons found it approximately 8 to 10 times more potent than morphine on a milligram-per-milligram basis via intravenous or intramuscular administration.citation needed The available literature does not provide a modern desomorphine-specific receptor subtype affinity panel or a defined functional Emax comparison that would justify calling it a full agonist without naming an assay.
Pharmacokinetics
In recombinant human enzyme experiments, CYP2B6, CYP2C8, CYP2C9, CYP2C18, CYP2C19, CYP2D6, and CYP3A4 contributed to desomorphine metabolism. Eight phase I metabolites were identified: nordesomorphine, desomorphine-N-oxide, norhydroxydesomorphine, and five hydroxylated species.7 Nine recombinant UGTs, namely UGT1A1, UGT1A3, UGT1A8, UGT1A9, UGT1A10, UGT2B4, UGT2B7, UGT2B15, and UGT2B17, contributed to formation of desomorphine-glucuronide. These in-vitro findings characterize candidate metabolic pathways but do not establish human oral or injected bioavailability, clearance, metabolite exposure, or half-life.7 Desomorphine has a pKa of 9.69 and exists in four isoforms (A, B, C, and D), with the C and D forms appearing to be the more commonly studied.
Dangerous
Highest riskThese combinations are considered extremely harmful and should always be avoided. Reactions to these drugs taken in combination are highly unpredictable and have a potential to cause death.
Unsafe
AvoidThere is considerable risk of physical harm when taking these combinations, they should be avoided where possible.
Caution
Use cautionThese combinations are not usually physically harmful, but may produce undesirable effects, such as physical discomfort or overstimulation. Extreme use may cause physical health issues. Synergistic effects may be unpredictable. Care should be taken when choosing to use this combination.
Tolerance
Tolerance timelines are rules of thumb, not exact schedules, and vary widely between individuals and use patterns.
All other opioids
Harm Potential
Addiction & Dependence
Psychological
Extremely HighDemonstrates significantly higher abuse potential than morphine in human use, with compulsive redosing patterns similar to heroin.citation needed The rapid onset produces an intense euphoric rush that reinforces addictive behavior. Animal studies showed limited addiction liability, but real-world use patterns indicate extremely high psychological addiction potential.
Physical
HighPhysical dependence develops with repeated administration, requiring increasing doses to achieve desired effects. Withdrawal syndrome occurs upon cessation.citation needed Animal studies in monkeys showed less severe tolerance and withdrawal compared to morphine, though human patterns indicate significant physical dependence typical of potent opioids.
Toxicity
Pure desomorphine produces more severe respiratory depression than morphine at equianalgesic doses, making this the primary mechanism of fatal overdose.citation needed
Pure desomorphine can cause hypotension as a clinical side effect. Illicitly manufactured krokodil is associated with destruction of blood vessels, phlebitis, thrombosis, and endocarditis from injection of contaminated material.citation needed
Injecting contaminated krokodil can rapidly injure and destroy tissue in the skin, blood vessels, muscles, and bones, sometimes requiring limb amputation in long-term users; pure desomorphine does not cause these effects.citation needed
Illicit krokodil use is associated with bone infection (osteomyelitis), cartilage damage, and muscle destruction; these effects stem from toxic synthesis contaminants rather than desomorphine itself.citation needed
Liver damage has been reported in users of illicitly manufactured krokodil, attributed to toxic synthesis contaminants rather than desomorphine itself.citation needed
Kidney damage has been reported in users of illicitly manufactured krokodil, attributed to toxic contaminants rather than desomorphine itself.citation needed
Iodine used in illicit synthesis can cause thyroid damage in users of contaminated krokodil.citation needed
Brain damage has been reported among users of illicitly manufactured krokodil, attributed to toxic contaminants; pure desomorphine causes sedation but no documented long-term neurotoxicity.citation needed
Urinary retention is a recognized side effect at clinical doses and was considered a significant adverse effect limiting therapeutic use.
Seizure Risk
Seizures are listed among serious medical complications but are not a primary concern or commonly reported adverse effect with desomorphine use.
History & Culture
Discovery and Early Development
Desomorphine was first discovered and patented in Germany in 1920 by researchers working for the pharmaceutical company Knoll, though this early work did not gain widespread recognition. The compound was independently synthesized in the United States in 1932 by chemist Lyndon Frederick Small, who…
Legality
International
Desomorphine is listed in Schedules I & IV of the 1961 Single Convention on Narcotic Drugs. It is not listed under the 1971 Convention on Psychotropic Substances. It is not listed under the 1988 Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances.
By Country
References
Source Pages
Citations
- Maximilian Gahr, Roland W. Freudenmann, Christoph Hiemke, Ingo M. Gunst, Bernhard J. Connemann, & Carlos Schönfeldt-Lecuona. (2012). Desomorphine goes "crocodile". Journal of Addictive Diseases, 31(4), 407–412. https://doi.org/10.1080/10550887.2012.7355701
- Desomorphine (Krokodil) Basics; curated drug-information summary, modified 2016-05-05. erowid.org (n.d.). https://www.erowid.org/chemicals/desomorphine/desomorphine_basics.shtml1
- Desomorphine substance reference page; current page accessed 2026-08-16. psychonautwiki.org (n.d.). https://psychonautwiki.org/wiki/Desomorphine1
- Synthetic substances with morphine-like effect: clinical experience; potency, side-effects, addiction liability. Bulletin of the World Health Organization, 17(4–5), 569–863 (1957). https://pubmed.ncbi.nlm.nih.gov/13511135/1
- Metabolism and Analysis of Desomorphine. ojp.gov (n.d.). https://www.ojp.gov/pdffiles1/nij/grants/254755.pdf1
- California Poison Control System; updated January 2023. calpoison.org (n.d.). https://calpoison.org/blog/krokodil1
- Jessica Winborn, Donovan Haines, & Sarah Kerrigan. (August 2018). In vitro metabolism of desomorphine. Forensic Science International, 289, 140–149. https://doi.org/10.1016/j.forsciint.2018.05.01712
- Emanuele Amorim Alves, Jean-Paul Cornelis Grund, Carlos Manuel Afonso, Annibal Duarte Pereira Netto, Félix Carvalho, & Ricardo Jorge Dinis-Oliveira. (April 2015). The harmful chemistry behind krokodil (desomorphine) synthesis and mechanisms of toxicity. Forensic Science International, 249, 207–213. https://doi.org/10.1016/j.forsciint.2015.02.0011
- Poisons Standard. tga.gov.au (n.d.). https://www.tga.gov.au/products/regulations-all-products/legislation-and-legislative-instruments/poisons-standard-susmp1
- Suchtgiftverordnung, Anhang I.1.b. ris.bka.gv.at (n.d.). https://ris.bka.gv.at/NormDokument.wxe?Abfrage=Bundesnormen&Anlage=1&Artikel=&Gesetzesnummer=10011053&Paragraf=&Uebergangsrecht=1
Further Reading
Article Status
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Josie Kins · Updated the article · also 1,4-Butanediol, 1B-LSD, 1cP-AL-LAD and 573 more
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