There have been many stories over the years about giant alligators and crocodiles supposedly living in the sewers of American cities. These wild yarns have been routinely dismissed as urban legends; tall tales spun to frighten, amuse and entertain. But sometimes truth is scarier than fiction, and in the city of Phoenix, a new drug called krokodil (the Russian word for crocodile) has risen like a monster from of the depths of the drug underground to threaten the town\u2019s citizens. Krokodil is so fearsome in its effects that it would make a team of snarling angry crocodiles emerging from the sewer seem like little more than a nuisance. "If you just want to speed up and horrify the death process a little more, take this drug," DEA supervisory agent Sue Thomas told the Deseret News in Utah. "It will rot you from the inside out, leaving you with gaping wounds that will leave bones exposed and horrible abscesses. It's a horrific death." A True Tale of Terror In September, officials with Banner Poison Control Center in Phoenix announced that two area residents had been admitted to emergency rooms for treatment after consuming krokodil. Even though the United States Drug Enforcement Agency first put krokodil on its watch list back in 2011, these are the first two cases of krokodil poisoning known to have occurred in the U.S., which is a dubious first that health officials in Phoenix are hopeful will not prove to be a preview of coming attractions. First seen in Siberia in 2002, krokodil is a wicked brew made from the opiate painkiller codeine and such non-consumable caustic substances as gasoline, paint thinner, hydrochloric acid, rubbing alcohol and iodine. The combination of chemicals used to synthesize desomorphine (the proper name for krokodil) is mixed together thoroughly and then boiled to remove impurities and prevent any remnants of the original toxins from surviving to cause harm to the people consuming the final product. But there is one big problem here: this crude process of purification doesn\u2019t work. Even after boiling, chemical traces of the biologically ruinous substances contained in the initial mix will still remain to contaminate the modified codeine compound, and whether they realize it or not, consumers of krokodil will be injecting a substance into their veins that can eat their organs, bones and cellular tissue from the inside out. If a case of desomorphine poisoning is severe enough, or if the drug is used repeatedly, open sores, blistering abscesses, ragged pustules and ugly crevices can form on the surface of the skin of its victim, along with scaly and crusty greenish patches that some say resemble the skin of a crocodile\u2014hence the name. Since desomorphine first appeared on the scene in Russia in the early 2000s, estimates are that about 2.5 million people have become addicted to it. When injected, it delivers a sensation similar to what is experienced with heroin but can be purchased at a fraction of the cost, making it especially popular among Russian youth attracted to krokodil\u2019s soothing yet euphoric opiate kick. Unfortunately, the average lifespan for a krokodil addict is just three years, so young people who do decide to begin experimenting with this drug are definitely playing with fire\u2014never a smart thing to do when you are shooting something into your veins that was made partially from gasoline. The gross and painful skin wounds associated with desomorphine consumption are only the most obvious manifestations of a process of biological destruction that runs silent but deep. Among its many nasty effects, krokodil in the human body can poison the bloodstream, dissolve the bones of the jaw and cheeks, rot out the inner tissue of the blood vessels, cause irreversible brain damage and intellectual disabilities, and sometimes leave feet, hands or limbs so lacerated and shredded that amputation becomes the only option. The green scaly appearance of the krokodil addict is a sign of a drug dependency run amok, but krokodil can be so potent in some instances that the skin can begin to crack, rot and slough away after just a few doses. Some krokodil abusers in Russia and in other areas of Europe where the drug has now spread have been able to survive and overcome their addictions. But no one escapes \u00a0the ferocious bite of krokodil without a few scars, and even those who manage to beat their addictions to this ghoulish alternative to heroin are usually left with a few lasting health problems as reminders of their past foolishness. From Russia Without Love No one knows for sure if the two cases of krokodil poisoning in Arizona are aberrations or the start of a horrific new pattern of drug abuse. Health officials in Phoenix are highly concerned and greatly fear what the immediate future may hold, but they are also hoping that by publicizing the apparent arrival of this nightmare drug in their city that they will be able to scare people enough to nip any potential new trend in the bud. Unfortunately, krokodil is manufactured from easily obtained materials and does not take sophisticated equipment or skills to make, so there are no barriers to prevent the curious from experimenting with it. And because desomorphine is so new to this country, many people may try it without realizing how dangerous it is. This is a worst-case scenario, to be sure. But the incidents in Arizona may be an ominous portent of things to come. What we are talking about here is no urban legend\u2014krokodil is far more menacing than any creature that ever crawled out of the sewer, and given how toxic and deadly this new Russian import is, we can only hope that its use will not spread too far beyond the fringes of the United States underground drug scene.