II. Background
- Morphine analog at 8-10x the potency (similar potency to Dilaudid)
- Injectable drug of abuse started in Russia
- Often self-produced by the user in small batches within homes (due to instability of the drug)
- Desomorphine is synthesized from Codeine with noxious chemicals
- Red Phosphorus
- Gasoline and other solvents
- Iodine
- Additional contaminants
III. Adverse effects
- Toxicity is associated with solvents, contaminants and variable pH
- Local tissue necrosis, infection or gangrene at injection site
- Diffuse involvement of the extremities may occur with Thrombophlebitis
- Potent Opioid effects
- Naloxone (up to 2 mg) may be effective for reversal
IV. Labs
- Desomorphine level (red top tube)
- Send-out to toxicology lab for processing
V. References
- Nordt and Swadron in Majoewsky (2012) EM:Rap 12(11): 10
- Nordt and Swadron in Majoewsky (2014) EM:Rap 14(3): 10