howaniec C

“Crocodile” – new dangerous designer drug of abuse from the East

We want to pay attention of clinical toxicologists to new dangerous designer drug, described as the “ crocodile ” or “ Russian heroin, ” which spreads and arouses concern in Europe. 1,2 Because of there is lack of current scientifi c papers dealing with this problem, our aim is also to sum up information available mainly on the internet. “ Crocodile ” is a street name of drug containing mainly desomorphine (Dihydrodesoxymorphine-D), produced in home conditions by simple synthesis from codeine, most often on the basis of codeine-containing medicines, in Russia available overthe-counter so far. 1,3 Desomorphine presents sedative and analgesic effects; it is 8 – 15 times more potent than morphine, and has weaker toxic, convulsant, emetic and respiratory depression action. 4 The drug is administered intravenously or intramuscularly. It has very fast onset of action (2 – 3 min) and a short duration of action (2 h). First symptoms of addiction usually appear after 5 – 10 days. From intake of the fi rst dose, death comes maximally after 2 – 3 years, but even single dose may be lethal for predisposed person. High toxicity is caused by the presence of impurities. Skin in the places of injections becomes grey and green, scabrous, fl akes off, so it resembles the skin of crocodile. Postproduction impurities (residues of acids and alkalis, petroleum derivatives, industrial oils, organic solvents, red phosphorus, iodine, heavy metals) act irritant on vessels which become damaged and afterwards obliterated. It causes peripheral limb ischemia with following necrosis, often secondarily infected, which require surgical intervention and even limb amputations. So this drug “ bites ” the limbs, as a real crocodile. Addicted people may be recognized by the smell of iodine, used during drug production. “ Crocodile ” generally is similar to so-called “ Polish heroin ” ( “ compote ” ) — drug produced also in home conditions from poppy straw, popular in Poland till the late 1990s. 5

Case-study of fatal gunshot wounds from non-lethal projectiles.

The authors present a case of the death of a 60-year-old man shot using rubber projectiles that were fired by a police officer from a Mossberg smooth-bore shotgun in an enclosed space from a distance of a few metres. The post-mortem examination revealed that death had been due to gunshot wounds in the chest which had caused heart and lung damage with subsequent massive internal haemorrhaging.

Evisceration and intestine damage as a rare form of suicide in forensic and psychiatric practice – description of two cases

Suicide is a major public health problem around the world. Case reports include extreme suicidal self-inflicted injuries, in which extensive damage to the abdominal wall associated with injury or even excision of fragments of the intestine and its fragmentation are present. These cases usually give rise to doubts of investigators as to the course of the incident, the circumstances of death and the possibility of participation of other people. At the same time they are interesting from the medico-legal and psychiatric perspective. The aim of this study is the presentation of two extremely rare cases of suicides through evisceration and intestinal injury from the clinical and opinioning practice of the authors, one of which ended with survival and the second one with death. Regardless of the final result of the suicide attempt (death or survival), good practice of the investigative teams in such cases should include a detailed examination of the place of the suicide attempt, obtaining opinion of an expert in the field of forensic medicine with full post-mortem diagnosis, and in-depth forensic psychological and psychiatric analysis of, among others, lifeline, mental state and suicidal motivation (so-called psychological autopsy).