Table 2 Homemade drug solutions, street names, ingredients, geographic area of use and key public health concerns

Krokodil.

Other common street names: Russian Magic, Crocodile, Russian Heroin

Opiate-desomorphine

Codeine, gasoline or paint thinner, iodine, red phosphorous, tropicamide

Injecting risks for BBV transmission and risks present in the production process, contamination, chemical reaction, sharing of paraphernalia, and group injecting practices.

High mortality rates.

Krokodil users presenting in surgeries/emergency rooms with serious and advanced medical complications.

Undesirable medical and social costs.

Russia, Ukraine, Georgia, Kazakhstan. Germany (Bochum, Berlin, Frankfurt), Norway (Tromsø). Also: Anecdotal reports in UK, Czech Republic, France, Belgium

Boltushka.

Other common street names: Baltushka, Balka

Cathinone

Ephedrine, pseudoephedrine, warm water, household vinegar, and potassium permanganate

Injecting risks for BBV transmission and risks present in the production process, contamination, chemical reaction, sharing of paraphernalia, and group injecting practices.

Long-term users of boltushka can experience partial loss of cognitive function, Alzheimer-type symptoms, and possible brain damage.

Manganese-induced Parkinsonism, which is irreversible.

Undesirable medical and social costs.

Odessa*

Jeff

Other common street names: Jaff, Cat, Mulka, Ephedrone

Methcathinone

Phenylpropanolamine, warm water, household vinegar, and potassium permanganate

Injecting risks for BBV transmission and risks present in the production process, contamination, chemical reaction, sharing of paraphernalia, and group injecting practices.

Manganese-induced Parkinsonism.

Injecting risks for BBV transmission.

Undesirable medical and social costs.

Ukraine

Fentanyl patches (new and used).

Other common street names: China White, White Persian

Opiate

Fentanyl, acetaminophen, caffeine

Fentanyl use is associated with increased odds of overdose.

Criminality such as misusers who resort to obtaining used patches from elderly nursing home residents, and searching hospital and nursing home dumpsters for discarded patches.

Undesirable medical and social costs.

Russia, Belarus

Cheornaya

Opiate

Poppy Straw, cigarette ash, sodium bicarbonate

Access to poppy straw is seasonal and when it is scarce, injectors will turn to other opiate-type drugs.

Injecting risks for BBV transmission and risks present in the production process, contamination, chemical reaction, sharing of paraphernalia, and group injecting practices.

Circulatory damage and soft tissue infections amongst injectors.

Undesirable medical and social costs.

Russia

Himiya

Opiate

Poppy straw

Access to poppy straw is seasonal and when it is scarce, injectors will turn to other opiate-type drugs, including krokodil.

Injecting risks for BBV transmission and risks present in group injecting practices.

Undesirable medical and social costs.

Ukraine

Braun

Other common street name: Brown

Opiate

Mixture of morphine and codeine products, e.g. hydrocodone

Injecting risks for BBV transmission and risks present in the production process, contamination, sharing of paraphernalia, and group injecting practices.

Czech Republic

Kompot

Other common street names: Polish heroin

Opiate

Poppy straw, acetic anhydride, acetone

Access to poppy straw is seasonal and when it is scarce, injectors will turn to other opiate-type drugs.

Injecting risks for BBV transmission

Guillain-Barré Syndrome.

Injecting risks for BBV transmission and risks present in group injecting practices.

Undesirable medical and social costs.

Poland

Shirka (Ukraine)

Other common street names: Cherniashka, Black, Hanka

Opiate

Poppy straw

Access to poppy straw is seasonal and when it is scarce, injectors will turn to other opiate-type drugs

Injecting risks for BBV transmission and risks present in group injecting practices.

Undesirable medical and social costs.

Ukraine, Moldova

Shirka (Odessa*)

Methamphetamine

Ephedrin, Pseudoephedrine

Binge-using patterns that enhance the probability of unintentional overdoses.

Injecting risks for BBV transmission, i.e. risks present in the production process, contamination, sharing of paraphernalia, and group injecting practices.

Undesirable medical and social costs.

Odessa*

Hemia

Opiate

Poppy straw

Access to poppy straw is seasonal and when it is scarce, injectors will turn to other opiate-type drugs, including krokodil and kolyosa.

Injecting risks for BBV transmission and risks present in group injecting practices.

Undesirable medical and social costs.

Odessa*

Kolyosa

Opiate

Mixture of codeine-containing pills

Users will turn to this due to poppy straw being unavailable with associated overdose and injecting risks.

Injecting risks for BBV transmission and risks present in the production process, contamination, sharing of paraphernalia, and group injecting practices.

Undesirable medical and social costs.

Moldova

Pervitin

Other common street name: Vint, Piko

Methamphetamine

Ephedrine, pseudoephedrine, industrial chemicals such as gasoline, toluene and tetrachlorethylene

Binge-using patterns that enhance the probability of unintentional overdoses.

Injecting risks for BBV transmission and risks present in the production process, contamination, sharing of paraphernalia, and group injecting practices.

Undesirable medical and social costs.

Czech Republic, Moldova