Oxana has been lying in bed for the past one year and half with her back permanently damaged. The high use of Krokodil damaged her mussels and her spine. Despite several surgeries she can't seat or stand. Her condition has also been worsened by her father's beatings who couldn't cope with her constant request for money to buy drug.
Oxana has been confined to a bed for more than 18 months after her use of the drug known as krokodil damaged her muscles. Photographer Emanuele Satolli first met Oxana in 2013 when she was still using the drug. Yekaterinburg, Russia.Emanuele Satolli
Oxana has been lying in bed for the past one year and half with her back permanently damaged. The high use of Krokodil damaged her mussels and her spine. Despite several surgeries she can't seat or stand. Her condition has also been worsened by her father's beatings who couldn't cope with her constant request for money to buy drug.
Oxana has been lying in bed for the past one year and half with her back permanently damaged. The high use of Krokodil damaged her mussels and her spine. Despite several surgeries she can't seat or stand and leaving the bed.
Oxana's wedding photo. After her husband died for drug abuse Oxana and her son went to live with he parents. The other picture is a portrait of Yevgeny Roizman, the founder of "City without Drugs" organization and the current mayor of Yekaterinburg.
Oxana has been lying in bed for the past one year and half with her back permanently damaged. The high use of Krokodil damaged her mussels and her spine. Despite several surgeries she can't seat or stand. Her condition has also been worsened by her father's beatings who couldn't cope with her constant request for money to buy drug.
Olga is buried in a cemetery in Uralmash district next to her relatives. She died in 2015 due to her liver failure after a long use of Krokodil.
Lyudmila in her flat in Uralmash district. Her daughter Zhanna died in 2015 due to the long use of Krokodil. Lyudmila is now living with her granddaughter.
Diana in the flat where she's living with her grandmother. Her mother Zhanna died in 2015 due to the long use of Krokodil.
Alexei is buried in a cemetery on the outskirt of Yekaterinburg. He died in 2015 because of the large use of Krokodil that reduced drastically his immune system.
Natalya in the flower shop where she's working. His boy friend Alexei died in 2015 because of the large use of Krokodil that reduced drastically his immune system.
Pavel and Alexei together in a picture taken about ten years ago. The two brothers have used Krokodil for several years. According to Pavel he quit completely after he was close to die for the third time. His brother Alexey died in 2015.
Pavel, a former krokodil user, quit completely to take drugs about two years ago. According to him after he was close to die for the third time in his life.
Due to the prolonged use of Krokodil Pavel has undergone numerous surgeries to remove the infected flesh. He quit completely to take drugs about two years ago, according to him ,after he was close to die for the third time in his life.
Due to the prolonged use of Krokodil Pavel has undergone numerous surgeries to remove the infected flesh. He quit completely to take drugs about two years ago, according to him ,after he was close to die for the third time in his life.
The building where Ilya and Natalya used to live and cook Krokodil. According to their neighbours they disappeared all of a sudden in 2014.
Andrey affected with tuberculosis is in the hospital for over two months. The treatment he is undergoing affects seriously his liver already damaged from a long use of Krokodil.
Andrey affected with tuberculosis is in the hospital for over two months. The treatment he is undergoing affects seriously his liver already damaged from a long use of Krokodil.
Andrey affected with tuberculosis lies in a hospital bed. The treatment he is undergoing is affecting seriously his liver already damaged from a long use of Krokodil.
Empty boxes of syringes distributed by Chance Plus an organization that support drug users in the region affected with HIV and other infectious disease ensuring the access to health services and providing legal consultations.
Ivan, a former drug addicted, currently works helping drug users. According to him about 90 percent of the people in the region who have used Krokodil have died. He called it 'a real epidemic'.
Lyudmila Vince in her office in Chance Plus, an organization that support drug users. According to Lyudmila in the region despite its not very long presence in the market Krokodil killed more people than heroin appeared right after the collapse of the Soviet Union.
A man who has just received syringes and condoms from Chance Plus, an organization that support drug users in the region affected with HIV and other infectious disease ensuring the access to health services and providing legal consultations.
Oxana has been confined to a bed for more than 18 months after her use of the drug known as krokodil damaged her muscles
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Emanuele Satolli
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The World's Deadliest Drug: Krokodil's Legacy

Jun 09, 2016

Early this spring, when the snow began to melt in the Russian city of Yekaterinburg, the photographer Emanuele Satolli went knocking on apartment doors in the Uralmash district, a grimy neighborhood in the north of the city. He knew many of its hallways by heart. This was the place he'd gone in 2013 to photograph young men and women addicted to a synthetic drug known as krokodil. Three years later, he came back to find them again. But their old haunts and cookhouses were mostly deserted.

Krokodil, a cheap substitute for heroin, was one of the deadliest designer drugs ever to sweep through Russia. Appearing on the black market in the early 2000s, it wound up ensnaring hundreds of thousands of addicts across the country, and it spread especially fast in poor, industrial areas like Uralmash.

Its appeal was simple: addicts could easily learn to cook it in their kitchens using ingredients purchased at local pharmacies and hardware stores, among them hydrochloric acid, paint thinner and red phosphorous, which they scraped from the sides of match boxes. For a fraction of the price of heroin, the drug produced a similar high and was just as addictive.

But the damage it caused was far more gruesome and often irreversible. The addict's flesh at the injection site would often rot away, while the tissues of the brain and other vital organs were severely eroded. “So my expectation was to find that some of them had died,” Satolli says of his trip to find the addicts in Yekaterinburg this year. “But not so many."

Read more: The World’s Deadliest Drug: Inside a Krokodil Cookhouse

Of the ten krokodil users Satolli had photographed in 2013, ranging in age from 30 to 43 at that time, three of them were dead by the time he came back this year. Extensive research and interviews with the friends and neighbors of four other addicts from Satolli’s list failed to turn up their whereabouts. “They disappeared,” says the photographer, and among those who knew them, they are usually presumed to be dead.

Of the three former addicts Satolli found alive, one was in the tuberculosis ward in a local hospital; another had been bedridden for two years and unable to leave her apartment. Only one of the recovering addicts Satolli tracked down, a man in his early 30s named Pavel, had managed to kick the habit without sustaining crippling damage to his health.

Photographing them presented a peculiar set of challenges. Three years ago, the hardest part of producing the series for TIME LightBox was to win enough trust to be invited into the kitchens where the addicts cooked krokodil and the shabby apartments they used to shoot up. “The challenge was not to make a cliché picture of an addict with a needle in the arm,” he says. “I tried to respect them, to show that they were more than just drug addicts, to show their whole lives.”

The World’s Deadliest Drug: Inside a Krokodil Cookhouse

The following photographs were taken in Yekaterinburg, Russia in 2013.Alexei, age 33, injects a dose of krokodil. Because of his dependence on krokodil, Alexei has injuries and swelling around his feet and is forced to walk with a cane.
The following photographs were taken in Yekaterinburg, Russia in 2013. Alexei, age 33, injects a dose of krokodil. Because of his dependence on krokodil, Alexei has injuries and swelling around his feet and is forced to walk with a cane.Emanuele Satolli
The following photographs were taken in Yekaterinburg, Russia in 2013.Alexei, age 33, injects a dose of krokodil. Because of his dependence on krokodil, Alexei has injuries and swelling around his feet and is forced to walk with a cane.
A stage of krokodil preparation. Pills of codeine are crushed and mixed with iodine, hydrochloric acid and other chemicals.
Olya, 35 years old, injects krokodil.
Pavel, 31 years old, shows the effects of the krokodil on his skin. The chemicals used to prepare krokodil cause deep wounds and sores.
A view from the top of Yekaterinburg. The city, the regional capital, has about 1.5 million inhabitants and was the first Russian city in Asia. About 80 percent of the population of the region lives in Yekaterinburg. Registered drug addicts number about 40,000.
Zhanna, 34 years old, is out in the Uralmash district about thirty minutes after she has taken krokodil.
A stage of krokodil's preparation.
Andrey, 43 years old, injects Zhanna with krokodil in his apartment in the Uralmash district.
Zhanna, under the influence of krokodil, tries to relax.
Andrey scratches out the desomorphine left on the pot.
Andrey prepares the pills containing codeine. The main ingredient of krokodil is desomorphine, an opiate that is obtained through the synthesis of codeine.
Zhanna checks the krokodil while it cooks.
Zhanna, under the influence of krokodil, tries to get up while Andrey drains the water from a pot to obtain dry sulfur.
Andrey injects krokodil, with Zhanna in the background already under the influence of the drug.
Zhanna, under the influence of krokodil, lies down on the couch.
A woman walks at night on a street in Yekaterinburg during a snow storm.
Oxana, 33 years old, cooks krokodil.
Oxana injects krokodil.
The codeine is boiled in a closed bottle for a few minutes as part of the preparation of krokodil.
Alexey, 30 years old, blows air in a bottle to push the liquid through a filter and use it to prepare the krokodil.
From the left, Alexey, Natalya, 34 years old, and her husband Ilya, 34 years old, prepare krokodil in a kitchen.
A dose of krokodil is ready to be injected.
Alexey injects krokodil. The effect of the drug lasts about 40 minutes.
Alexey lies in bed soon after haven taken the krokodil.
Elman, 40 years old, displays the injuries on his legs which hes says were caused by the use of krokodil and methadone.
The following photographs were taken in Yekaterinburg, Russia in 2013. Alexei, age 33, injects a dose of krokodil. Beca
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Emanuele Satolli
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But the production of his follow-up series on krokodil was in many ways more difficult. It forced Satolli to ask himself: “How can I represent the deaths, the empty places?”

Sometimes the answer was clear. At the city’s crematorium, he was able to access the records of addicts who had died, as well as the names of the relatives who had identified their bodies. Some of those family members then took Satolli to see their graves, which were decorated with the photos of their young faces staring somberly out at the snow.

But beyond that, the photographer was left to ring a lot of doorbells while looking for the remnants of the other addicts' lives. “A lot of people were suspicious, especially old people who [grew up] in the Soviet Union,” he says. Many would stare at him through their peepholes or open a crack in the door before sending Satolli away.

All of the cookhouses and drug dens he had visited in 2013 were either empty or occupied by other tenants – a sign of the fact that krokodil has, thankfully, fallen out of favor in Russia.

Its decline came almost as suddenly as the epidemic that it caused. In the first three months of 2011, the country’s counter-narcotics agency said it had seized around 65 million doses of the drug, a 23-fold increase from 2009. The agency then lobbied for the government to impose a ban on the over-the-counter sale of codeine, the main ingredient in krokodil. By 2014, two years after the ban took effect, federal authorities announced that the drug had been practically eradicated from the streets.

Watch Emanuele Satolli's video report from 2013

In the stairwells of Uralmash, Satolli still found it lurking earlier this year. He says he noticed the distinctive, acrid stink that the cooking process of krokodil produces coming from a kitchen, and the man living in that apartment admitted that he still makes the drug from time to time. But other synthetic drugs, such the ones known in the streets as bath salts, now dominate the market in Russia, while the most common sign of krokodil is the quiet devastation it has left behind.

Emanuele Satolli is an Italian journalist and photographer based in Istanbul. His previous work, See What Undocumented Immigrants Carry Across the Border and The World’s Deadliest Drug: Inside a Krokodil Cookhouse has been published on TIME LightBox.

Olivier Laurent, who edited this photo essay, is the editor of TIME LightBox. Follow him on Twitter and Instagram @olivierclaurent

Simon Shuster is a TIME correspondent based in Berlin.

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