Bursted blood vessels, scaly green skin, and gangrene are just some of the horrifying effects of one of the newest drugs to hit the American drug trade. Krokodil, named for its ability to make users look like they’ve been bitten by crocs or are turning into one, has made its way over from Russia, with the first two reported cases in Arizona this week.

“We’ve had two cases this past week that have occurred in Arizona,” Dr. Frank LoVecchio, co-medical director at the Banner Poison Control Center in Arizona, told CBS 5. “As far as I know, these are the first cases in the United States that are reported. So we’re extremely frightened.”

Krokodil, also known as desomorphine, rots flesh from the inside out, starting from the point of injection. It’s three times cheaper than heroin, but still delivers the same effects. The designer drug is made by mixing the opioid, codeine, with hydrocarbons — oil, alcohol, or gasoline — as well as paint thinner, hydrochloric acid, and sometimes red phosphorus taken from the tips of matches. It’s then filtered and boiled until the added gasoline or alcohol is removed, presumably.

“They extract [the drug] and even though they believe that most of the oil and gasoline is gone, there is still remnants of it. You can imagine just injecting a little bit of it into your veins can cause a lot of damage,” Dr. LoVecchio told CBS 5.

LoVecchio’s main concern is that this could only be the beginning of an epidemic in the United States. Cases of Krokodil addiction skyrocketed in Russia between 2009 and 2011, with over 2.5 million people seeking treatment during that time. Russia’s Federal Drug Control Service seized as much as 65 million doses of the drug in 2011 alone.

One recovering addict, Irina Pavlova, used to inject the drug almost every day for six years because she had learned to cook it. But even as she recovers, irreparable damage, such as scars, speech impediments, and impaired motor skills from brain damage, still remain. “I can’t go back to that,” she told Time. “I was beautiful when I started out, but what happened … It was like living in a horrible swamp.”

If you want to see the effects of the drug, check out some (graphic) photos here.