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What Is Lean? The Harmful Substance and Its Side Effects

With history dating back to the 1960s in Houston, Texas, “lean” or “purple drank” has become increasingly popular—particularly in the hip-hop community. With artists such as Mac Miller admitting to being addicted to lean, the dangers of the concoction have become a huge focal point within the sprawling crisis of addiction.

Lean is known by several names, including purple drank, purple stuff, syrup, and sizzurp. In recent pop culture history, artists like Lil’ Wayne, Bow Wow, Soulja Boy, and Justin Bieber have each made headlines for their use of the substance, with many hip-hop songs featuring references to the drug.

What Does Lean Consist Of?

Lean is a concoction that contains two major active ingredients: promethazine (aka Phenergan, an antihistamine used to treat motion sickness or nausea) and codeine (a narcotic medication that is an opiate). Together, the two ingredients are used as a cough syrup, as it includes a pain reliever and a cough suppressant.

Promethazine alone is currently listed as a Schedule V drug, which indicates it has a low potential for abuse, though promethazine with codeine is listed as a Schedule III drug, making the potential for abuse somewhat more likely. Though if recent headlines are any indication, the potential for abuse of lean is an incredible danger.

Both promethazine and codeine are prescription medications, and are classified as central nervous system depressants. Because codeine is an opiate, its use is regarded as a last resort for those suffering from a severe cough, just as promethazine is specifically intended to treat allergies or motion sickness.

Lean is often a combination of the following:

  • Promethazine with codeine
  • Lemon-lime soft drink (such as Sprite)
  • Hard candies (like Jolly Ranchers)

The ingredients are often mixed together and poured over ice in a large cup. With the hard candies mixed in, the substance is purple in color (hence the name purple drank) and is extremely sweet—making it palatable for the user to drink in large quantities. The amount of promethazine and codeine used when making the drink is typically 25 times that of the recommended dose.

Each of the ingredients in lean are legal, though Actavis, the pharmaceutical company that produced Prometh, a combination of promethazine and codeine, ceased production of the drug in 2014. One article featuring commentary from UT professor Ronald Peters referred to the extinct product as “the caviar of drugs.”

Although Actavis took their version off the market, lean as a whole continues to be abused.

What Happens When Drinking Lean?

Lean users may experience a feeling of euphoria that can be attributed to the opiate codeine. As the user drinks, they may experience different side effects such as:

  • Dizziness
  • Blurred vision
  • Nausea
  • Memory impairment

Promethazine side effects are also risky, and can include:

  • Seizures
  • Severe drowsiness
  • Confusion or hallucinations

An overdose of codeine can lead to coma or even death, which is why drinking lean in large quantities carries such an enormous risk.

Is Lean Addictive?

Following the death of Mac Miller, a known user of lean, rapper Bow Wow came forward to reveal his own addiction to the substance. While Miller’s death has not yet been attributed to any particular substance, his passing has left the hip-hop community reeling.

Bow Wow tweeted about his experiences using lean, writing in part, “Go back and watch the face off show BET gave us! Look how dumb i looked. My ranting i was angry every day. They try to protect the truth by saying i was dehydrated… nawww bro. I WAS HIGH OFF PROMETHAZINE CODEINE! Actavis. SAY NO TO THESE DRUGS.”

Experiences like those of Bow Wow and others prove that lean is highly powerful and is certainly addictive when used routinely.

Addiction to codeine can lead to addiction of other opiates, and the use of lean should not be taken lightly. As use becomes more common, we must be aware of lean’s effects, and provide the proper treatment for those who are struggling with an addiction.

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