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What is Lean? Cough Syrup, Purple Drank Substance Abuse

Cough syrup. Lean, also called purple lean, sizzurp, or lean drink, combines prescription cough medicine, soft drinks, and hard candy. The cough syrup used to make lean often contains codeine, an opioid drug, and promethazine, which can impair motor function. Abuse of lean has contributed to overdose deaths and harmful effects like constipation and weight gain.

By We Level Up NJ Treatment Center | Editor Yamilla Francese | Clinically Reviewed By Lauren Barry, LMFT, MCAP, QS, Director of Quality Assurance | Editorial Policy | Research Policy | Last Updated: April 19, 2023

What is Lean?

Lean, also called purple lean, sizzurp, or lean drink, combines prescription cough medicine, soft drinks, and hard candy. The cough syrup used to make lean often contains codeine, an opioid drug, and promethazine, which can impair motor function. Abuse of lean has contributed to overdose deaths and harmful effects like constipation and weight gain. While prescription cough syrup can treat colds and allergies, mixing it with alcohol or other drugs can be deadly. Some soft drinks marketed to young adults as “lean” may serve as a gateway to drug abuse.

Because some people replace ingredients with those that better suit their tastes, the color of Lean can vary greatly from batch to batch. Some people, for instance, choose to drink juice or sports drinks instead of carbonated soda, while others opt to add alcohol to their beverages. When combined with other substances, Lean can have extremely dangerous effects.

Lean drug abuse has caused few overdose deaths in the past decade. Abusers also blame Lean drugs and similar mixtures for constipation, dental decay, urinary tract infections, and weight gain. Lean: drug? Prescription-strength promethazine and codeine cough syrup treat allergies, bronchitis, colds, influenza, and sinusitis.

What drug is lean? Over-the-counter cough syrups are sometimes mixed with alcohol and abused like the prescription-strength cough syrup used for Lean. Lean’s fame has also helped legal soft drinks. Despite not containing controlled substances, marketing these soft drinks to teens and young adults may lead to Lean drug abuse.

How to Make Lean Drug (Purple Drank)

In most cases, lean is produced by combining an awful lot of cough syrup available only with a doctor’s prescription that contains codeine and promethazine with soft drinks and candy. The cough syrup is typically the primary component, though the amount added to the mixture is variable. Alcohol or other substances might also be added to the mixture by certain consumers. The production and consumption of lean can be risky. The improper use of lean can have devastating effects on one’s health, including the development of an addiction, an overdose, and even death.

Prescription Cough Syrups

Prescription cough syrup with codeine or promethazine is used to make lean. Here are some possible prescription cough syrups:

  • Robitussin cough syrup.
  • Tussin cough syrup.
  • Robitussin cough syrup.
  • Mytussin AC.
  • Phenergan VC with Codeine.
  • Delsym cough syrup.
  • Zarbee’s cough syrup.
  • Buckley’s cough syrup.
  • Promethazine DM cough syrup.
  • Vicks cough syrup.

    Are Promethazine Cough Syrups Addictive?

    It is a common misconception that this drug is safe because it contains an antihistamine; however, this couldn’t be further from reality. Abusers of substances put themselves in danger of developing a dependency on the substance and even overdosing on it. Abuse and addiction to promethazine can result in side effects that are extremely harmful and transformative to one’s life in the most perilous ways. The psychological and physiological effects of substance abuse and addiction can have a detrimental impact on anyone. It is important to exercise extreme caution when working with potentially dangerous substances like promethazine, which is one of many such substances.

    Lean cough syrups (purple drank) that do not contain codeine do not possess inherent addictive properties. However, they may be subject to misuse with other substances to attain the desired outcome. Adhering to the prescribed usage of medication, such as promethazine cough syrup, is crucial to prevent the possibility of addiction and other unfavorable consequences. It is imperative to follow the guidance of a physician or healthcare provider.

    Is Codeine Cough Syrups Addictive?

    Yes, cough syrups containing codeine can be addictive. When taken in high doses, the opioid drug codeine can produce feelings of euphoria and relaxation. This opens the door to the possibility of abuse and dependence on the substance. Long-term use of codeine cough syrup can lead to tolerance, which means that higher doses are required to achieve the same effects. Tolerance also makes it more difficult to stop using the product abruptly without experiencing withdrawal symptoms. Avoid using codeine cough syrups for purposes other than those recommended by a medical professional and never give them to other people or use them for recreational purposes.

    Cough syrup. Lean, also called purple lean, sizzurp, or lean drink, combines prescription cough medicine, soft drinks, and hard candy. The cough syrup used to make lean often contains codeine, an opioid drug, and promethazine, which can impair motor function. Abuse of lean has contributed to overdose deaths and harmful effects like constipation and weight gain.
    Cough syrup. Lean, also called purple lean, sizzurp, or lean drink, combines prescription cough medicine, soft drinks, and hard candy. The cough syrup used to make lean often contains codeine, an opioid drug, and promethazine, which can impair motor function. Abuse of lean has contributed to overdose deaths and harmful effects like constipation and weight gain.

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    Lean Addiction Statistics

    In 2016, codeine phosphate with pseudoephedrine and guaifenesin was the 241st most prescribed medication in the United States, with more than two million prescriptions. Additionally, a study found that prescriptions for Tylenol, which combines codeine with acetaminophen, increased by nearly 600% as medical professionals looked for alternatives to more potent narcotics. According to the 2016 National Survey on Drug Use and Health, 11.8 million U.S. residents aged 12 or older — or 4.4% — were current users of prescription opioids like codeine.

    33 million

    An estimated 33 million people use Codeine every year.

    Source: NIDA

    500,000

    Almost 500,000 Americans fatally overdosed on Opioids, like Codeine, from 1999 to 2019.

    Source: NIDA

    48 to 72 hours

    This is typically when, after quitting Codeine, withdrawal symptoms are at their height.

    Source: NIDA

    Codeine Drug Facts

    Codeine 

    Codeine sulfate is an opioid analgesic indicated for the relief of mild to moderately severe pain where the use of an opioid analgesic is appropriate.


    Respiratory depression and death have occurred in children who received codeine following tonsillectomy and/or adenoidectomy and had
    evidence of being ultra-rapid metabolizers of codeine due to a CYP2D6 polymorphism.

    Indications and Usage

    Usual adult dosage: 15 to 60 mg up to every 4 hours as needed.

    Doses above 60 mg may fail to give commensurate pain relief and may be
    associated with an increased incidence of undesirable side effects.

    Warnings and Precautions

    • Risk of death in ultra-rapid metabolizers: Conversion of codeine into its active metabolite, morphine, may occur more rapidly and completely resulting in higher-than-expected morphine levels and respiratory depression or death.
    • Respiratory depression: Increased risk in elderly, debilitated patients, those suffering from conditions accompanied by hypoxia, hypercapnia, or upper airway obstruction.
    • Controlled substance: Codeine sulfate is a Schedule II controlled substance with an abuse liability similar to other opioids.
    • CNS effects: Additive CNS depressive effects, including respiratory depression, hypotension, profound sedation, coma, or death when used in conjunction with alcohol, other opioids, or illicit drugs.

    1. Is Lean a Drug? What is lean drug?

      Cough syrups containing codeine can be addictive. Codeine is an opioid that, when taken in large doses, can induce feelings of euphoria and relaxation as well as the potential for abuse and dependence. Long-term use of codeine cough syrup can lead to tolerance, meaning that higher doses are required to achieve the same effects, and abrupt cessation of use can result in withdrawal symptoms. It is essential to use codeine cough syrups only as prescribed by a medical professional and to avoid recreational use and sharing.

    2. How to make purple drank lean?

      The ingredients of purple drank can vary, but it typically includes prescription-strength cough syrup containing codeine and promethazine, a carbonated soft drink, and hard candy.

    3. Does lean show up in a drug test?

      Yes, drugs like codeine and promethazine, which are in lean, can be found in drug tests. Codeine can be found in urine tests for up to two to three days after use, while promethazine can be found for up to four days.

    4. Can cough syrup for adults be used to make lean?

      Yes, cough syrup for adults can make lean, but it is not recommended without a prescription and proper medical guidance.

    What is purple drank? Purple drank, also known as lean, is a recreational drug that is typically made by mixing prescription-strength cough syrup containing codeine, promethazine, and other ingredients with soda, candy, and sometimes alcohol.
    What is purple drank? Purple drank, also known as lean, is a recreational drug that is typically made by mixing prescription-strength cough syrup containing codeine, promethazine, and other ingredients with soda, candy, and sometimes alcohol.

    Short Term Effects of Lean Drug

    Here are some short term effects of the Lean drug:

    • Euphoria: Lean can make you happy, relaxed, and satisfied.
    • Drowsiness: The antihistamine in Lean can make you feel sleepy and slow down your movements.
    • Slower breathing: slouching can slow down your breathing, which can be life-threatening.
    • Some people who take Lean get sick and throw up because of how the ingredients work together.
    • Constipation: The opioid in Lean can cause constipation, which can be unpleasant and lead to other health problems.
    • Dizziness: Because Lean is a sedative, it can make you feel dizzy and make it hard to move around.
    • Dry mouth: The antihistamine in Lean can make your mouth dry, which can cause problems with your teeth.

    Long Term Effects of Lean Drug

    Few studies have been done in this area, so we don’t know much about the long-term effects of Lean Drug abuse. But long-term use of Lean has been linked to many bad health effects, including:

    • Addiction: Using Lean regularly can lead to physical dependence and addiction, which can be hard to break without help from a professional.
    • Respiratory problems: The cough syrup and soda in Lean can cause respiratory depression, making breathing hard, especially for people with lung problems.
    • Damage to the liver: Over time, the high amounts of acetaminophen in the cough syrup used to make Lean can damage the liver.
    What type of drug is lean? Lean is a combination drug typically containing prescription-strength cough syrup, soft drinks, and candy. The active ingredients in cough syrup are usually codeine and promethazine, both drugs that can cause sedation and respiratory depression. As such, lean is considered a type of depressant drug. However, due to the inclusion of other substances like caffeine and sugar, it can also have stimulating effects.
    What type of drug is lean? Lean is a combination drug typically containing prescription-strength cough syrup, soft drinks, and candy. The active ingredients in cough syrup are usually codeine and promethazine, both drugs that can cause sedation and respiratory depression. As such, lean is considered a type of depressant drug. However, due to the inclusion of other substances like caffeine and sugar, it can also have stimulating effects.
    • Kidney damage: Using codeine in Lean for a long time can damage the kidneys.
    • Mental health problems: Being lean can cause or make anxiety, depression, and other mental health problems worse.
    • GI problems: Using Lean for a long time can make you constipated, leading to bowel obstruction and other GI problems.
    • Problems with your teeth: The soda and candy used to make Lean have a lot of sugar, which can cause tooth decay and other problems with your mouth.
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    How Long Do The Effects of Lean Last?

    The length of time that lean’s effects last can change depending on many factors. In general, the effects of lean can last anywhere from a few hours to a few days, depending on the dosage and individual factors. The duration of the effects of lean can be affected by several factors, including the following:

    • Dosage: The effects may continue for a longer period of time if the dosage is increased.
    • Tolerance: People who use lean consistently may develop a tolerance to its effects, which may lengthen or shorten the duration of those effects.
    • Metabolism: A person’s metabolism can affect how quickly their body processes and eliminates the drug, which can affect the duration of the effects.
    • Orally administered lean has the potential to produce effects that are more long-lasting than those produced by snorting or injecting the substance.
    • The duration of the effects of being leaner can also be influenced by a person’s body composition, which includes their weight, percentage of body fat, and level of hydration.

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    Does lean show up on drug tests? Because the drug is legal (with a prescription), many people mistakenly think it is safe to use for recreational purposes. 
    Does lean show up on drug tests? Because the drug is legal (with a prescription), many people mistakenly think it is safe to use for recreational purposes. 

    Effects Of Lean Abuse

    What drug is lean? Lean is so named because of its effect on people who drink it — they tend to slouch or lean to one side the more they consume the mixture. The effects of Codeine are similar to those of other addictive Opioids (such as Oxycodone and Percocet). Typically, its effects kick in within 30 to 45 minutes, though differing amounts of Codeine in Lean (sometimes up to 25 times the recommended dose) can shorten onset times. The peak effects begin 1 to 2 hours after ingestion and last about 4 to 6 hours. Knowing how to make a lean purple drink is risky as it can lead to poisoning and overdose.

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    Is Lean Dangerous to Drink?

    Many Lean users underestimate the dangers of drinking Codeine. Abusing any substance is dangerous to one’s health, but Opioids are of particular concern because of the high risk of developing a tolerance and, eventually, addiction.

    As tolerance to Lean builds, the system produces less and less of its natural Opioids until it entirely depends on the foreign substance. This dependency compels the individual to consume more and more of the drug to get the same feeling or, in most cases, to feel normal.

    The more you drink lean regularly, the more likely you will develop withdrawal symptoms when you stop drinking.
    The more you drink lean regularly, the more likely you will develop withdrawal symptoms when you stop drinking.

    The abuse of opioids like Lean can also lead to life-threatening health complications and even fatal overdose. Upon consuming too much Lean, the brain is flooded with Opioid molecules and becomes unable to regulate its response or mitigate their effect.

    The highly addictive nature of opioids is due, in part, to their rewarding, euphoric effects. Opioids should only be used in a therapeutic context under the direction of a physician and should only be taken as prescribed to mitigate some of this addictive potential.

    Chronic use of opioids, such as the codeine found in purple drank, can lead to the development of drug tolerance and dependence. As tolerance mounts, people may need to consume increasing amounts of the drug to experience the desired effects.

    This ramping up of drug-taking behavior can drive the development of significant physiological dependence. Opioid-dependent people are likely to experience a range of unpleasant withdrawal symptoms should they go without the substance for too long.

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    Dual Diagnosis Treatment for Polysubstance Abuse

    it is crucial to realize that mixing codeine and alcohol can lead to addiction and dangerous side effects, including a greater risk of overdose. People with a history of problem drinking and alcohol dependence will need to inform their doctor about these problems. In addition, these individuals must get help from a qualified addiction rehabilitation center. 

    To determine the most effective ways to treat alcohol addiction, getting an accurate assessment of all the symptoms is crucial. When a mental health professional has evaluated the symptoms, it may be determined that another form of mental condition is present and needs a particular treatment. Very often, some combination of psychotherapy, medication, and lifestyle changes are effective for coping with functional.

    Medically Assisted Detox

    Medical detox is often considered the first stage of treatment. It will help you navigate the complicated process of alcohol withdrawal but doesn’t address patterns of thought and behavior contributing to drug use. Various treatment approaches and settings can help provide the ongoing support necessary to maintain long-term sobriety after you complete detox.

    Cravings are very common during detox and can be challenging to overcome. This often leads to relapse. Constant medical care provided during inpatient drug and alcohol rehab helps prevent relapse. Clinicians can provide the necessary medication and medical expertise to lessen cravings and the effects of withdrawals.

    Psychotherapy 

    Several different modalities of psychotherapy have been used in the treatment of mental health disorders along with addiction, including:

    • Cognitive Behavioral Therapy (CBT) – is an effective treatment that involves changing both the patterns of negative thoughts and the behavioral routines which are affecting the daily life of the depressed person for various forms of depression.
    • Dialectical Behavioral Therapy (DBT) – is a comprehensive mental health and substance abuse treatment program whose ultimate goal is to aid patients in their efforts to build a life worth living. The main goal of DBT is to help a person develop what is referred to as a “clear mind.” 
    The best alternative for these individuals abusing lean is to seek professional help immediately.

    Dual Diagnosis Treatment

    Drug abuse and mental health disorders often co-occur. Traumatic experiences can often result in mental health disorders and substance abuse. Dual-diagnosis rehabilitation treats both of these issues together. The best approach for the treatment of dual diagnosis is an integrated system. This strategy treats both the substance abuse problem and the mental disorder simultaneously. Regardless of which diagnosis (mental health or substance abuse problem) came first, long-term recovery will depend largely on the treatment for both disorders done by the same team or provider.

    Medication-Assisted Treatments

    Medication-Assisted Treatments (MAT) for substance use and mental health disorders are commonly used in conjunction. This includes the use of medications and other medical procedures. During your rehab, the staff from your treatment facility will help you identify what caused your addiction and teach you skills that will help you change your behavior patterns and challenge the negative thoughts that led to your addiction. Sometimes, the pressures and problems in your life make you rely on substances to help you forget about them momentarily.

    If an alcoholic decides to stop drinking, they may alcohol experience withdrawal effects such as anxiety, restlessness, insomnia, and tremors. The development of tolerance and withdrawal are indications of addiction. If you or a loved one are struggling with long-term codeine and alcohol abuse and a co-occurring mental health condition such as depression, contact one of our helpful treatment specialists today. We Level Up NJ can provide information on dual diagnosis and detox programs that may fit your needs.

    Prescription Drug Abuse Sobriety Story

    “I wanted my life back. I was a shell of a person. I wanted to be trusted, I wanted relationships back that I lost, mainly my children and family. It started innocent enough, I got into a car accident, and then I got kind of sucked into the whole, you know, medication issue with the pills. And before I knew it, I was in a cloud. I was sucked in by addiction, and with my mind, I kept thinking it was OK because a doctor was prescribing this for me, a doctor was giving me this, a doctor was giving me that.

    So, I didn’t think I was doing anything wrong. Level Up supports my family and my relationships with my family, and they’ve helped me grow as a person. When I first started there, I was so intimidated and kind of scared, you know? But, they’ve taught me, they’ve kind of taught me how to come into my own. And then, you know, when I get the call from my twenty-one-year-old daughter in the middle of the day, just to say ‘I love you, Mom.’ that’s amazing.”

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