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Lean (Sizzurp or Purple Drank) is a recreational beverage that commonly contains codeine cough syrup, soda, hard candy, and occasionally alcohol, as well as the antihistamine promethazine. [1] Its euphoric and sedative effects have fueled its popularity, particularly within hip-hop culture and among partygoers at electronic dance music (EDM) events. Its appeal grew due to the accessibility of its ingredients and the perception that prescription medications are safer than street drugs.
However, this seemingly harmless concoction carries significant dangers, including respiratory depression, liver damage, and addiction. These risks become more likely to occur if lean is incorrectly prepared or has additional harmful substanxes added to it. Understanding the preparation process is essential to recognizing why Lean use has persisted despite its serious health consequences.
- Lean, also known as “purple drank” or “sizzurp,” is a mixture of codeine-based cough syrup, the antihistamine promethazine, soda, candy, and sometimes alcohol. It first emerged in the southern United States in the 1990s.
- People who use Lean often seek it for its euphoric and sedative effects, believing prescription-based ingredients pose fewer risks. Repeated misuse, however, can lead to respiratory depression, organ damage, and addiction.
- Treatment typically begins with supervised medical detox, sometimes supported by medication-assisted treatment like methadone or Suboxone. Therapy (e.g., CBT) aims to address psychological triggers, rebuild healthier habits, and manage co-occurring mental health issues.
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What is Lean (purple drank)?
Lean, also referred to as "purple drank," "sizzurp," or "dirty Sprite," is a recreational drug usually made by users themselves, mixing prescription cough syrup containing codeine and promethazine with soda and oftentimes candy for flavor. The cough syrup provides the primary psychoactive effects, with codeine being an opioid that induces euphoria and relaxation, while promethazine adds to the sedative properties. The drink originated in the southern United States, particularly within the hip-hop culture of Houston, Texas, during the 1990s and became a cultural phenomenon.[4][5]
Why do people make and use lean?
The accessibility of the primary ingredients, which are mostly prescription medications, contributes to its widespread recreational use, as some people perceive it to be easier to obtain than illicit drugs. Lean is most commonly used for its euphoric and sedative effects, creating a feeling of detachment from stress and reality.[2]
How Lean is made
The lean preparation process involves mixing cough syrup with sweet, fizzy drinks and other ingredients to create the beverage.
- A certain amount of cough syrup is mixed in a large plastic or Styrofoam cup (oftentimes, this is doubled for cultural reasons).
- A fizzy drink such as Sprite, Fanta, or Big Red is typically added to dilute the syrup. Soda can also be replaced with an equal amount of liquor, such as Hennessy, vodka, rum, or whiskey.
- Hard candies are usually dissolved in the mixture, enhancing sweetness and creating vibrant color for aesthetic reasons.
- A few ice cubes are usually added to chill the drink if preferred.
Primary Lean ingredients
What makes Lean unique is that it primarily consists of two relatively easy-to-access psychoactive drugs, which are codeine and promethazine.
However, there are variations in ingredients, and they include:[2]
- Cough syrup: Prescription-strength cough syrups contain codeine, an opioid that suppresses coughing, and promethazine, an antihistamine and sedative. Popular brands include Phenergan with Codeine and Wockhardt. Over-the-counter (OTC) syrups, such as Robitussin DM, NyQuil, or Delsym, contain dextromethorphan (DXM), which can cause dissociative effects or an “out of body” sensation when taken in large amounts, commonly referred to as “robotripping.” In some countries, codeine cough syrup is available without a prescription.
- Mixers: The most commonly used mixers are soft drinks like Sprite and Mountain Dew. Other fruity, carbonated sodas such as Fanta (grape, orange, or pineapple), Big Red, and Tahitian Treat are also popular choices. Some people add alcohol to the mix, using liquors like Hennessy, vodka, rum, or whiskey.
- Candy (Optional): Hard candies, such as Jolly Ranchers, are added for sweetness, color, and aesthetics.
- Ice (Optional): Ice is sometimes included to keep the drink cool, though it’s not an essential ingredient.
Availability and risks of homemade Lean
Lean is a homemade mixture. It is not a commercially produced or standardized product; rather, it is a recreational concoction typically mixed by individuals who consume it. Homemade Lean is widely available due to the accessibility of its ingredients. However, because it is homemade, it can carry significant risks due to inconsistent dosages and the potential for dangerous combinations, especially when mixed with alcohol or other substances.
Effects of lean use on the body
Lean use can cause a range of physical and mental effects, from mild symptoms like drowsiness to severe complications such as respiratory depression, organ damage, and addiction.
- Drowsiness
- Dizziness
- Slowed breathing
- Nausea and vomiting
- Skin itchiness (pruritus)
- Damage to the liver and the kidney
- Respiratory depression (especially when mixed with other substances and with overdose)
- Euphoria
- Confusion
- Seizures
- Anxiety
- Depression
- Memory loss
- Reduced psychomotor performance
- Hallucinations (rare)
- Dependence
- Addiction
Lean addiction and dependence potential
It is clear from various studies that Lean does have dependence and addiction potential; this is due to its key ingredients: prescription cough syrup containing codeine and promethazine.[2] Codeine is an opioid that activates the brain's reward pathways, leading to feelings of euphoria and relaxation, which can result in physical and psychological dependence when used regularly, in specific circumstances, or in high doses.[9] Promethazine may further enhance these effects, making Lean more addictive for many people.
The recreational use of Lean normalizes consumption and increases the likelihood of misuse. Regular use builds tolerance, meaning people need increasingly larger doses to achieve the same desired effects, further entrenching the cycle of dependency.[10] Withdrawal symptoms, such as restlessness, nausea, and intense cravings, can also make it challenging for users to quit. All of these factors contribute to the addiction potential of Lean.
Dangers of codeine overdose
When someone overdoses on codeine, the most immediately life-threatening effect is severe respiratory depression. Additional physical signs of codeine overdose may include:[11]
- Diminished levels of consciousness
- Pronounced drowsiness progressing to stupor or coma
- Constricted pupils
- Limp skeletal muscles
- Cold, clammy skin
Lean's cultural significance
Lean’s cultural significance extends beyond its use in hip-hop and EDM party scenes. It is deeply tied to socio-economic, racial, and systemic inequalities. For instance, its origins in Houston's hip-hop culture reflect a localized rebellion against systemic marginalization. The drink became a symbol of escapism in communities wrestling with economic hardship and systemic oppression. In this context, Lean is not merely a recreational beverage but a coping mechanism shaped by societal stressors.
This connection can be juxtaposed with its adoption by EDM party attendees, where Lean is recontextualized as a hedonistic, countercultural indulgence, rather than a socio-political artifact. This appropriation reflects broader patterns of cultural commodification, where substances rooted in specific socio-economic struggles are detached from their original context and rebranded for mass consumption.
Additionally, the glamorization of Lean in mainstream music, including references by artists, like Future, Lil Wayne, and Roddy Ricch, plays a critical role in shaping its cultural perception. Lyrics often romanticize its use, contributing to its appeal among younger, impressionable audiences while simultaneously obscuring its health risks.
This is evidenced by its frequent mention in Billboard Hot 100 songs, even those peaking within the top 10 position. Some notable examples include Lil Nas X’s 2019 “Old Town Road,” which peaked at the first position for nineteen weeks (lyrics: “Lean all in my bladder”), Roddy Ricch’s 2019 “The,”x,” which peaked at the first position for eleven weeks (lyrics: “Pour up the whole damn seal, I’ma get lazy”) and Internet Money’s 2020 “Lemonade”, which peaked at the sixth position (lyrics: “Off the juice, codeine got me trippin’”).[6][7][8]
Treatment for Lean addiction
Treating Lean addiction involves a combination of therapy and medical detoxification as part of a complete addiction treatment plan.
Talking therapies, such as cognitive behavioral therapy (CBT), can help people who use the drug identify emotional links in behavior and drug use, look to identify the root cause, learn to control urges, and help with any co-occurring conditions (such as trauma, anxiety, depression, etc.).
A full medical detox is often the first line of therapy. It is recommended to ensure that withdrawal symptoms and cravings in the first instance are managed with medications such as suboxone and methadone if needed.
If you or someone you care about is struggling with Lean addiction, help is available. Visit our addiction rehab directory to find treatment for lean addiction near you.
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