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Lean: Prescription Cough Syrup Abuse

December 1, 2016


In a previous blog post, we discussed the dangers of over-the-counter (OTC) cough medicine abuse. Dextromethorphan (DXM), the active ingredient in many popular OTC cough and cold medications, is often abused by teenagers because of its mind-altering effects. It is usually mixed in with soda or other drinks and referred to as “robo” or “drank.” A similar concoction commonly known as “lean” has become increasingly popular as well. 

Lean, also known as “sizzurp” or “purple drank," was first popularized in the 1990s and early 2000s following sizzurp-themed songs by hip-hop artists like Three 6 Mafia and DJ Screw. In recent years, celebrities such as Lil Wayne and Justin Bieber have been associated with the drink and its use has once again become popular, especially among teenagers. With this growing popularity, it’s important to learn about lean and the threats it poses to those who use it.

What is Lean?

Lean is made from a mixture of soda, candy and a cough medicine only available by prescription: promethazine-codeine. This syrup is usually prescribed to treat symptoms caused by the flu, common cold, allergies, or breathing illnesses such as bronchitis. Promethazine is normally used to treat allergies, motion sickness, and as a sedative. Codeine is an opiate used to treat pain and relieve cough. These drugs combined can be very effective when used for specific purposes as prescribed by a physician, but can be dangerous when consumed irresponsibly.

Promethazine-codeine can cause the following side effects:

  • Blurred vision
  • Restlessness and hyperactivity
  • Dizziness
  • Nausea and vomiting
  • Hallucinations
  • Difficulty breathing

The appeal lean presents to those who misuse it is the euphoric high brought on by the codeine and the “relaxed” feeling the promethazine causes. These effects are the result of higher doses of promethazine-codeine than are recommended by doctors, which induces the “slow” and “relaxed” feeling the drink is known for and makes its consumption dangerous. 

The Dangers of Lean

Teens often believe that prescription drugs are not as bad as illicit ones, and they may be inclined to see “purple drank” as a safe cocktail to experiment with. However, the drink can be dangerous and even fatal. In fact, Dr. Robert Glatter of Lenox Hill Hospital called lean “very dangerous” in an interview with the Today Show, stating that “it can lead to seizures and essentially lead you to stop breathing.” When consumed in excess, promethazine-codeine can produce respiratory and central nervous system depression, preventing the lungs and heart from working. Lean has even been associated with the overdose deaths of some prominent musicians who paid tribute to the concoction in their songs. 

Another reason lean can be so dangerous is its users’ tendency to drink alcohol at the same time. As is the case with many drugs, lean is often found at parties and social gatherings in which alcohol is also present. This makes for an especially risky mix because both alcohol and codeine act on the central nervous system. The National Institute on Alcohol Abuse and Alcoholism states that, when using both of them together, the side effects are augmented and the risk for overdose becomes higher. 

Teen Prescription Drug Abuse

The misuse of prescription medications is a trend among teenagers. In fact, after marijuana and alcohol, prescription drugs are the most commonly abused by Americans 14 and older according to the National Institute on Drug Abuse. Given the affordability and accessibility of these medications compared to illicit drugs, it’s easy to see why many teenagers tend to choose them. However, many of these drugs, including the codeine in prescription cough syrups used for lean, can be highly addictive. 

Although there are different ways for teens to get their hands on prescription drugs, the Partnership for Drug-Free Kids reports that 65 percent of teenagers who abuse prescription medications take or steal them from family or friends. This is why it is imperative for adults to keep track of any prescription medications they may have in their home, and be sure to dispose of any that are no longer being used. Parents should take suggested precautions to prevent this risky habit and get help as soon as possible if a teen is suspected of abusing prescription drugs such as promethazine-codeine. If you suspect your teen may be using lean, find help today by calling us at (844)319-5239 or chatting with us. Our admissions counselors are glad to answer any questions you may have 24 hours a day, 7 days a week.

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