Alcohol Addiction Treatment

Lean, Purple Drank, Sizzurp: What is it, What's in it, and Why is it So Risky?

It goes by many names, but no matter what you call it, it’s as sweet as it is dangerous. You may know it by many street names, including lean, sizzurp, purple drank, purp or dirty Sprite, but all monikers refer to the same concoction. While it doesn’t always include liquor, alcohol dependency is a common comorbidity, as is additional opioid use.

Here, we’ll take a closer look at what lean is, why it’s particularly hazardous to teens and young adults, and what types of treatment are available to help you or a loved one toward recovery.

What is Lean?

Lean is a mixed drink that can include many ingredients. Like alcohol, it’s consumed as a beverage, but due to the mix of drugs it contains, lean can be exponentially stronger. It’s often referred to as “purple drank” due to the coloring that results from the cough syrup and soda mixture, and is usually called “lean” due to the impact of the cough syrup, which causes those who consume it to lean, slump or slouch.

Ingredients of Lean

The specific ingredients found in lean will vary because it is most frequently mixed from items easily accessed over the pharmacy counter (OTC) or in people’s homes. However, there are many elements of lean that are considered to be the most common, including:

Codeine: Codeine is the active ingredient in many prescription cough syrups. It is classified as an opioid, and while it isn’t available over the counter, leftover prescriptions can easily be found in the medicine cabinets of many average homes.
Promethazine: This is an antihistamine that is easily available at any pharmacy or drug store. It is used for allergies or to treat nausea and insomnia and is often sold under the brand name Phenergan.
Dextromethorphan (DXM): Found in many over-the-counter cough medications, DXM is a common ingredient in syrups. While not an opioid, it can have dissociative and intoxicating effects when misused.
Soda: Sprite or Mountain Dew are the most common sodas used to make lean, which is why it’s frequently called “dirty Sprite.”
Hard candy: Candies like Jolly Ranchers may be crushed up or allowed to dissolve to give it additional color and sweetness.
Alcohol: Alcoholic beverages are sometimes added to lean to increase the potency.

Dangerous Side Effects of Lean

There is a perception of lean as a fun or even teen-friendly party drug. This reputation is misleading, as consumption of lean can put you in danger of serious health risks and a potentially fatal overdose.

Sedation

Both codeine and promethazine have a sedative effect, even when taken as directed. When drinking lean, it’s difficult to know how much you’re consuming in a single serving.

Your heart rate and breathing can slow to dangerous levels before you realize you’ve had too much. You’re likely to feel extreme drowsiness as the effects of codeine kick in.

Impaired Motor Skills

As the sedatives in the drink begin to take effect, you would find it increasingly difficult to remain in an upright position. Most people who consume lean are unable to stand, walk, or perform any type of movement that requires coordination and fine or gross motor skills.

Hallucinations

Lean puts you into a state of altered consciousness due to its impact on your brain and nervous system. This can lead to hallucinations, seizures or a break from reality. In this state, you might make extremely risky or dangerous decisions that can lead to great harm.

Tooth Decay

While not deadly, the dental problems associated with lean consumption can be severe. Due to the high sugar content of lean, overconsumption can contribute to tooth decay, gum disease, painful infections or abscesses and eventual tooth loss.

Weight Gain

Weight gain is a likely side effect of regular lean use due to the sugar in most mixes. Additionally, the sedative nature of the drugs leads to impairment and a more sedentary life, which can also contribute to weight gain.

The mix of sugar and chemicals can be hard on many body systems and can also lead to issues like UTIs, liver damage and kidney or bladder infections.

Mental Health

Mental well-being can suffer dramatically when taking lean on a regular basis. The sedatives and the impact it has on the central nervous system can lead to depression, anxiety, and other psychological issues. Because of this, addiction treatment frequently includes mental health therapy.

Potential for Codeine and Opioid Addiction

Lean is a highly addictive substance due to the opioids and sedatives it contains. Lean addiction is very similar to other types of substance use disorders but closest to heroin, oxycodone, fentanyl and other opioids.

Because there is no “recipe” for lean, it can be mixed in batches that contain dozens of doses of codeine and promethazine. The already sweet cough syrup is then mixed with soda and candy, which covers the taste of the medication and can lead to overconsumption.

The effects of lean are usually felt within 30-45 minutes, and the euphoric feeling can last up to six hours. With continued use, the potential for dependence and then addiction only grows, and the road to recovery gets harder.

Cultural Impact and Misconceptions Around Purple Drank

Mixes similar to lean have been around for decades, but purple drank first came to prominence in pop culture in the ‘90s and early 2000s, mainly through subsets of the rap and hip-hop genres of the music industry.

It is now mostly prevalent among males under the age of 21 (below the legal drinking age in the U.S.). Until recently, codeine cough syrup was regularly prescribed for sick children, making it a common find in many family homes. Promethazine was also easily sourced from medications already on hand or at the pharmacy.

Additionally, it is made or obtained without the need for a dealer and at a much lower cost. All these factors mean that lean is used far more frequently by young people, particularly those who idolize the rappers and social media influencers who promote it in the entertainment industry.

Legal Issues and Regulations on Controlled Substances

While the medications needed to make lean were once very easily obtained, it’s now become harder to acquire codeine cough syrup. In 2017, the FDA cracked down on codeine prescriptions for children and required warning labels to be added to bottles. While the FDA has also tightened the laws around promethazine injection, it can still be found over the counter in most pharmacies.

Lean is made of legal substances, but those substances may be obtained illegally. Stealing prescription drugs and misusing or distributing them, especially to minors, can come with severe legal consequences.

Treatment and Recovery from Lean Addiction

Treatment for lean addiction is very similar to that of opioid use disorder. Inpatient or outpatient care may be required for teens and young adults. Because lean contains opiates, there may be withdrawal symptoms that occur when starting treatment. In this case, detox is typically a necessary part of the process. How long the detox takes and how intense it is often depends on the length of substance use and the amount taken.

Therapy is also frequently an important part of the recovery process. For teens and young adults, family therapy can be beneficial, but individual therapy may help as well. It is important to note that lean addiction is opioid addiction and is a serious substance use disorder that depends on long- or short-term professional help to overcome.

How Caron Treatment Programs Can Help

If you, your child, or a loved one is at risk and facing addiction, drug abuse help is available, and recovery is within reach. At Caron, we offer inpatient treatment at the Caron Pennsylvania Campus and the Caron Florida Campus. Our compassionate team of healthcare providers is made up of the best experts in substance abuse treatment and recovery.

We use an evidence-based approach to care through our signature and core programming. We seek results, but we treat with empathy and understanding. Learn more about how Caron can start you or someone you love on the road to recovery, and contact us today.