Lean, also referred to as “purple drank” or “sizzurp,” is a recreational drug cocktail that consists of codeine linctus (an opiate), promethazine and hydrocodone. The substance is usually mixed with a fizzy drink containing sugar and has earned a somewhat notorious reputation, particularly among the rap and hip-hop communities and among teens and young adults aged 13 to 21. In spite of its fun appearance, the lean drink poses some serious side effects and long-term health risks. This article covers everything you need to know about the drink, including how to spot addiction in teens and how to get help.
What Is Lean?
Lean is a narcotic recreational drink that’s highly addictive. While its main ingredient, prescription cough syrup containing small amounts of codeine, seems relatively benign, the substance is still an opiate that should only be used under a physician’s care.
Cough syrup also contains promethazine, an antihistamine with strong sedative properties. Consuming these compounds by themselves is unpleasant. To improve the taste, lean users mix the active components with a sugary carbonated drink. Users may also add a hard candy, such as a Jolly Rancher, to make the concoction more appealing. Lean users often take the drug with other substances like marijuana and alcohol. Music videos frequently depict the drug being casually consumed out of a Styrofoam cup.
What Are the Effects of Lean?
Serious side effects of lean include:
- Slowed heart rate. Because codeine depresses the nervous system, drinking lean can dangerously lower your heart rate and breathing.
- Depressed breathing. High doses of codeine can slow breathing rates, which can lead to oxygen deprivation and even death.
- Seizures. Lean can decrease heart and breathing rates to the point that not enough oxygen is getting to vital organs, causing seizures.
- Tooth decay. Lean is a sugary drink that can cause tooth decay. Individuals with poor dental hygiene may experience harmful effects.
- Hallucinations. Codeine can make you see and hear things that aren’t there. Hallucinations can also make a person take unnecessary risks that can cause bodily harm.
- Impaired vision. Blurry vision, double vision and problems seeing in the dark are all common effects of opioid use.
The Realities of Lean Addiction
Most lean-dependent individuals are drawn in by how the substance takes hold of their brain and rewires their current state of consciousness. As an opiate, codeine creates sensations of warmth and well-being. It even has the potential to reduce emotional suffering because users are often in a mellow, low-stress state.
People who misuse codeine may suffer the following effects:
- Urinary tract infections
- Dental problems
- Excessive weight gain
- Constipation
- Seizures
Promethazine, while not a controlled substance, also contributes to lean’s addictive potential because of its qualities as a sedative. This element of cough syrup is known to produce symptoms such as drowsiness and dizziness that contribute to the sense of euphoria people experience after drinking lean. Some say the drug helps them relax, while others fall into deeply lethargic, dreamlike states.
The health impacts of excessive lean consumption become dangerous when heart rate and breathing slow. These symptoms can lead to coma and even death, especially when mixing lean with other prescription drugs.
How Addictive Is Lean?
The addictive potential of lean is reasonably high. All opioids carry a high risk of dependency, and many believe the current opioid crisis originated in the misuse of legally prescribed painkillers like codeine.
Opioids contribute to addiction because they activate the brain’s reward center and send an influx of dopamine to its receptors. This means that after consuming opioids, your body produces the chemical and physical reactions that generate cravings, causing you to seek repeated use. The more a person uses an opioid-based substance, the more tolerance they build up and the more substance they need to achieve the same effects.
How Do You Know When You’re Addicted to Lean?
Several key signs point to potential physical and psychological dependence on codeine cough syrup. Some of these indicators of addiction may include:
- Increased compulsion to consume lean
- Continued usage despite wanting to quit
- Opioid withdrawal symptoms (insomnia, sweating, agitation)
- Persistent cravings
- Social and occupational problems
- Increased risky behaviors
- Noticeable changes in personality
- Legal and financial problems
Spotting Lean Use in Children
Because lean is most commonly abused by teens and young adults, parents need to recognize the signs of use before it becomes an addiction. The following are signs to watch for that might indicate your child may be using lean:
- Missing medications. The lean drink uses common ingredients found in most medicine cabinets. These drugs include antihistamines and Phenergan. If you notice you’re missing cold medicine, be sure to ask your child.
- Changes in behavior. Personality changes are a warning sign of drug use and addiction in both adults and children. If your child is constantly angry, refusing to get out of bed, not taking part in activities, losing weight or ignoring old friends, it might be time to talk.
- Changes in their vocabulary. Your child may try to hide their use of lean when talking to friends on the phone or in person by using drug-specific lingo. Pay attention to words like sip-sip, purp, Texas tea and purple drink, which are all alternative words to describe lean.
You may also hear your child talking about robotripping, which refers to using dextromethorphan, an over-the-counter cough suppressant. When consumed quickly in large amounts, dextromethorphan can cause hallucinogenic effects. It’s important to note that consuming too much of this medication at one time can also cause liver damage, stroke, breathing problems, psychosis and overdose.
Barriers to Seeking Help for a Lean Drink Addiction
Finding yourself in the middle of any unhealthy habit is hard to admit, and knowing when to seek addiction treatment often comes with a lot of hesitation, self-doubt and other barriers. Many people fear the stigma associated with seeking treatment for a substance use disorder. They worry about being judged or labeled for their inability to manage a potentially dangerous health condition that’s simply beyond their control.
Some people worry that treatment could potentially impact their professional life and reputation. In reality, substance use disorder is a disease like any other. It’s not a sign of a personal shortcoming or individual weakness. The most impressive minds and hardest-working individuals have been known to face serious bouts of addiction and overcome them to lead productive lives again.
The stigmas associated with chemical dependency may seem like too much to handle as you grapple with your situation. Remember that addiction isn’t a moral failing on your part, and you should be treating it like any other health concern you might have. Professional help is available, and attempting to fight this battle without support can be dangerous. This is especially true when dealing with a prescription opioid addiction that can quickly spiral into dependence on more dangerous street forms of the drug.
Get the Help You Need
Working with an experienced addiction professional will help you address your physical dependency, any underlying behavior patterns and other health concerns that may be contributing to your addiction.
Take the first step by calling the National Rehab Hotline now. We’ll familiarize you with a variety of treatment options that can help you develop the coping mechanisms you need to put your addiction behind you permanently and connect you with local resources.


