What is Lean and Is It Dangerous?

Medically Verified: 2/1/24

Medical Reviewer

Chief Editor

All of the information on this page has been reviewed and verified by a certified addiction professional.

What is Lean?

Lean is the slang term for an illicit substance that contains codeine. It is also known as sizzurp, dirty sprite, purple drank, or purple drink. In addition to codeine, lean often contains cough syrup, soda, hard candy, and an antihistamine known as promethazine.

Codeine is an opioid that is highly addictive and habit-forming. If you abuse lean or any other codeine cough syrup, you could develop an addiction quickly because of the manner that opioids affect your brain’s reward system.[1]

The drug became popular in the 1990s due to famous rappers and other musical artists referencing the drug in their music. It is not packaged and sold in stores, so people make it at home, and ingredients often change. Being aware of what lean is and why abusing it is dangerous can prevent you from suffering the consequences of a codeine addiction.

The Effects of Lean

Lean was named after the effects it has on people. Codeine, an opioid that can make you feel drowsy, and when you abuse lean, you may become so drowsy that you begin to lean on things to stand up. Typically, lean takes effect within 30 to 45 minutes of drinking it, however, this may vary based on the dosage of codeine the lean contains.

Common side effects of abusing codeine cough syrup include:[2]

• Euphoria
• Dizziness
• Slowed heart rate
• Slowed breathing
• Constipation
• Dental decay
• Nausea
• Weight gain
• Urinary tract infections
• Impaired vision
• Memory loss
• Hallucinations
• Seizures (in at-risk individuals)

What are the Dangers of Abusing Lean?

Lean is popular among teens and young adults because it is frequently referenced in rap and popular music. Because it is made at home, there is no way to tell how much codeine one drink of lean contains, making it extremely dangerous to abuse.

Large Amounts of Codeine

When taken at recommended doses, codeine and promethazine cough syrup can provide relief from allergies or symptoms of a common cold. However, lean tends to contain an excessive amount of codeine, putting you at risk of life-threatening emergencies like overdoses or brain damage.

Large Quantities of Promethazine

In addition to high doses of codeine, lean can also contain excessive amounts of promethazine. Promethazine is a central nervous system depressant that is used as an antihistamine. The sedative effects of promethazine are intended to prevent people from drinking large amounts of it, however, people who abuse lean do not consider this.

When mixed with large doses of codeine, promethazine can slow your breathing to the point of respiratory depression.[3] You may also experience hallucinations and delirium.

Possibility of Addiction

Since lean contains high volumes of codeine, an addictive opioid drug, abusing it increases your risk of developing an addiction.

When you regularly abuse lean, eventually your body will become tolerant of the substance, meaning you will have to increase the dosage to experience the desired effect. Once you develop a tolerance, dependency and addiction are not far behind.

Risk of Overdose

When you take a large dosage of an opioid like codeine, you are at an increased risk of overdose.

Symptoms of a codeine overdose include:[4]

• Bluish fingernails and lips
• Breathing problems, such as slow and labored breathing, shallow breathing, no breathing
• Cold, clammy skin
• Confusion
• Constipation
• Drowsiness, fatigue, weakness
• Flushing of the skin
• Itching
• Lightheadedness, dizziness
• Loss of consciousness, coma
• Low blood pressure, weak pulse
• Muscle twitches
• Nausea and vomiting
• Tiny pupils
• Spasms of the stomach and intestines

If you or someone you know displays the symptoms of a codeine overdose after consuming lean, contact emergency medical services immediately. If you have access to the opioid overdose reversal medication naloxone (Narcan), administer it quickly as it can restore breathing in a person who has overdosed.[5] The quick use of naloxone can stop an opioid overdose, however, the individual must receive proper medical treatment afterward to ensure safety and health.

Getting Help for Lean Abuse and Addiction

If you or a loved one suffer from an addiction to lean, getting help from a drug rehab center is the best decision you can make. Living with an addiction to opioids can be extremely difficult, often putting you at risk of experiencing dangerous overdoses. A combination of medical detox, evidence-based behavioral therapy, peer support, and relapse prevention planning, can help you learn how to maintain long-term sobriety.

If you or a loved one are interested in learning more about our North Carolina addiction treatment programs or if you’re ready to begin your recovery journey, please contact us today.

References:

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851054/
2. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/008306s033lbl.pdf
3. https://fco.factsandcomparisons.com/lco/medguides/659577.pdf
4. https://medlineplus.gov/ency/article/002613.htm
5. https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/naloxone