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  • Purple Codeine | What Is Lean & Purple Drank?

    Published on November 2, 2020
    white styrofoam cup on a street curb

    Purple codeine is slang for an addictive beverage or concoction made with codeine cough syrup, promethazine, and various sugary soft drinks like Sprite or Mountain Dew.

    Also called “purple drank”, “lean cough syrup”, “sizzurp” or just “drank,” the purple reference comes from the color of most codeine cough syrups. 

    Since codeine causes drowsiness, sedation and euphoric effects, the term “lean” was established decades ago and refers to when people high on purple codeine struggle to stand up or walk properly.

    Lean is popular among rappers and hip hop artists. References are apparent in their songs, and  artists like Lil Wayne have been hospitalized due to purple drank. Some artists, including DJ Screw, have died as a result of purple codeine abuse. 

    Codeine & Promethazine In Prescription Cough Suppressants

    Doctors prescribe codeine cold medicines to stop coughing due to colds, allergies, influenza and bronchitis. Codeine reduces activity in the medulla oblongata, a brain area controlling reflexes such as sneezing, swallowing, and coughing. 

    Ingested codeine is quickly converted into morphine in the body where it targets brain receptors involved in regulating pain and sedation. 

    Some codeine prescription cough syrups also contain promethazine, an antihistamine that decreases sneezing, runny nose and itchy eyes associated with seasonal allergies. 

    Like other antihistamines, promethazine cough medicine causes drowsiness but not sedation. When combined in one syrup, codeine and promethazine can suppress breathing, slow down heart rate, and lead to unconsciousness if abused. 

    Codeine Cough Syrup Abuse Potential

    The U.S. Drug Enforcement Administration (DEA) lists codeine (in cough syrups) as a Schedule III drug with a low to moderate potential for substance abuse and addiction. Other Schedule III drugs include anabolic steroids, ketamine, and testosterone.

    When codeine is used to make pain relief prescription drugs (over 80 mg per dose), it is then listed as a Schedule II controlled substance. 

    If you’re caught in possession of drugs containing codeine and do not have a prescription for them, you could be charged with felony drug possession and/or sale.

    Why Do People Drink Lean Cough Syrup?

    Purple drank produces a dreamy, dissociative euphoria that is powerfully addicting, both physically and psychologically. Lethargy and impairment of motor skills (walking, talking, sitting, or standing upright) contributes to the feeling of being “outside the body.” 

    Anecdotal reports further claim that people enjoy the taste and “mouth-feel” of purple drank more than alcohol or drugs that are smoked. This mouth-feel can be increased by throwing in hard candies, which is known as Jolly Ranchers.

    Purple Codeine Alternative: DXM

    When codeine cough syrup can’t be obtained, some people with purple codeine addiction will replace codeine with dextromethorphan (DXM), an over-the-counter cough suppressant found in Robitussin cough syrup. 

    Like codeine, DXM suppresses the cough reflex area of the medulla oblongata but does not affect opioid receptors in the brain. Instead, DXM increases serotonin levels in the brain and acts as an ecstasy-like stimulant at low doses. 

    Consuming around 300 mg of DXM will cause side effects similar to being extremely drunk. Higher doses of DXM produce euphoria, hallucinations, complete loss of motor coordination, and severe breathing difficulties.

    The Dangers Of Purple Drank Use

    Codeine is an opioid that can be just as addictive as prescription pain pills or even heroin. 

    Side effects of abusing purple drank include:

    • hyperthermia (high body temperature)
    • nausea and uncontrollable vomiting
    • palpitations/heart arrhythmia
    • hives/skin swelling
    • respiratory depression or slowed breathing
    • muscle tremors/seizures
    • Unconsciousness

    Codeine Addiction

    Addiction to purple codeine exists when finding and using the drug becomes your top priority. You may begin to:

    • neglect your responsibilities in favor of drug use
    • continue to use codeine despite consequences to your health and relationships
    • experience withdrawal symptoms when you stop use 

    Tolerance builds rapidly to codeine, causing you to need higher doses of codeine to get high. A full-blown addiction can develop within just several weeks of regularly drinking purple drank, which can lead to withdrawal when you try to quit.

    Codeine Withdrawal Symptoms

    Codeine withdrawal symptoms come in two phases, with the initial phase beginning within six to 10 hours following the last drink. 

    Withdrawal symptoms may include:

    • stomach cramps
    • nausea
    • insomnia
    • anxiety 

    Long-term codeine misusers can expect the second round of withdrawal symptoms to last about a week or two and be more severe, especially when trying to stop cold turkey: 

    • painful leg cramping
    • chills
    • increased anxiety
    • continued sleeplessness
    • nausea/vomiting
    • low-grade fever

    The longer you have abused purple drank, the worse your withdrawal symptoms will likely be.

    In both phases of withdrawal symptoms, you may be constantly fighting powerful cravings for lean cough syrup. Cravings combined with withdrawal symptoms may force you back to drinking purple drank or resorting to mixing DMX with alcohol or other depressants for relief. 

    Treating Purple Codeine Addiction

    The best way to beat drug abuse or an addiction to purple codeine is to complete a medical detoxification program in a treatment center. 

    Following medical detox, patients undergo evidence-based therapies and counseling to better understand addiction and learn coping skills essential for recovering and remaining sober.

    For more information about getting help for codeine/purple drank abuse for yourself or a loved one, contact Ark Behavioral Health today.

    Written by Ark Behavioral Health Editorial Team
    ©2024 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.

    American Pharmacists Association - Dextromethorphan abuse: Clinical effects and management
    National Institute on Drug Abuse - DrugFacts Cough and Cold Medicines final
    U.S. Drug Enforcement Administration - Drug Scheduling

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