Purple Drank Abuse: Addiction Symptoms, Risks, and Treatment

Several drugs can be easily made for recreational use by mixing prescription or over-the-counter medications (OTC), and one growing concern among parents and schools is purple drank.

This concoction, also known as lean or sizzurp, combines codeine and promethazine—two ingredients that, when misused, cause significant health risks. Popularized by music and social media, lean is now part of a dangerous trend among young people seeking ways to cope with stress, PTSD, and other mental health issues.

The lean drug can cause central nervous system (CNS) depression, which can lead to drowsiness, hallucinations, and in severe cases, respiratory failure or even death. Keep reading to learn about the dangers of this seemingly innocuous drink and how to recognize addiction before it’s too late.

Table Of Contents:

• What Is Lean?
• Is Purple Drank Illegal?
• What is Robotripping?
• Side Effects of Purple Drank
• Can You Die from Drinking Lean?
• Is Lean Addictive?
• Signs of Purple Drank Addiction
• Purple Drank Addiction Treatment
• Treatment for Purple Drank Near Me
• Don’t Get Lost in Purple Cough Syrup Addiction
• People Also Ask

What Is Lean?

Lean, also known as purple drank or sizzurp, is a potent mix of codeine and promethazine, often sweetened with soda or candy to cover its bitter taste. It became popular in the 1960s when Robitussin was mixed with beer. Later, in the 1990s and 2000s, it became mainstream in rap culture.

Codeine, a synthetic opioid derived from morphine, is typically used as a pain reliever and cough suppressant, but its potential for misuse and addiction is well-documented. Promethazine, on the other hand, enhances the sedative effects of codeine, creating a combination that can severely depress the central nervous system.

Other purple drank variations may include:

• Using over-the-counter cough syrup containing dextromethorphan (DXM), known as robotripping.
• Since OTC cough syrups no longer contain alcohol, users add alcohol to the OTC version of lean.
• A combination of codeine tablets was added to cough syrup and soda.

The quantity of purple drank ingredients can vary, but achieving the desired effects typically requires consuming far more than the recommended or safe dose.

Unfortunately, a recent study shows that 66% of lean users are between the ages of 13 and 21, with high concurrent use of alcohol and cannabis. The same research reports up to 66% of frequent purple drank users developing severe substance use disorder.

Can Lean Be Pink?

Yes, lean can sometimes appear pink. While traditional lean is typically purple due to the combination of codeine and promethazine syrup, users may alter the drink’s appearance by mixing it with different ingredients like fruit juice, sports drinks, or other colored beverages.

Depending on the added liquids or flavorings, these variations can change the color, making it pink or even other hues. Different brands or formulations of cough syrup may also affect the final color of the mixture.

Is Purple Drank Illegal?

The legality of purple drank is nuanced. Codeine is classified by the Drug Enforcement Administration (DEA) as a Schedule II controlled substance when used on its own.

Combined with other ingredients, such as cough syrups, it is classified under a lower schedule (class III-V) but still carries a high risk of misuse. Products containing codeine are only available with a prescription. Manufacturing or distributing codeine without proper authorization is illegal.

While some OTC cough syrups containing dextromethorphan (DXM) are legal, states may restrict their sale to individuals over the age of 18 due to potential abuse.

What is Robotripping?

As briefly mentioned above, robotripping is another way of recreational misuse of cough medicines containing dextromethorphan (DXM), a common ingredient in over-the-counter cough syrups like Robitussin. When consumed in large quantities, DXM produces hallucinogenic effects and causes a dissociative “high.”

While DXM is safe when taken at recommended doses to relieve coughs, excessive use can lead to dangerous side effects such as:

• Confusion
• Nausea
• High blood pressure
• Impaired motor function
• Drug overdose

Because it’s readily available without a prescription, Robotripping has become a popular yet risky method of substance abuse, especially among teenagers.

Side Effects of Purple Drank

The side effects of lean purple drank can range from mild to life-threatening, especially when consumed in high doses. Some common and serious side effects include:

• Drowsiness/lethargy: The mix causes extreme drowsiness, impairing cognitive and motor functions.
• Respiratory depression:  Codeine can slow down breathing, leading to potentially respiratory failure.
• Nausea/vomiting: Promethazine can induce nausea, vomiting, and gastrointestinal discomfort.
• Dizziness/impaired coordination: Codeine and promethazine affect the CNS, leading to coordination loss.
• Hallucinations: In higher doses, purple drank can cause visual and auditory hallucinations.
• Seizures: Prolonged use or large doses may lead to seizures due to the impact on brain function.
• Overdose: The risk of opioid overdose is high, especially when combined with alcohol or other depressants.
• Organ Damage: Long-term use can cause liver damage, kidneys and other organ failure.

Can You Die from Drinking Lean?

Yes. Sadly, the dangerous effects of purple drug drinks are not a myth, and several high-profile cases have underscored its deadly consequences in the hip-hop/rap community.

Purple drink rappers like Lil Wayne have experienced multiple seizures, widely speculated to be related to his use of sizzurp liquor. Tragically, some rappers have lost their lives due to codeine overdoses. Pimp C died in 2007 from respiratory depression after a lethal combination of codeine and promethazine.

Is Lean Addictive?

Yes, lean can be very addictive. Regular use of codeine can lead to tolerance and physical dependence. Tolerance is when increasingly larger doses are needed to achieve the same effects, and physical dependence is when the body becomes reliant on the substance to function normally.

Opioid withdrawal symptoms, such as nausea, muscle pain, and anxiety, can occur if use is abruptly stopped. While not physically addictive, promethazine enhances the sedative effects of codeine, contributing to the overall appeal of the syrup purple drug and increasing the risk of misuse.

The combination of these substances can create a euphoric high that users may find psychologically addictive, leading to repeated use despite adverse consequences.

Signs of Purple Drank Addiction

Due to its prominence in pop culture, lean is most abused by teens and young adults, raising serious concerns for parents and teachers who may suspect a child or a student is experimenting with illicit drugs or alcohol. If you believe someone may be using lean, don’t wait to seek help.

Here are a few signs indicating your child or your student may be using lean:

• Extreme lethargy makes it hard for users to stay awake or alert.
• Difficulty speaking clearly or coherently due to the sedative effects of the drink.
• Respiratory depression is a common side effect, with noticeable shallow or labored breathing.
• Poor appetite and neglect of basic nutrition may lead to significant weight loss.
• Shifts in mood or behavior (irritability, increased secrecy, avoiding activities they used to enjoy)
• A drop in grades, missed assignments, or skipping school.
• The presence of cough syrup bottles, prescription labels or soda cans.
• Isolation from friends and family or spending time with friends who encourage risky behaviors.

If any of these signs are present, opening a dialogue and seeking professional help immediately is important. Early intervention can prevent further harm and guide your child or student towards recovery.

Purple Drank Addiction Treatment

Treating lean addiction involves a comprehensive approach that addresses the physical and psychological aspects of the addiction. Individuals battling lean addiction often require specialized care that includes addiction treatment and mental health support.

Here are the most advisable treatment options to follow:

Opioid Withdrawal Treatment

Since codeine is an opioid, individuals meeting the criteria for lean use disorder should be screened for opioid withdrawal treatment. Medically supervised detox is often the first step to ensure a safe and gradual reduction in opioid use.

Dual Diagnosis Treatment

For those using lean to cope with mental health conditions like PTSD, anxiety, or depression, simultaneous treatment of both the mental health disorder and the substance use disorder is critical. A dual diagnosis treatment plan will integrate therapies targeting the root emotional or psychological issues driving the addiction.

Behavioral therapies play a crucial role in lean addiction treatment. Some effective options include:

• Cognitive behavioral therapy (CBT) to identify and change negative thought patterns and behaviors.
• Motivational Interviewing (MI) to find internal motivation to quit using lean and choose a healthier life.
• Contingency Management to reinforce positive behavior and sobriety.
• Family therapy helps to change family dynamics involving the family group in the recovery process.

Support Groups and Aftercare

Joining groups like Narcotics Anonymous (NA) or participating in local recovery groups can provide ongoing encouragement and help individuals stay accountable. Aftercare programs, including sober living homes or outpatient rehab counseling, help reinforce the skills learned in treatment and provide long-term support.

Treatment for Purple Drank Near Me

If you or someone you know is struggling with purple drank addiction, finding the right treatment center is essential for recovery. Here are tips to help you locate effective treatment programs in your area:

• Use online directories to find licensed rehab centers near you.
• Your primary care doctor can be a good starting point for local treatment options.

• Search for dual diagnosis treatment centers that offer integrated care.
• Reach out to local health departments or non-profit organizations that provide addiction support.
• Contact your insurance provider to see which treatment centers are covered under your plan.
• Check rehab centers’ accreditations (such as Joint Commission or CARF certification).
• Consider visiting centers or calling to ask about their approach to treating lean addiction.

Don’t Get Lost in Purple Cough Syrup Addiction

Purple drank causes severe risks to physical and mental health. Despite its glorification in popular culture, this mixture of codeine and promethazine is far from harmless. It can lead teens and young adults to long-term health complications and even death.

Recognizing the signs of addiction, but also underlying mental health issues like PTSD or anxiety, can be a breaking point between recovery and addiction.

If you or someone you know is struggling with dank syrup addiction, plan an intervention and seek help as soon as possible. Contact a qualified treatment center for professional guidance.

People Also Ask

What is purple syrup?

Purple syrup is a mixture of codeine and promethazine cough syrup, often mixed with soda or candy. It’s known as “lean” or “purple drank” and is abused for its euphoric and sedative effects.

Is codeine purple?

Codeine itself is not purple. The “purple” in purple drank comes from the color of certain cough syrups containing codeine and promethazine, which are often tinted purple.

Is Robitussin lean?

No, Robitussin is not lean. Lean typically uses codeine-based syrup, while Robitussin contains dextromethorphan (DXM), a different cough suppressant. DXM can be abused separately, leading to “robotripping.”

Page Sources

1. Ware, O. D. (2023). Lean/Sizzurp Ingredients, Use, and Coping With Mental Health Symptoms. Substance Abuse: Research and Treatment, 17. https://doi.org/10.1177/11782218231195226
2. Ware, O. D., et al. (2024). Codeine and promethazine: Exploratory study on “lean” or “sizzurp” using national survey data and an online forum. PLOS ONE, 19(3). https://doi.org/10.1371/journal.pone.0301024
3. U.S. Department of Justice. (2011). Resurgence in abuse of ‘Purple drank.’ In the U.S. Department of Justice. https://www.justice.gov/archive/ndic/pubs43/43924/sw0008p.pdf
4. Peechakara, B. V., et al. (2024, February 28). Codeine. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK526029/
5. Martinak, B., et al. (2017). Dextromethorphan in Cough Syrup: The Poor Man’s Psychosis. Psychopharmacology Bulletin, 47(4), 59-63. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5601090/
6. Lee, C. (2016, June 14). Lil Wayne seizure puts spotlight on rappers’ use of “sizzurp” - Los Angeles Times. https://www.latimes.com/entertainment/music/posts/la-et-ms-lil-wayne-sizzurp-codeine-20130321-story.html
7. Kreps, D. (2018, June 25). Coroner: Pimp C died of accidental cough syrup overdose, sleep apnea. Rolling Stone. https://www.rollingstone.com/music/music-news/coroner-pimp-c-died-of-accidental-cough-syrup-overdose-sleep-apnea-75980/