Lean Addiction and Abuse

Lean, also known as Purple Drank and Sizzurp, is a mixture of codeine cough syrup, soda, and hard candy. It is among the prescription opioids causing addiction.

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What Is a Lean Addiction?

Lean Addiction and Abuse Is a Very Serious Problem with Potentially Fatal ConsequencesLean is an illicit substance made with codeine cough syrup, soda, and hard candy. Codeine is derived from the opium poppy plant (similar to morphine) and is one of the weaker opioids. However, because it is still highly addictive and potentially damaging to the body. It’s possible for an individual to develop a lean addiction in a relatively short period of time due to the way opioids short-circuit the brain’s reward response system.

Nicknamed Purple DrankSizzurp, and Dirty Sprite, lean was initially a popular drink among blue musicians in Houston who mixed Robitussin® with beer. Then, in the 1980s, Houston rappers opted to instead use codeine, soda, and a piece of hard candy (commonly Jolly Ranchers) for sweetness. The drink’s popularity spread throughout the south, becoming the cornerstone of countless songs, including some by Three 6 Mafia (“Sippin on Some Sizzurp”), Lil Wayne (“Me and My Drank”), and Future (“Dirty Sprite”). Today, lean is responsible for the deaths of a number of hip-hop entertainers and is widely popular among young people around the globe.

Effects of Lean Abuse

Lean is so named because of the effect it has on people while drinking–they tend to slouch or lean to one side the more they consume. The effects of codeine are similar to those of other addictive opioids (such as oxycodone and heroin). Typically, its effects begin to kick in within 30 to 45 minutes, though differing amounts of codeine in lean (up to 25 times the recommended dose) can shorten onset times. The peak of effects begins 1 to 2 hours after ingestion and lasts about 4 to 6 hours.

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Possible Consequences of Drinking Lean

Feelings of euphoria


Slowed heart rate

Slowed breathing


Dental decay

Weight Gain

Urinary tract infections

Impaired vision

Memory loss


Seizures (in at-risk individuals)

Is Lean Dangerous to Drink?

Lean Addiction and Abuse Is Closely Associated With Hip Hop Music

Many lean users underestimate the dangers of drinking codeine. Moreover, celebrities like Justin Bieber, Rob Kardashian, and Soulja Boy have popularized the drink on social media. However, opioid abuse commonly leads to the body developing a tolerance to its effects. As a tolerance to lean builds, the body produces less and less of its own natural opioids until it is entirely dependent on the foreign substance. This dependency compels the individual to consume more and more of the drug to get the same feeling or, in a majority of cases, to feel normal.

The abuse of opioids like lean can also lead to life-threatening health complications and even fatal overdose. Upon consuming too much lean, the brain is flooded with opioid molecules and becomes unable to regulate its response or mitigate their effect. Subsequently, the reduced breathing rate caused by drinking lean becomes a complete cessation of an individual’s ability to breathe. When breathing stops, the brain no longer receives enough oxygen to function properly. In about 6 minutes, brain death begins. Cut off from oxygen, the individual may enter a coma or die.

“Robotripping” with DXM Cough Syrup

In some parts of the U.S., lean drinkers have swapped codeine cough syrup for another over-the-counter (OTC) prescription, dextromethorphan (DXM) cough medicine. DXM can be found in cough syrups like NyQuil®, Robitussin®, and Theraflu®. Drinking the DXM-soda-candy combo is known as “robotripping.” DXM is different from opioids and codeine because DXM acts on the same receptors as hallucinogens like ketamine or PCP. DXM is in a class of dissociative drugs that cause “out of body” hallucinations.

Possible Consequences of Robotripping



Increased blood pressure

Loss of coordination


Rapid heart rate


Memory loss


Reduced oxygen to brain (in rare cases)

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Lean Addiction Statistics



In Australia, codeine-related deaths doubled between 2000 and 2009.



In 2017, 3.6% of 10th graders reportedly abused cough medicine.



In 1992, Texas estimated that at least 148 gallons of hydrocodone cough syrup had been diverted for illegal use.

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Treating Lean Addiction

For an individual suffering from a lean addiction, reducing use or quitting can feel impossible. The opioids in lean help cause addiction and require treatment, counseling, and sometimes medication to treat. The first step of treating a lean addiction is to enter detox. Opioid treatment medications may be prescribed to reduce painful symptoms of withdrawal including pain, nausea, vomiting, and diarrhea. Detox may also reveal comorbid diseases or disorders (such as hepatitis or nerve damage). Accordingly, medically-supervised detox is integral in ensuring a safe and successful rehabilitation.

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