Lean, also known by the street names “purple drank” or “sizzurp,” is a recreational drug typically produced by combining codeine (an opioid pain reliever) and promethazine (an antihistamine). Those two ingredients are usually mixed with soda, candy, cough syrup, or alcohol to give the beverage a sweeter flavor.
Lean is typically used as a party drug for the strong “high” it creates with the combination of these substances. However, using it can also be very addictive and dangerous.
What does lean do to your body? We’ll explore that thoroughly in the rest of this article to help you understand its effects. Plus, if you or someone you care about is showing signs of lean addiction, we’ll provide you with a guide to finding the right treatment.
The Widespread Use and Dangers of Lean
Recreational use of lean first began in the 60s and then resurfaced again in the 90s. In the last 10 to 15 years, we’ve again seen increases in lean abuse and other opioids or prescription drugs.
Recent research suggests that of the estimated 19.8 million people prescribed codeine each year, about 9.3% (or 1.8 million people) misuse the drug on its own or in concoctions like lean.
Abuse and misuse of these substances is dangerous, especially in polysubstance concoctions like lean that contain opioids, antihistamines, and alcohol. Opioid-related overdose deaths have risen substantially in recent years, going from 7.3 per 100,000 people in 2011 to 24.7 per 100,000 people in 2021, and they still remain high today.
Now that you know lean can have serious consequences, how does it affect the body when you first take it?
Immediate Effects on the Body
Within a few minutes and up to the first hour after drinking lean, you’ll start to feel drowsy or like your thoughts are getting cloudy. Each of the primary substances in lean (codeine, promethazine, and sometimes alcohol) are depressants, meaning they slow down your central nervous system and cognitive function.
When someone drinks lean, it’s absorbed in the stomach and begins entering the bloodstream. Within three to five minutes, the substance reaches the brain and begins disrupting neurotransmitters that send chemical messages to the rest of the body to help you process thoughts or movements.
Therefore, while immediately after drinking lean, you might start feeling more relaxed or a euphoric high from it, things will also begin slowing down. You can expect effects like:
- Poor judgement
- Loss of coordination
- Fatigue
- Memory problems
- Potentially more serious side effects like loss of consciousness or hallucinations
Due to these side effects, doing things like driving after drinking lean is extremely dangerous and can lead to serious accidents. Plus, it could lead to irrational decision-making with negative consequences in the short or long term.
Short-Term Health Risks
One of the major health risks immediately after drinking lean is the potential for overdose. An overdose usually happens because the substances in lean can all lower the heart rate and suppress breathing when taken in large quantities. When left untreated, the person’s breathing or the heart could stop completely, leading to death.
Signs that someone might have overdosed on lean include:
- Extremely slowed breathing, or they aren’t breathing at all
- They’re unresponsive or won’t wake up
- Making gurgling or snoring sounds
- Cold or clammy skin
- Blue or gray skin or lips
When someone is experiencing these signs of an overdose, it’s important to call 911 immediately so they can get proper medical treatment. Upon arrival, you should tell paramedics that you suspect the person overdosed on lean so they can provide the right treatment immediately for the situation.
Other Short-Term Health Risks
Other short-term health risks from lean include:
- Complications of pre-existing heart conditions since it slows the heart rate
- Seizures, especially in those already prone to seizures
- Hallucinations that lead to irrational or harmful behaviors
- Impaired vision and coordination that could lead to falls or accidents
All of these health risks can have major consequences and long-term side effects that reduce quality of life. That’s why lean abuse or misuse of the substances in it shouldn’t be taken lightly.
Long-Term Health Consequences
One of the biggest long-term consequences of lean is it has a high potential for addiction. Lean can cause both physical and psychological dependence, meaning you could experience physical and mental withdrawals when you stop taking it.
Physical withdrawals could include muscle aches, shaking, sweating, cramps, and nausea. Psychological withdrawals could include anxiety, mood swings, or agitation.
Medical treatment during detox from lean is important to prevent relapse since it’s common to feel strong cravings for the drug during this time, and serious complications like seizures could occur and have lasting effects if not treated properly.
Other long-term consequences include:
- Significant changes to the brain’s structure and functionality. Many studies show that opioids, such as codeine contained in lean, can alter the brain’s structure when taken in high doses for a long time, lowering cognitive abilities and increasing mental health risks.
- Liver damage that could lead to liver disease, cirrhosis, or failure. The liver will process and eliminate most of the substances in lean when they enter the body. Eliminating these substances is toxic and hard on the liver, so it will accrue damage over time.
- Damage to the cardiovascular system (lungs and heart). Since lean slows down breathing and heart rate, it can cause damage and health issues over an extended amount of time.
Social and Legal Implications
Codeine and promethazine, the primary substances in lean, can both be obtained legally when you have a prescription. However, they aren’t meant to be bought and sold as recreational substances. Therefore, someone who buys it or sells it on the streets for recreational use could face legal consequences like fines or jail time.
Negative actions taken while someone is on lean could also cause legal complications. For instance, getting caught driving after drinking lean could lead to a DUI, fines, and potentially jail time.
Additionally, addiction can have many social implications, such as isolation, when someone is trying to cover up the addiction. Research shows that those who struggle with substance use disorders experience between 38-55% greater levels of loneliness, which is why socialization and sharing is often a significant part of recovery programs.
Prevention and Treatment
In general, the best way to prevent an addiction to lean is to avoid using it. While codeine and promethazine are both relatively safe to take within recommended dosages when prescribed for medical conditions, mixing them or taking them in high doses for recreational use is never advisable. Always practice precaution and follow your doctor’s instructions with medications like these.
Since lean is often consumed in party settings, it’s also a good idea to avoid drinking beverages given to you when you don’t know what’s in them. Never feel pressure to use lean, alcohol, or other drugs when you don’t want to.
If you or someone you care about is showing signs of addiction to lean, such as trying to stop using it and not being able to, social isolation, lower mood, or irrational behavior, there are many resources that can help. Going to a treatment center will help you get a diagnosis and start working toward the first steps of a recovery plan.
Generally, the first step in treatment is a detox to remove the drugs from your system. Then, following up with a full residential treatment program and aftercare, like participating in a 12-step program, will help get the best results.
Conclusion
Lean is a highly addictive combination of drugs that can have several negative effects on the body in both the short and long term. For health and safety, it’s always best to avoid the misuse or abuse of prescription substances.
If you or someone you love is struggling with addiction, our treatment center has resources for you. We can help you with a complete medical detox and residential treatment program tailored to your needs. Contact us to get started on the first steps today.
References
- Cooper, M., Gyawali, S., Smith, T., & Yan, J. (2022). Key Substance Use and Mental Health Indicators in the United States: Results from the 2022 National Survey on Drug Use and Health. https://www.samhsa.gov/data/sites/default/files/reports/rpt42731/2022-nsduh-nnr.pdf
- (2022, December 21). Drug Overdose Deaths in the United States, 2001–2021. www.cdc.gov. https://www.cdc.gov/nchs/products/databriefs/db457.htm
- Upadhyay, J., Maleki, N., Potter, J., Elman, I., Rudrauf, D., Knudsen, J., Wallin, D., Pendse, G., McDonald, L., Griffin, M., Anderson, J., Nutile, L., Renshaw, P., Weiss, R., Becerra, L., & Borsook, D. (2010). Alterations in brain structure and functional connectivity in prescription opioid-dependent patients. Brain, 133(7), 2098–2114. https://doi.org/10.1093/brain/awq138
- Hosseinbor, M., Yassini Ardekani, S. M., Bakhshani, S., & Bakhshani, S. (2014). Emotional and Social Loneliness in Individuals With and Without Substance Dependence Disorder. International Journal of High Risk Behaviors and Addiction, 3(3). https://doi.org/10.5812/ijhrba.22688
