What Is Lean? (Purple Drank, Sizzurp, or Syrup)

No one can walk into a liquor store or pharmacy and walk out with lean.

But you could put together all the ingredients you need with one quick trip (and some prescription medication from a doctor). Mix up the elements, and you have a drink capable of changing how you feel, act, and react.

Individual recipes vary, but most lean batches contain the following:

• Prescription cough syrup: Users hope for the most powerful version, which contains codeine, promethazine, and dextromethorphan. In a pinch, they can use codeine-only versions instead. 
• Carbonation: Grape Fanta is the most desirable form of fizz, but some people use Mountain Dew or another soda of choice. 
• Candy: A Jolly Rancher adds color and sweetness to the mix.

The fizz and sweetness aren’t crucial to the function of the drink. The cough syrup is.

Codeine is an opioid drug that makes people feel drowsy and euphoric, but it can also make them feel queasy at high doses. Promethazine blocks nausea, so people can drink more with no ill effect. 

How Many People Use Lean?

Codeine is a controlled substance. You must have a prescription to get these cough syrups from a pharmacy. However, this rule doesn’t seem to keep people away from lean.

In the 1990s, sizzurp was associated with rap music. Now, researchers say lean has moved mainstream, and it’s popular among all sorts of people, including college students from urban areas.

Lean causes dissociative symptoms, making it a good addition to a dance party. In a study of rave-goers, researchers found that almost 16 percent have ever used lean, and 14 percent would use it if it were offered to them by a friend.

It’s difficult to determine just how many people use purple drank, as researchers can’t track sales or drug busts easily. Homemade concoctions like this are much easier to hide. But these studies suggest that many young people turn to lean when they hope to get high.

When Did Purple Drank Get Popular?

While there is no official recipe for lean, people didn’t spontaneously dream up the combination of cough syrup and fizz. Instead, they heard about the drink from famous people and decided to try it themselves.

In the early 1990s, rap singers started discussing the drink in their songs, and some offered lyrics detailing the specific benefits of their drinks.

In one study of lyrics, researchers found that singers discussed lean’s connection to the following:

• Other drugs
• Sexual activity (including benefits)
• Sleep 
• Mental health

In general, these lyrics made lean sound like a perfect alternative to alcohol or other drugs. Listeners could walk away with real recipes they could use to build their own beverages at home.

One of the leading voices singing about purple drank allegedly died from an overdose of his creation, but even that hasn’t stopped others from trying it. 

Risks & Side Effects of Sizzurp

Plenty of people believe that mixtures like purple drank are safe. After all, they contain household substances and prescription medications. Unfortunately, this combination comes with plenty of hazards.

Short-term side effects include the following:

• Amnesia 
• Blurred vision 
• Dissociative sensations 
• Dizziness

Lean’s codeine element is addictive, and some people find themselves craving more and more. Some people take in lean every day, and their health problems intensify.

Long-term lean use is associated with the following:

• Dental decay: Cough syrup is sticky and designed to coat irritated throats. That action puts sugar in contact with teeth, and carbonation intensifies the damage. 
• Constipation: Codeine and other opioids slow down the digestive tract. Some people find it’s impossible to empty the bowels without medications or enemas when they are taking opioids. 
• Weight gain: Sipping on sweet, sugary drinks all day can quickly add up to fat around your middle.

Many people who abuse purple drank die due to their decisions. In a study of 1,543 reactions to the drink, a whopping 55.6 percent had to do with fatalities.

Opioids like codeine slow down vital functions your body needs to survive. Your blood pressure can drop so quickly that your heart stops circulating fluids to your tissues.

You stop breathing, so oxygen isn’t flowing into your body. And your temperature drops, so tissues die.

Opioids caused 68,000 deaths in 2020 alone. Anyone who abuses purple drank should remember that they are using a drug that causes widespread death. 

How to Quit Purple Drank

If you’re using lean recreationally, it’s time to reconsider your choices. The drink isn’t benign, and if you take in too much, you could end your life prematurely. If you’re offered the drink at your next party, say no.

If you’ve been using lean regularly, you could have an addiction. Ask yourself these questions:

• Do you crave lean almost all the time?
• Do you spend most of your day plotting how to get and use more lean?
• Do you keep using lean even when it makes you sick, or do you face consequences for using it?
• Do you spend most of your money getting and using lean?
• Do you need a dose of lean in the morning to get you going?
• Do you find that your regular lean dose isn’t strong enough?

A treatment program could help. A care team helps you get sober from lean, which might include medications that ease opioid withdrawal symptoms.

Therapy can help you understand your cravings and learn how to say no when you’re tempted. If you’ve tried to quit before and couldn’t, a treatment program could be just right for you. 

Lean FAQs 

What’s lean made of?

Recipes for lean or purple drank vary, but most people mix a prescription cough syrup with carbonation and candy to make lean.

Cough syrups with a hallucinogenic ingredient (dextromethorphan), an opioid (codeine), and an anti-nausea medication (promethazine) are the most valuable to people making lean. But some people make do with codeine-only cough syrups. 

Is lean legal?

No. Lean is typically made with prescription-grade cough syrup, and it’s illegal in most states for people to obtain and use these medications for recreational purposes. In Virginia, for example, it’s illegal to take or use a relative or friend’s prescription for any reason at all.

Some companies created a product they call “legal lean,” which they sell in gas stations and head shops. This concoction is indeed legal, but it typically contains herbs and no active ingredients. 

How long does lean last in the body?

It’s not clear how long lean can stay active, as no firm formula exists. Your intoxication times can vary depending on the cough syrup used, the amount of other elements included, and other factors.

But codeine typically makes people feel intoxicated for up to six hours. It can appear in a urine screening test for about three days.

References

Here’s What ‘Purple Drank’ Can Do to Your Body. (March 2017). WSFA12.

Purple Drank Prevalence and Characteristics of Misusers of Codeine Cough Syrup Mixtures. (September 2013). Addictive Behaviors.

Use of ‘Lean’ Among Electronic Dance Music Party Attendees. (May 2019). American Journal on Addictions.

“Purple Drank” (Codeine and Promethazine Cough Syrup): A Systematic Review of a Social Phenomenon With Medical Implications. (August 2020). Journal of Psychoactive Drugs.

Purple Drank, Sizzurp, and Lean: Hip-Hop Music and Codeine Use, a Call to Action for Public Health Educators. (2020). International Journal of Psychological Studies.

Resurgence in Abuse of Purple Drank. (February 2011). U.S. Department of Justice.

Beyond the ‘Purple Drank’: Study of Promethazine Abuse According to the European Medicines Agency Adverse Drug Reaction Reports. (January 2021). Journal of Psychopharmacology.

Opioid Data Analysis and Resources. (June 2022). Centers for Disease Control and Prevention. 

Prescription Drugs. Commonwealth of Virginia.