The Street Drug Called Lean: Falling for Codeine

Last Updated on October 2, 2020

cough syrup drug

The glamorization of “syrup” and its inebriating effects in recent songs and videos has triggered a rise in popularity of a dangerous drink mixture called Lean. Lean, sizzurp, or syrup, are street names for the intoxicating and addictive drink. It’s not new; abuse of this drink has been around for years, but users should be aware of its potentially dangerous effects.

What is the Drug Lean Made Of?

The street drug referred to as “lean” is made by mixing codeine-based prescription cough medicine with soda, and often, a hard candy. Users then sip the drink throughout the day to get high. It’s often called “purple drank” because the codeine often turns the liquid a purplish color.

Is Lean an Opiate?

Codeine, the primary ingredient in the street drug lean, is an opiate. It is a prescription drug that is used to treat a cough and moderate pain. It affects the brain the same way other opiates do, by binding to opioid receptors and changing the way the user experiences pain. Codeine is also frequently combined with other drugs because when it’s taken on its own, the user can usually still feel some pain. Many people who become addicted to opioid drugs like morphine and heroin may have abused codeine first. For this reason, codeine is considered a “gateway drug” to other opiates.

Lean and Codeine Street Names

Codeine is frequently abused for recreational purposes and several different slang terms, or street names, are used for it. Common codeine street names are:

  • Schoolboy
  • Coties
  • Cough syrup
  • T-three’s

Common street names for lean include:1

  • Purple drank
  • Drank
  • Syrup
  • Sizzurp
  • Dirty Sprite

Looking for treatment for you or a loved one?
Nova Recovery Center can help!
Call (512) 605-2955 today to learn about our outpatient and inpatient options.

What Does the Street Drug Lean Do?

The promethazine in the cough syrup acts as a sedative, and the opiate, in this case, codeine, creates a feeling of euphoria. One of the street names for the drink is “lean” because as the user sips on the drink throughout the day they get highly intoxicated, like being very drunk, and often need to literally lean on something to stand up.

How Addictive is Lean?

Lean is highly addictive and is classified by the DEA as a Schedule II drug, which means it has a high potential for abuse. The high that codeine produces provides users with pleasurable effects that will likely drive them to continue drinking lean.

However, codeine is designed to be used on a short-term basis, so if a person drinks lean regularly, he or she is likely to become physically dependent or addicted. As the person develops a tolerance, he or she may also start to crave a more powerful high, which can lead to the abuse of other opioid drugs like heroin or morphine.

Drinking lean on a regular basis can lead to harmful physical effects, mental health issues like depression, and can also cause addiction.

Talk to a Treatment Expert - (512) 605-2955

Dangerous Lean Drink Side Effects

Codeine is not meant to be consumed as a recreational beverage so drinking lean can cause many physical problems, especially if it’s abused for a long period of time. Dangerous side effects of the lean drink include:

  • Wheezing
  • Night terrors
  • Extreme confusion
  • Hallucinations
  • Seizures
  • Liver damage

Additionally, lean has three different depressants that can cause harmful physical side effects like:2

  • Extreme sleepiness
  • Very low blood pressure
  • Respiratory depression
  • Coma
  • Sudden death

Signs and Symptoms of Codeine Overdose

Because the amount of codeine in lean is unpredictable and will vary based on the batch, lean users are at high risk for overdose. Signs and symptoms of codeine overdose include:3

  • Difficulty breathing
  • Cold, clammy skin
  • Drowsiness
  • Itchiness
  • Extreme confusion
  • Blue fingers and lips
  • Constipation
  • Muscle spasms
  • Dizziness
  • Loss of consciousness or coma
  • Low blood pressure
  • Nausea and vomiting
  • Pinpoint pupils

How Dangerous is Lean?

The drugs in the cough syrup codeine and promethazine both have the potential to depress the central nervous system and respiratory system stopping the heart and lungs. Doctors are also warning that along with side effects like nausea, dizziness, impaired vision and memory loss, abuse of the drug can lead to hallucinations, seizures, and even death, especially when mixed with other drugs or alcohol. The National Institute on Drug Abuse warns, “Teens may think that just because something is available from the pharmacy, it won’t harm them — but that’s not true.”

As the drug is consumed, a tolerance builds, and higher and higher doses are needed to feel similar effects. The promethazine can double the amount of codeine that affects the body. Also, by consuming the cough syrup with a carbonated drink, the body absorbs even more of the drug.

There is also a major risk for addiction. Like most opiates, the consumption of codeine can lead to chemical dependency as the body’s central nervous system stops producing painkillers or endorphins on its own. These unused nerve cells degenerate, and the body is no longer producing its own painkillers. When an addicted user wants to quit, the process is not simple; it often means a painful withdrawal period.

The consumption of the street drug lean or other prescription cough syrup when not medically necessary is dangerous. The use of drink mixtures like lean, sizzurp, or syrup to get high means risking injury, addiction, or even death.

Looking for treatment for you or a loved one?
Nova Recovery Center can help!
Call (512) 605-2955 today to learn about our outpatient and inpatient options.

Addiction Treatment for Lean Addiction

If you or a loved one is addicted to the street drug lean, or some other OTC or prescription drug, Nova Recovery Center can help. Recovery from lean addiction may require several treatment programs, such as drug detox, inpatient or outpatient rehab, sober living, and aftercare. We have two detox centers that provide medically assisted detox programs for all kinds of addictive substances, including lean. To learn more about our detox programs or to enroll yourself or a loved one, please call Nova Recovery Center today.


  1. https://ndews.umd.edu/sites/ndews.umd.edu/files/dea-drug-slang-code-words-may2017.pdf
  2. https://www.verywellmind.com/is-purple-drank-going-down-1123889
  3. https://medlineplus.gov/ency/article/002613.htm
Call Now Button