“Lean,” also known as “purple drank” or “sizzurp,” is a recreational drug mixture primarily composed of prescription cough syrup containing codeine and promethazine, often mixed with a soft drink. This concoction gained notoriety for its sedative effects. This article explains lean’s ingredients, how drug tests identify them, and factors influencing their detection times.
Understanding Lean’s Components
Lean typically contains two main active ingredients: codeine and promethazine. Codeine is an opioid that acts on opioid receptors in the brain and spinal cord to reduce pain and suppress coughs. It contributes to the mixture’s euphoric and sedative effects, and can also lead to slowed breathing and reduced heart rate. Codeine is metabolized in the liver, with a portion converting into morphine, its more potent active form, and other inactive metabolites.
Promethazine is an antihistamine with sedative properties, commonly used to treat allergies, nausea, and vomiting. It affects the central nervous system by blocking histamine receptors and influencing neurotransmitters, which contributes to the overall drowsy and disoriented feeling associated with lean. While promethazine is not a controlled substance on its own, its combination with codeine classifies the mixture as a Schedule V drug due to the opioid content. Both substances undergo metabolism in the body before being eliminated, primarily through urine.
How Drug Tests Detect These Components
Drug tests identify codeine and promethazine, or their metabolites, in various biological samples. Urine drug screens are a common initial method, often using immunoassays that can detect opiates like codeine for approximately one to three days after use, though some studies indicate detectability up to four and a half days or even a week for heavy users. Promethazine can be detected in urine for about two to four days following last use. If an initial immunoassay yields a positive result, a more precise confirmatory test, such as Gas Chromatography-Mass Spectrometry (GC-MS) or Liquid Chromatography-Mass Spectrometry (LC-MS), is typically performed to confirm specific substances and rule out false positives.
Blood tests offer a shorter detection window, typically identifying codeine for up to 24 hours and promethazine for up to 24 hours. These tests are often used to determine recent use or impairment. Saliva tests can detect codeine for up to four days, though some reports suggest a shorter window of around seven hours, while promethazine may be detectable for one to three days.
Hair follicle tests provide the longest detection window, as drug metabolites become incorporated into the hair shaft as it grows. Codeine can be detected in hair for up to 90 days, and promethazine may also be found in hair for up to 90 days. Hair tests can reveal a history of drug use over several months, making them useful for assessing long-term patterns rather than recent use.
Factors Influencing Detection Times
Several physiological and behavioral factors can significantly influence how long codeine and promethazine remain detectable in the body. An individual’s metabolic rate plays a substantial role, as faster metabolism generally leads to quicker elimination. Genetic variations, particularly in liver enzymes like CYP2D6, can affect how quickly codeine is converted to morphine and subsequently cleared.
The dosage and frequency of lean consumption also directly impact detection times. Higher doses and more frequent or chronic use result in greater accumulation of the drugs and their metabolites in the body, extending the period they can be detected. Hydration levels can influence urine concentration; dilute urine might temporarily lower metabolite concentrations, potentially affecting initial screening results. Body mass index (BMI) and body fat percentage can also play a role, as some drug metabolites can be stored in fat tissues, potentially prolonging detection.
Overall health and organ function, particularly the health of the liver and kidneys, are important because these organs are responsible for metabolizing and eliminating the drugs from the system. Impaired liver or kidney function can slow down the clearance process. Interactions with other medications or substances consumed simultaneously can alter metabolism and excretion rates. Due to these varied factors, detection windows are estimates and can differ considerably among individuals.
Test Interference and Accuracy Considerations
Drug tests, especially initial screening tests like immunoassays, can sometimes produce results that require further investigation. False positives can occur when certain non-drug substances or medications trigger a preliminary positive result for a drug. For instance, promethazine has been reported to cause false positives for amphetamines or methamphetamines in some urine immunoassay screens. Similarly, consumption of poppy seeds can lead to false positives for opiates due to their natural codeine content.
To address these potential interferences and ensure accuracy, confirmatory testing is crucial. When a screening test yields a positive result, a more specific and sensitive method, such as Gas Chromatography-Mass Spectrometry (GC-MS) or Liquid Chromatography-Mass Spectrometry (LC-MS), is typically used. These advanced laboratory techniques can precisely identify and quantify specific drug compounds and their metabolites, distinguishing them from other substances that might cause cross-reactivity in initial screens.
While some substances might interfere with initial drug screens, reliable testing protocols are designed to minimize these issues through confirmation. Confirmatory tests are considered the gold standard in drug testing due to their high accuracy and specificity, providing definitive results. Therefore, a preliminary positive result does not automatically mean a confirmed positive, as it often necessitates further, more detailed analysis to verify the presence of the drug.