“Lean,” also known as purple drank or sizzurp, is a dangerous illicit substance. Its use carries severe health risks, most notably the potential for fatal overdose. Understanding the components of lean and their effects on the body is important to grasping why it poses such a significant threat. This article explains the inherent dangers of this substance, the factors that contribute to its overdose risk, and the crucial steps to take in an emergency.
What is Lean?
Lean is a homemade mixture, primarily consisting of prescription-strength cough syrup that contains codeine and promethazine. This syrup is then combined with a soft drink. The combination of these specific ingredients is what makes this concoction particularly hazardous. Its origins trace back to the southern United States, specifically Houston, in the 1990s, gaining popularity within the hip-hop community. Other common street names for lean include “dirty Sprite”.
Why Lean is So Dangerous
The danger of lean stems from its two primary active ingredients: codeine and promethazine. Codeine is an opioid and central nervous system (CNS) depressant, slowing essential bodily functions like breathing and heart rate. Promethazine, an antihistamine, also possesses strong sedative properties and contributes to CNS depression. When these two drugs are combined, their effects are synergistic, significantly increasing the risk of severe respiratory depression, where breathing becomes dangerously slow or even stops, and can lead to cardiac arrest. The sedative effects can appear quickly, leading to drowsiness, relaxation, and a clouded mental state.
Understanding Overdose Risk
There is no amount of lean that can be considered safe, and determining a precise lethal dose is impossible due to variable factors. An individual’s history of drug use, which influences their tolerance, plays a significant role in how their body responds to the substance. Body weight and metabolism also affect how quickly the drugs are processed and eliminated from the system. A major contributing factor to overdose risk is the unknown purity and concentration of codeine and promethazine in any given mixture, as these are often prepared illicitly with no quality control.
Mixing lean with other depressants such as alcohol, benzodiazepines (like Xanax), or other opioids drastically increases the risk of overdose. Each of these substances further depresses the CNS, leading to a cumulative and potentially fatal effect on breathing and heart function. Pre-existing health conditions, particularly those affecting the respiratory or cardiac systems, can make an individual more susceptible to overdose, even from a relatively small amount of the substance. Even a small quantity can be fatal, especially for first-time users or those with low tolerance.
Recognizing Overdose and Seeking Help
Recognizing the signs of a lean overdose is crucial for timely intervention. Symptoms often include severely slowed or stopped breathing, unresponsiveness, and pinpoint pupils. Other indicators can be blue or dusky lips and fingernails, cold and clammy skin, gurgling or snoring sounds, confusion, and extreme drowsiness. The individual may also have a weak pulse, appear limp, or be unable to talk.
In the event of a suspected overdose, immediate action is necessary. The first and most important step is to call emergency services, such as 911, without delay. If available and trained, administer naloxone, a medication that can reverse the effects of an opioid overdose, as it can be life-saving and will not cause harm even if opioids are not involved. While waiting for emergency responders, it is important to stay with the person and place them in the recovery position to prevent choking. Acting quickly and without hesitation, regardless of potential legal concerns, can make a difference in saving a life.