Lean, also known as purple drank, sizzurp, or dirty Sprite, is a dangerous recreational drug mixture. It typically combines prescription cough syrup containing codeine, an opioid, and promethazine, an antihistamine, with a soft drink. This concoction can also include hard candy or alcohol, increasing its potency and risks.
Immediate Physiological Impact
Upon consumption, lean can induce rapid and noticeable changes in the body due to the depressant effects of codeine and promethazine. Both substances slow down the central nervous system, leading to feelings of relaxation and drowsiness. This can manifest as impaired coordination, dizziness, confusion, and slowed reflexes.
A particularly dangerous immediate effect is respiratory depression, where breathing becomes shallow or slows significantly. This occurs because both codeine and promethazine can suppress the respiratory drive. The heart rate can also slow, and blood pressure may decrease, contributing to systemic depression.
Users often experience gastrointestinal issues such as nausea, vomiting, and constipation shortly after ingestion. Other common immediate side effects include dry mouth and blurred vision. The combination of these effects can quickly lead to a state where an individual is unable to function normally or respond appropriately to their environment.
Chronic Health Consequences
Prolonged or repeated use of lean can inflict lasting damage across various bodily systems. The continuous exposure to opioids like codeine can lead to neurological changes, including cognitive impairment and memory problems. This can alter brain chemistry, impacting thought processes and mental clarity.
The gastrointestinal system is also significantly affected, with chronic constipation being a common and severe issue due to the opioid’s effect on gut motility. This can potentially lead to more serious conditions like bowel obstruction or megacolon. The liver and kidneys endure considerable strain as they process the drugs over time, increasing the risk of damage to these organs, especially if other substances are mixed in.
Dental health deteriorates due to the high sugar content of the soft drinks combined with dry mouth, a side effect of promethazine, leading to severe tooth decay known as “lean mouth.” The cardiovascular system can also be compromised, potentially resulting in long-term heart issues, including arrhythmias, particularly when other substances are co-ingested. Mental health can worsen, with existing conditions like depression and anxiety potentially exacerbated, and new psychological issues, including psychosis, may emerge due to neurochemical imbalances.
Risk of Overdose and Dependence
Lean carries a significant risk of acute overdose, which can be fatal. Symptoms of an opioid overdose, primarily caused by the codeine, include severe respiratory depression, pinpoint pupils, unresponsiveness, and discolored skin, particularly around the nails or lips. Overdose risk is significantly heightened when lean is mixed with other depressants, such as alcohol or benzodiazepines, amplifying the central nervous system depression.
In an overdose emergency, naloxone is a medication that can rapidly reverse the effects of opioids by blocking their receptors in the brain, restoring normal breathing within minutes. It is a temporary measure, however, and medical attention is still required.
Regular use of lean can quickly lead to physical and psychological dependence. The body adapts to the consistent presence of codeine, an opioid, leading to tolerance where higher doses are needed to achieve the same effect. When use is stopped, individuals can experience withdrawal symptoms, which are often severe and include flu-like symptoms, muscle aches, insomnia, anxiety, and stomach cramps. Beyond physical dependence, a psychological component of addiction develops, characterized by compulsive drug-seeking behavior despite negative consequences.