“Lean,” also known by various names such as “purple drank,” “sizzurp,” or “dirty Sprite,” refers to a dangerous concoction that has gained notoriety for its psychoactive effects. This illicit mixture primarily impacts the central nervous system, leading to a range of physiological and psychological changes. Understanding its components and combined actions is important for comprehending the significant risks it poses.
What Lean Is
Lean is typically a mixture of prescription-strength cough syrup, a carbonated soft drink, and often hard candy. The primary active ingredients in the cough syrup are codeine, an opioid, and promethazine, an antihistamine. These components are mixed with sodas like Sprite or Mountain Dew, and sometimes candy such as Jolly Ranchers, to mask the bitter medicinal taste and add sweetness.
Codeine is classified as an opioid and a controlled substance. Promethazine is a prescription drug, primarily used to treat allergy symptoms, nausea, or as a sedative.
The use of lean originated in the hip-hop culture of Houston, Texas, during the 1990s. It gained popularity within this community and spread through references in music and media. The drink’s appeal grew partly due to the accessibility of its ingredients and a misconception that prescription medications are safer than illicit street drugs.
Immediate Effects on the Body and Mind
The immediate effects of lean stem from the combined actions of codeine and promethazine, which are central nervous system (CNS) depressants. Codeine, as an opioid, primarily induces feelings of euphoria, relaxation, and pain relief by acting on opioid receptors in the brain. This can lead to a sense of detachment and disinhibition shortly after consumption.
Promethazine, an antihistamine, enhances the sedative effects of codeine. It works by blocking histamine and affecting other natural substances in the brain, contributing to drowsiness and a relaxed state. The combined depressant action often results in impaired motor skills, poor coordination, and a general slowing of physical and mental processes.
Physiological responses to lean include slowed breathing, a condition known as respiratory depression, a serious risk. Users may also experience constricted pupils. The onset of these effects can be rapid, occurring within minutes to an hour, depending on dosage and individual factors.
Prolonged Health Impacts
Chronic use of lean can lead to severe health problems affecting multiple organ systems. The presence of acetaminophen in some codeine formulations, or the common practice of mixing lean with alcohol, increases the risk of liver damage. This can range from inflammation to severe hepatic failure, as the liver processes these substances.
Kidney function can also be compromised with prolonged use, leading to kidney damage. The high sugar content from the soda and hard candy mixed into lean contributes to dental decay. This is often exacerbated by poor oral hygiene that can accompany substance abuse and the dry mouth caused by opioids.
Respiratory problems can worsen over time, with chronic suppression of the breathing reflex leading to issues. Opioid-induced constipation is another severe long-term effect, resulting from the slowing of intestinal motility. Neurological consequences may include cognitive impairment, memory issues, and an increased risk of seizures, especially during withdrawal.
Developing Dependence and Withdrawal
Prolonged use of lean can lead to the development of both physical and psychological dependence due to the opioid content of codeine. Tolerance builds over time, meaning individuals require progressively higher doses of the mixture to achieve the desired euphoric and sedative effects. This escalating consumption amplifies the health risks associated with the drug.
Once dependence is established, stopping lean can trigger severe withdrawal symptoms. These can include nausea, vomiting, muscle aches, anxiety, and insomnia. Restlessness and cravings are also common symptoms, adding to the discomfort.
In severe cases, withdrawal from codeine, especially when combined with promethazine, can lead to complications such as seizures. Due to severe symptoms, medical supervision is necessary for individuals attempting to withdraw from lean to ensure their safety and manage discomfort.