The illicit beverage known as “Dirty Sprite,” or by its street names “Lean” or “Sizzurp,” is a dangerous concoction. This drink is created by mixing prescription-strength cough syrup with a soft drink, often lemon-lime soda, and sometimes hard candy for sweetness and color. The practice originated in the Houston hip-hop scene and was popularized through music and media. The sweet flavor masks the potency of the controlled substances, leading many to underestimate its severe and potentially fatal risks.
The Primary Active Ingredients
The danger of “Dirty Sprite” stems from its two main pharmaceutical components: Codeine and Promethazine. Codeine is a prescription opioid used medically to treat pain and suppress the cough reflex. It converts to morphine in the brain, binding to mu-opioid receptors and triggering neurotransmitters like dopamine that produce pain relief and euphoria.
Promethazine is a powerful antihistamine typically used to relieve allergy symptoms, motion sickness, and nausea. It is also a central nervous system (CNS) depressant with strong sedative effects. When these two drugs are combined, promethazine intensifies, or potentiates, the euphoric and sedative effects of the codeine. This synergistic action increases the overall potency of the mixture, substantially elevating the risk profile.
Immediate Physiological Impact
The immediate effects of consuming the mixture are linked to the profound depression of the central nervous system (CNS) caused by the combined action of the opioid and the antihistamine. This potentiation results in a rapid onset of effects, usually within an hour of consumption. Users experience euphoria and relaxation, quickly followed by pronounced drowsiness and lethargy.
The mixture severely impairs motor skills, leading to a characteristic swaying or difficulty standing upright, which is the origin of the name “Lean.” Cognitive function is also significantly affected, resulting in mental fog, confusion, and impaired judgment. Promethazine’s antihistamine properties can contribute to blurred vision and dry mouth, while the high concentration of codeine slows gut motility, often causing severe constipation.
The most concerning immediate physiological effect is respiratory depression, where breathing becomes dangerously slow and shallow. Both codeine and promethazine are CNS depressants, and their additive effect on the respiratory center of the brain can reduce the breathing rate to life-threatening levels. This slowed breathing is the primary mechanism leading to fatal outcomes in cases of acute overdose.
Acute and Chronic Health Risks
The use of “Dirty Sprite” carries significant acute and chronic health risks. The most immediate danger is the potential for fatal overdose due to respiratory depression. The sweet taste and gradual onset of effects can cause an individual to consume dangerous quantities before realizing the mixture’s potency, drastically increasing the chance of respiratory arrest.
The danger is amplified when “Dirty Sprite” is combined with other depressants, such as alcohol or benzodiazepines, which further suppress the central nervous system and breathing. This polydrug use is common and raises the risk of seizures, cardiac arrhythmias, and loss of consciousness. Even non-fatal overdoses can result in long-term damage due to prolonged lack of oxygen to the brain.
Chronic use leads quickly to physical dependence and severe addiction due to the codeine, a highly addictive opioid. The brain adapts to the drug, leading to tolerance where higher doses are needed, and intense withdrawal symptoms when the substance is stopped. Long-term physical consequences include potential organ damage to the liver and kidneys. Furthermore, the mixture’s high sugar content, combined with the dry mouth effect, accelerates dental decay and severe oral health problems.