Lean or purple drank — also called dirty Sprite, sizzurp, and purp — is made by combining prescription-strength cough medicine that contains codeine with soft drinks and sometimes candy. All of its ingredients are perfectly legal and can be obtained in most pharmacies and department stores without any form of identification. However, while lean may be easy to make, this drink is dangerous to consume, and, in some cases, can even be deadly.

Celebrities like platinum-selling artist Lil Wayne have made lean quite popular — especially in the hip-hop community. Lil Wayne has been drinking lean for years and has a history of related health problems.1 Other chart-topping rappers, such as Soulja Boy, have posted pictures of cough syrup on social media.2 This public endorsement of lean is dangerous because each of these celebrities has the potential to influence many fans.

What Lean Does to the Body

When looking at lean’s side effects, it’s important to keep in mind that the drink is a mix of several drugs.

Codeine, one of the main ingredients in lean, is an opiate that produces feelings of euphoria. This classification puts codeine in the same grouping as morphine and opioids like heroin, Oxycontin, or Vicodin.3 When consumed in large doses or for non-medical uses, codeine can lead to harmful side effects and opioid withdrawal symptoms between doses.

Six common signs of codeine abuse include:

  • Anxiety
  • Yawning
  • Loss of appetite
  • Nausea
  • Cramps
  • Diarrhea5

The prescription cough syrup used in lean also contains promethazine, which relaxes the user. As a result, people who consume the drink often lean over — the reason for the drink’s nickname.4 In some cases, lean may include dextromethorphan (DXM), a sedative found in many over-the-counter cough syrups that acts as a cough suppressant.
When taken in high doses, DXM can cause any or all of these six side effects:

  • Impaired vision
  • Rapid breathing
  • Irregular heartbeat
  • Slurred speech
  • Memory loss
  • Coma6



Mixing Lean with Alcohol & Other Substances

Lastly, lean may also contain a combination of alcohol, caffeine, and/or sugar. For example, an individual may mix fruit-flavored vodka, cough syrup, and candy together. The sugar and other ingredients in the drink often cover up the flavor of alcohol and codeine, making it easier to consume in large quantities.6

Mixing the cough syrup with alcohol makes the drink even more dangerous.

Getting behind the wheel of a car or operating machinery after drinking lean increases the likelihood of accidents. As a depressant, alcohol can cause sedation and even euphoria. Once the buzz from the drink wears off, however, you may feel very sleepy and possibly depressed.

Alcohol also essentially amplifies the effects of the other drugs. This is concerning because the body can (and will) react in unpredictable ways. Someone who’s normally reserved and uses good judgment is capable of irrational behavior. In other cases, the body may simply shut down. For example, DJ Screw died in 2000 due to a codeine-promethazine-alcohol overdose. Big Moe was another DJ who died after falling into a coma related to lean misuse.7

What You Can Do About Lean

The truth is, many people have no idea that lean is an issue. As a parent or friend, you may spot a problem when you see empty cough suppressant or liquor bottles laying around. Any drug — even cough medicine — can be dangerous when taken incorrectly. If your friend, child, or loved one behaves in unusual ways, don’t hesitate to take action. Ask questions and get involved.

If you’re not sure what to do or simply want to talk to someone about your treatment options, give us a call. Help is available. At Black Bear Lodge, we know how you feel. We offer comprehensive care to help you or your loved one move forward without substance use. This simple phone call can be a turning point that starts the journey to recovery. Please don’t wait any longer. Call us today at 706-914-2327.


1 Sblendorio, Peter. “As Lil Wayne Recovers From Seizure, ‘Lean’ Drug Cocktail Is Back Under the Microscope.” New York Daily News, July 12, 2016.

2 Malm, Sara. “‘Sizzurp Cough Syrup Reportedly Popular With Celebrities Including Lil’ Wayne, Justin Bieber and Soulja Boy Has Been Pulled off the Market Amid Manufacturer Fears It’s Being Abused as a Drug.” Daily Mail, April 23, 2014.

3Lean Back: The Dangers of Drinking Lean.” BlackDoctor.org, Accessed February 5, 2018.

4 Painter, Kim. “Sizzurp: What You Need to Know About Cough Syrup High.” USA Today, January 23, 2014.

5Codeine Withdrawal: What It Is and How to Cope.” Healthline, Accessed February 5, 2018.

6What’s ‘sizzurp’? A Dangerous Way for Kids to Get High.” Today, January 23, 2014.

7 Drea, Maria. “10 Dangers of ��Lean’ – What You May Not Know.” Syllabus Magazine, March 18, 2013.