Lean (drug)

Lean or purple drank (known by numerous local and street names) is a polysubstance drink used as a recreational drug. It is prepared by mixing prescription-grade cough or cold syrup containing an opioid drug and an antihistamine drug with a soft drink and sometimes hard candy. The beverage originated in Houston as early as the 1960s and is popular in hip hop culture, especially within the Southern United States. Codeine/promethazine syrup is usually used to make lean, but other syrups are also used. Users of lean are at risk of addiction, and serious complications include respiratory depression, respiratory arrest, and cardiac arrest. Lean is especially dangerous when consumed with alcohol.

Names The term lean refers to the tendency for users to have difficulty standing up straight and walking while under the influence of the drug. "Purple drank" references the mixture's typically purple hue, as the cough syrups employed are often purple in color, and the African-American Vernacular English term "drank" for an alcoholic beverage. Other names include "syrup/sizzurp", "surp/zurp", "jelly", "Tussin/Tuss'", "Barre", "Wock", "Act", "Texas tea", "mud", "dirty Sprite", and "tsikuni". In areas where lean had not yet been introduced, codeine-based cough syrup mixed with antihistamine pills was called "juice and beans". Lean is also sometimes referred to by color in slang, usually purple (usually shortened to "purp"), but can also be red, green, or yellow based on the ingredients used.

Preparation

Typically, the base for lean is a strong prescription cold medicine, specifically cough syrup that contains both promethazine and codeine. Other preparations use codeine/guaifenasin, hydrocodone/chlorphenamine, hydrocodone/APAP, and hydrocodone/homatropine. Over-the-counter cold medicines that contain dextromethorphan (often paired with guaifenasin or acetaminophen) as the active ingredient have also been used, as they do not require acquiring a prescription. To create a drinkable mixture, the cough syrup is combined with soft drinks, especially fruit-flavored drinks such as Sprite, Mountain Dew, or Fanta, and is often served in foam cups. A hard candy, usually a Jolly Rancher, may be added to give the mixture a sweeter flavor. Masking the undesired taste may impair judgment of the potency, which is a factor in overdosing.

Effects Lean produces mild-to-moderate "euphoric side effects" accompanied by "motor-skill impairment, lethargy, drowsiness, and a dissociative feeling from all other parts of the body." It has been suggested that the super-sweet combination of soda, cough syrup, and Jolly Ranchers provides a pleasing flavor and mouthfeel that lingers on the user's tongue for an extended duration. This phenomenon is often appealing to first-time users. Lean is often used in combination with alcohol, smoked cannabis or other recreational drugs.

Hazards When taken in prescribed quantities, codeine-promethazine syrup is quite safe, but dangers arise in higher doses since it can cause one to stop breathing. Using alcohol and other drugs alongside lean increases the chance of serious adverse effects. The drink does not appear to cause seizures itself, but can increase their likelihood in those already susceptible to them. It has been suggested that the promethazine in the drink may heighten the euphoric effects of the codeine. The addictive nature of the drink means that trying to discontinue regular usage can bring about symptoms of opioid withdrawal. In a 2008 interview with MTV News, Lil Wayne described the withdrawal as feeling "like death in your stomach when you stop. Everybody wants me to stop all this and all that. It ain't that easy."

History Lean is thought to have developed in Houston around the 1960s, when blues musicians would take Robitussin and cut it with beer. Later, when wine coolers came onto the market, they substituted for beer. These blues musicians lived in Houston's Fifth Ward, Third Ward, and South Park neighborhoods and the practice was taken up by the generation of rappers growing up in the same parts of the city. In the 1980s and 1990s the formula changed to using codeine promethazine cough syrup, somewhat like the glutethimide and codeine combination that was popular from the 1970s up to the early 1990s. Codeine-based cough syrups were also turned to as an alternative to pentazocine/tripelennamine ("T's and blues") after the pharmaceutical industry added naloxone to the tablets, effectively blocking their potential for abuse. Lean remained a local phenomenon in Houston until the 1990s, when the American rapper DJ Screw released several tunes mentioning the drink in his mixtapes, which were extremely popular in the Houston area. DJ Screw's music was particularly appropriate for Houston's climate. Due to the heat and expanse of the Houston area residents spent long drives in their cars, "the music that most appropriately complements that has always been the music of DJ Screw, it's slowed down—and when I say slowed down I mean he would record sessions in his apartment with rappers freestyling over beats and he would make these big mixtapes and then he would actually slow them down even further on his cassette recorder." DJ Screw's invoking lean in his lyrics and his use of slow tempos had caused his style to be characterized "[a]s if the song itself has taken too much codeine promethazine". Rappers far beyond Houston would come to adopt aspects of DJ Screw's unique style, but not before he died of a codeine overdose in 2000.

Popularization

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