What is Lean? How long does Lean stay in your system?

Purple drank. Sizzurp. Texas tea. Dirty sprite. Purple tonic. The most commonly known name is lean. Lean is a liquid substance mixture of codeine-based cough syrup, an antihistamine such as Promethazine, soda and hard candy for added sweetness. In some cases, alcohol is also added to the mixture. The combination of prescription-strength cough medication and an antihistamine can produce feelings of euphoria and intense relaxation. It is most popular among teens and young people and can become highly habit-forming within a short period of time and lead to addiction.

A group of friends in their mid 20s party with drinks in hand. The drinks may contain alcohol or a the substance called lean.

The history of Lean and why has it become so Popular?

The drug combination originated in Houston, Texas. In the 1960s, blues musicians began using it for its soothing and relaxing effects. It started from mixing over-the-counter cough medication Robitussin and beer. By the 80s and 90s, the drug mixture evolved into using codeine and promethazine.

Pop culture, entertainment and social media heavily influenced the popularity of the drug combination, where it was glamorized through the hip-hop and rap scene. Recently, rapper Bow Wow opened up about his addiction to lean, which almost took his life. Late rappers Mac Miller and Juice WRLD were also known to have addictions to lean. It has become so prominent in the music entertainment culture that there are now many songs leisurely portraying the consumption of the drug.

One of the other reasons why this drug has become so popular is due to ease of accessibility. Prescription cough syrup or codeine can easily be obtained or found in the family medicine cabinet. Promethazine and other powerful antihistamines are also easily obtained. All of the ingredients are legal substances so there are fewer stigmas behind using the drugs. 

Many users take lean to cope with symptoms of post-traumatic stress disorder and other mental health disorders. It is used as a form of self-medication to cope with the stresses of their mental health issues. Users who take lean seek out a

“high” and sense of euphoria that the drug can produce.

Infograph describing what is lean and what the substance is made of.

What is Lean?

Lean is a combination of prescription cough medication containing codeine and promethazine, a powerful antihistamine. The name lean comes from the effects of the substance in which users tend to lean or slouch to one side after taking the drugs. Because it is most popular among young people, soda and hard candy is often added to make the substance more sweet and appealing to consume. The mixture often results in a purple hue, which is why it is also referred to as purple drank. In some cases, alcohol can be added to the mixture to create an even more intense effect. It is often consumed at parties or during social settings.

Codeine is an opioid pain reliever. Like many other opioids, there is a risk of addiction when misused. It causes side effects such as hallucinations, difficulty breathing, changes in heart rate, blurred vision and seizures. Promethazine is an antihistamine used to treat allergic reactions, nausea, vomiting and motion sickness. Its side effects include blurred vision, difficulty falling or staying asleep, dizziness, drowsiness, loss of coordination, restlessness and sedation.

Infograph showing the different warning signs of lean abuse.

When combined, codeine and promethazine can produce intense sedative sensations similar to that of opioids. Lean affects the central nervous system and slows down brain activity. In some cases, alcohol is also added to the mixture. When adding alcohol, the depressive effects are compounded even more. It prolongs the sedative effects of the drug leading to delayed motor skills or reactions as well as brain fog.

Lean produces opioid-like effects such as drowsiness, euphoria and relaxation. There are very few studies and research done on this fairly new addictive substance. Despite limited research, addiction experts and physicians say lean is not safe to drink under any circumstances.

Today, there are very few companies and manufacturers that make codeine with promethazine cough syrups. This is due to the dangerous side effects and high risk of addiction.

How long does Lean stay in your system?

The length of time in which lean can stay in your system depends on varying factors. Each user is different. Some users have developed a high tolerance for the drug while others are more sensitive. The user’s history of other substance abuse and how often they engage in using lean plays a role. Gender, age, body composition and individual metabolic system also significantly impact how long the drug mixture stays in the body.

On average, codeine can remain active in the bloodstream for about 12 hours and can stay in the body for about 24 hours until it has been processed. Promethazine’s half-life is between 10-19 hours and takes an average of 5 half-lives for the substance to be eliminated from the body. Ultimately, lean can remain in the system for a few days before it can be fully eliminated.

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Side Effects of Taking Lean

The effects of lean can take place within 30 minutes, with its peak at about 1-2 hours and lasting between 4-6 hours after the initial dose. Despite its glamorization through social media, entertainment and pop culture, lean can cause serious and dangerous side effects.

  • Hallucinations – They are sensations or perceptions that aren’t real making someone believe they are hearing, seeing, or feeling something that isn’t there.
  • Impaired vision – It can cause blurry vision and seeing double.
  • Dental decay – The lean mixture of codeine and promethazine is often mixed in with sugar drinks and candy. The added sugar can lead to tooth decay over time when drinking regularly.
  • Extreme sedation
  • Loss of coordination
  • High body temperature
  • Nausea and vomiting
  • Respiratory depression – Lean causes difficulty breathing and is the primary cause of overdose and death.
  • Slowed heart rate – The heart can slow down to the point where the body will also stop breathing. It can also put users at risk for a heart attack.
  • Seizure and loss of consciousness – Lean’s sedative effects on the heart and lungs can deprive the brain of oxygen and lead to a seizure.
  • Brain lesions – Changes in behavior or personality along with memory loss, cognitive impairment and permanent psychosis can happen when abusing lean.
  • Withdrawal symptoms – Users who drink lean can quickly develop a tolerance and dependence. When that happens, they can also experience withdrawal symptoms when drug use has stopped or significantly slowed down.
  • Organ damage – Codeine and promethazine are metabolized in the liver. When there are high amounts of both medications within the body, it can prevent the liver from properly functioning and lead to toxic build-up. According to the FDA, prescription and over-the-counter medications are often the leading cause of liver damage. When alcohol is added to the lean mixture this could also compound the effects on the liver.  

Reach out to Hotel California by the Sea

We specialize in treating addiction and other co-occurring disorders, such as PTSD. Our Admissions specialists are available to walk you through the best options for treating your addiction.

Treatment for Substance Use Disorder

Lean contains a dangerous mixture of addictive substances that have become popular among young people across the country. Despite its positive portrayals across pop culture and entertainment media, it is a dangerous substance. An addiction to lean can be formed quickly. Hotel California by the Sea provides the resources and support users need to overcome their addiction to lean.

Our behavioral health program offers unique treatments for people struggling with substance addiction, polysubstance abuse and co-occurring mental health disorders. Our program provides detox, residential, PHP and IOP. We offer evidence-based treatments such as group therapy, family counseling and cognitive behavioral therapy. At Hotel California by the Sea, we understand the struggles of addiction. We can take clients through every step of their recovery process, as they work to gain and maintain sobriety.