What are the Effects of Lean?

Lean is an illicit substance often referenced in popular culture, media and entertainment. The effects of lean often mimic those of opioids and other sedation-producing substances. People of all ages use lean, but it primarily impacts teens and young adults who use it at parties and other types of social gatherings. The popularity of lean has also contributed to the ongoing opioid crisis in the US.

A group of young people partying and drinking lean representing the effects of lean when the drink is being abused.

What is Lean?

Lean is an illicit substance made up of a variety of substances. However, it primarily consists of cough syrup containing codeine, soda, hard candy and sometimes alcohol or promethazine. Some mixtures include an antihistamine to strengthen the effects of codeine and induce feelings of relaxation and sleepiness.

Ultimately, lean is a variation of a polydrug cocktail that includes an opioid containing cough syrup, an antihistamine and some sort of sugary liquid. The exact formula will vary. The usage of candy and soda creates a sweet taste, which appeals greatly to a younger audience. Common types of alcohol mixed with lean include vodka, whisky and rum.

Slang names for the drink include Purple Drank, Sizzurp, Texas Tea, Dirty Sprite, Purple Tonic, Sip Sip and Purp. The name lean comes from the effect it produces on users. It makes people lean to one side or slouch to one side, the more they continue to consume the drink.

The main component of lean is codeine. Codeine is a weak opioid. But when mixed with other substances, it can create a very dangerous mixture. Especially when people are ingesting large amounts of it within a drink.

Why do people use Lean?

For many young people, their first exposure to lean is through rap and hip-hop music. It is often mentioned in popular music, adding more the appeal of using the substance. The use of lean has traditionally been heavily influenced by pop culture, media, music and entertainment. The glorification of lean through popular culture and music has highly influenced the use of the drug.

Most of the ingredients of lean are legal substances that can easily be obtained. This makes it easier to access for young people. There is also a misunderstanding that lean users view the codeine promethazine liquid as a “better” or “safer” alternative to using hard opioids such as heroin. The thought process behind this is that because codeine can be legally obtained through a prescription, it must be safer to use.

Infograph showing the effects of lean and the risks of drinking the polysubstance cocktail.

Effects of Lean

Many people do not realize how dangerous lean can be. Rapper Juice WRLD died of a codeine overdose in 2021 due to the effects of lean. Rapper Lil Wayne has been hospitalized for lean-induced seizures on multiple occasions.

In a 2023 study of the effects of lean, users experienced an altered state of consciousness that included hallucinations and changes in the way they think. They may experience feelings of fatigue and drowsiness due to the slowdown of the nervous system causing a sedative effect. High doses of codeine and promethazine can cause hallucinations, vivid dreams or even nightmares.

  • Euphoria
  • Relaxation
  • Feeling tired and slow
  • Irritability
  • Dizziness
  • Loss of coordination
  • Changes in consciousness
  • Pinpoint pupils
  • Nausea and vomiting
  • Itchy skin
  • Shaking
  • Abdominal pain and constipation
  • Infertility
  • Organ damage
  • Increased heart rate
  • Weight gain
  • Dry mouth
  • Changes in cognitive function – Poor judgement and confusion along with behavior and personality changes.
  • Slowed heart rate and breathing – Opioids are the main components in lean and can decrease heart rate and cause respiratory depression
  • Seizures – Lean is often associated with a high risk of seizures due to opioid like effects it has on the heart and lungs which can be deprived of oxygen
  • Dental decay – The sugary mixture of the cough syrup, hard candy and soda can lead to the development of cavities and tooth decay. Especially when drunk regularly, teens and young adults often don’t take the best care of their teeth. Lean can also cause dry mouth, which has been linked to a number of gum-damaging bacteria.
  • Hallucinations – Hallucinations are sensations and perceptions that are not real. It can make someone hear, see or believe things that are not really there. In this state of mind, they are more likely to engage in risky behaviors that can lead to physical harm.
  • Impaired vision – Even small amounts of lean can lead to impaired vision, blurred vision or seeing double.
  • Codeine overdose
  • Tolerance, overdose and addiction

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How long do the Effects of Lean last?

The effects of lean can begin within 30-45 minutes after ingestion. The peak effects begin around 1-2 hours and the duration of the effects of lean can last around 4-6 hours.

History of Lean

The use of lean dates back all the way to the 1960s in Houston, Texas, where it was popular among blue musicians. In the 60s, it started as a drink mixing Robitussin with beer. By the 80s and 90s, the formula changed to codeine, promethazine, cough syrup, soda and hard candy.

Its popularity grew again in the 90s with DJ Screw. The musician helped to popularize lean and said the mixture inspired his “chopped and screwed” style of hip hop music. DJ Screw later died of lean related causes in 2000.

Other musicians like Justin Bieber, Lil Nas and hip hop group Three 6 Mafia also reportedly referenced the drug in their music.

By 2006, the DEA began focusing on the rising trend of the abuse of lean.

Addiction to Lean

Lean consists of the opioid codeine, which slows down your nervous system and suppresses your breathing. Lean is an addictive substance due to the opioid component. Depending on the formulation of lean, it can be classified as a Schedule III, IV or V controlled substance.

Codeine is among the most commonly abused prescription opioids in the US. In 2023, codeine was the 3rd most frequently misused prescription pain reliever among Americans age 12 and older. This makes an estimated 2 million people who abuse codeine products.

The two active ingredients in lean are promethazine and codeine. Both of these substances are central nervous system depressants and can lead to symptoms of euphoria and sedation. The two effects that cause a person to become addicted. An addiction to lean can develop even in a short period of time due to the opioids impact on the brain’s reward system.

Can you mix Lean with Alcohol?

Some lean cocktails contain alcohol. What happens when you mix other lean ingredients and add alcohol? It can lead to even more dangerous side effects such as liver and kidney damage, drowsiness, dizziness, abdominal bloating, ulcers, impaired motor control, memory loss, blackouts, difficulty breathing and overdose.

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Substance Use Disorder

Lean is not safe to drink under any circumstances. It is a dangerous polysubstance mix of opioids, antihistamines and sugar. It can greatly impact the brain’s reward system due to its effect on the central nervous system. Because of this, lean can quickly become very addictive. Behavioral health treatment programs such as Hotel California by the Sea provide treatment for lean and other substances.

We offer treatment at all levels of care including detox, residential, PHP and IOP. We utilize evidence-based treatment programs such as CBT, DBT and EMDR therapy. Hotel California by the Sea is dedicated to helping clients achieve their goals in sobriety and overcome their addiction.

References:

https://www.addictioncenter.com/opiates/codeine/lean-addiction-abuse

https://www.medicalnewstoday.com/articles/what-is-lean

https://zinniahealth.com/substance-use/lean/side-effects

https://anrclinic.com/blog/what-is-lean

https://www.addictionhelp.com/prescription-opioids/codeine/lean