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Promethazine lean, also known as purple drank, sizzurp, or lean, is a recreational drug drink made by mixing promethazine, a prescription antihistamine, with codeine (a prescription opioid), and typically a sugary soft drink like Sprite or Fanta. Sometimes, users also add Jolly Rancher candies to enhance the flavor. This combination, originally popularized in the Southern United States, became associated with hip-hop culture and has been referenced in numerous songs and media. However, it is dangerous and carries significant health risks.

Key Ingredients:

  1. Promethazine:
    • Promethazine is an antihistamine commonly used to treat allergies, nausea, and motion sickness. It has sedative effects and is often prescribed for insomnia or as a sleep aid. When mixed with codeine, it contributes to the drowsy and relaxed feelings people seek from lean.
  2. Codeine:
    • Codeine is an opioid analgesic, often prescribed for pain relief and cough suppression. In high doses, it can cause a feeling of euphoria and sedation. However, codeine is a controlled substance and can be highly addictive and dangerous, especially when abused.
  3. Soda:
    • The soda, typically Sprite or Fanta, is added to mask the bitter taste of the cough syrup. The sugary soda makes the drink more enjoyable and palatable, but it also contributes to high caloric and sugar content.
  4. Candy (Optional):
    • Many users add Jolly Ranchers or other hard candies to sweeten the drink and enhance the flavor.

Effects of Promethazine Lean:

  • Sedation: Lean has a strong sedative effect due to the combination of promethazine and codeine, leading to drowsiness and an overall relaxed feeling. It can feel like a state of euphoria, often described as “nodding off” or feeling “out of it.”
  • Pain Relief: Codeine in the drink acts as a pain reliever, which is why some people with chronic pain or who misuse the drug may seek it out.
  • Impaired Coordination: Lean significantly impairs motor function and coordination, making tasks like driving dangerous.
  • Cognitive Impairment: It can lead to memory and focus problems, affecting mental clarity and alertness.
  • Euphoria: The drink can induce a sense of well-being and happiness due to the opioid properties of codeine.

Health Risks:

Promethazine lean is extremely dangerous and has several severe health risks, including:

  1. Addiction: Both codeine and promethazine have addictive properties. Long-term use can lead to physical and psychological dependence, making it difficult to stop using without professional help.
  2. Respiratory Depression: Codeine is an opioid, and opioid overdoses often result in respiratory depression, where breathing slows down or stops. In severe cases, this can lead to death.
  3. Overdose: The mixture of promethazine and codeine in high doses can result in a fatal overdose, especially when combined with other substances like alcohol or other sedatives.
  4. Liver Damage: Many promethazine-containing cough syrups also have acetaminophen (paracetamol), which, in excessive amounts, can cause liver damage or failure.
  5. Increased Risk of Accidents: The sedative effects of lean can impair motor skills, judgment, and reaction time, increasing the likelihood of accidents, including driving under the influence.
  6. Psychological Effects: Regular use can lead to cognitive decline, memory loss, and other mental health issues. The feeling of euphoria from codeine can lead to misuse and psychological addiction.
  7. Cardiovascular Issues: The high sugar content in the soda used for lean can contribute to weight gain, diabetes, and heart disease in the long run.

Legal Issues:

Promethazine with codeine is a controlled substance in many countries, including the United States. Misusing prescription medications like these is illegal, and possessing or distributing lean without a prescription can result in serious legal consequences, including arrest and imprisonment.

Signs of Overdose:

Signs of a codeine overdose (which may be caused by drinking too much lean) include:

  • Slow or irregular breathing
  • Extreme drowsiness or inability to wake up
  • Blue lips or fingernails (sign of low oxygen levels)
  • Severe confusion or disorientation
  • Slowed heart rate
  • Unconsciousness

If you suspect someone has overdosed on lean, call emergency services immediately.

Conclusion:

While promethazine lean may be glamorized in popular culture, it is a highly dangerous and addictive substance with serious health risks. The use of prescription medication like codeine and promethazine outside of a medical setting can have life-threatening consequences. If you or someone you know is struggling with substance misuse, seeking help from a healthcare provider or addiction specialist is critical for recovery and safety.

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