What Is Lean Made Of?
The lean drug, also known as purple drank or sizzurp, is a dangerous cocktail made by mixing prescription-strength cough syrup with soda and hard candy. The key ingredients in the cough syrup are codeine, an opioid that creates feelings of euphoria, and promethazine, an antihistamine that acts as a sedative.
The sweet flavors from the soda and candy mask the medicine’s taste, making it deceptively easy to consume large, harmful amounts. People often use this mixture to experience a relaxing, sedative high, but this temporary feeling comes with a high risk of prescription drug misuse and dependency. Because codeine is an opioid, it carries a significant potential for addiction, similar to other drugs in its class.
The Side Effects of Lean Abuse
Using lean might seem like a way to unwind, but the short-term and long-term effects are incredibly dangerous. In the short term, the lean drug causes extreme sedation, dizziness, blurred vision, and slowed breathing. Because both codeine and promethazine are central nervous system depressants, combining them can dangerously suppress the body’s essential functions.
Over time, chronic drug abuse can lead to severe health consequences like dental decay, liver damage, and an increased risk of seizures. The most life-threatening danger is respiratory depression, where breathing slows down so much that it can stop completely, leading to a fatal overdose. This risk becomes even higher when lean is mixed with alcohol or other substances, which can amplify its sedative effects and overwhelm the body, as explained by the National Institute on Drug Abuse.
Signs of Lean Addiction
It can be hard to know if a loved one is struggling with lean abuse, especially since the signs can sometimes be subtle. If you’re worried, here are a few things to look for that may be signs of lean abuse:
- Secretive behavior or hiding cough syrup bottles.
- Unexplained drowsiness, lethargy, or nodding off at odd times.
- Slurred speech or difficulty concentrating.
- Noticeable changes in mood, such as euphoria followed by depression.
- Poor coordination or stumbling.
- Changes in social circles or loss of interest in hobbies.
- Constricted, “pinpoint” pupils.
Recognizing these addiction symptoms is a critical step in helping someone get the support they need. Understanding the psychological effects of withdrawal can also provide insight into what they may be experiencing.
Why Lean Is So Addictive and Hard to Quit
One of the reasons lean is so dangerous is its highly addictive nature. The active ingredient codeine is an opioid, and when combined with the sedating effects of the antihistamine promethazine, it creates a powerful psychoactive drug cocktail. The euphoric effect, relaxation, and slowed heart rate can feel comforting at first, especially for young adults dealing with stress, anxiety, or underlying mental health issues. Over time, however, the brain begins to rely on these effects, increasing the risk of lean addiction.
As tolerance builds, people often consume larger quantities or drink lean more frequently to feel the same effects. This can lead to codeine misuse, cough syrup abuse, and dangerous behaviors like mixing alcohol or other substances with prescription cough syrup. These combinations greatly increase the risk of respiratory depression, codeine overdose, and long-term medical implications such as liver damage, kidney problems, and heart complications.
When someone tries quitting lean, withdrawal symptoms can make stopping even harder. Opioid withdrawal may include nausea, sweating, muscle aches, anxiety, depression, and intense cravings. Managing withdrawal symptoms safely often requires support from a licensed therapist and a structured treatment center where medical professionals can monitor symptoms and reduce the risk of overdose stemming from relapse. Because lean use often starts as a social phenomenon tied to popular culture and hip hop music, many people underestimate how serious and harmful it can become. What begins as experimentation can quickly turn into substance abuse with lasting consequences for both physical and mental health.
Finding Help for Substance Abuse
If you or someone you know is struggling with codeine addiction, the most important thing to remember is that you don’t have to face it alone. The first step in recovery is often medically supervised detox, which helps manage the difficult and sometimes dangerous symptoms of lean withdrawal in a safe environment. From there, addiction treatment can continue through various levels of care tailored to your needs. Exploring the different types of substance abuse treatment programs can help you find the right fit.
At pH Wellness, we provide compassionate, evidence-based care for opioid addiction here in California. We offer a full list of services, from detox to residential and outpatient programs, and understand the unique challenges of recovery. There are many benefits of a residential treatment center, including having a supportive, structured environment to focus on healing. Don’t let financial concerns hold you back; you can verify your insurance with us to get started.
Frequently Asked Questions
The name ‘purple drank’ comes directly from the color of the prescription-strength cough syrups most commonly used to make the mixture. These syrups often contain purple dye, which gives the final drink its signature violet hue when combined with clear soda.
While names like ‘purple drank’ or ‘sizzurp’ have been popularized in music, they can unfortunately make a dangerous substance sound harmless. The color is just a disguise for a risky combination of drugs.
Lean is intentionally made to taste very sweet. People mix the prescription cough syrup with large amounts of sugary soda and often add hard candies, like Jolly Ranchers, to completely mask the medicinal flavor of the active ingredients.
This sweetness is one of the biggest dangers. Because it tastes more like a soft drink than a powerful drug combination, it’s easy for someone to consume hazardous quantities without realizing the immediate risk of overdose.
Yes, making and using lean is illegal. Its key ingredients, codeine and promethazine, are Schedule II and Schedule V controlled substances that are only legal to possess with a valid prescription from a doctor for a legitimate medical issue.
Using these medications recreationally, or possessing them without a prescription, is considered prescription drug misuse and is a criminal offense. The legal consequences can be quite serious.
Yes, you can absolutely become addicted to lean. The main ingredient, codeine, is an opioid. Just like other opioids, it carries a high risk of creating physical and psychological dependence, especially with repeated use.
The brain can quickly adapt to the presence of codeine, leading to intense cravings and a compulsive need to keep using it despite negative consequences. This is the definition of a substance use disorder.
Withdrawing from lean is essentially opioid withdrawal, and it can be very difficult. Common symptoms include severe anxiety, muscle aches, insomnia, sweating, stomach cramps, nausea, and diarrhea. Many people also experience intense irritability and restlessness.
Because these symptoms can be so challenging to endure alone, seeking help from a medical detox facility is the safest first step. Professionals can help manage your discomfort and provide support to get you through it safely.
What Is Lean? Why Awareness Matters
Understanding the dangers of lean is a powerful first step toward making a change. Whether you’re seeking help for yourself or a loved one, know that recovery is entirely possible with the right professional support. You don’t have to carry this burden any longer. Taking action is a sign of strength, and it opens the door to a healthier, more fulfilling future. When you’re ready, we’re here to guide you with compassion and expertise every step of the way.
If you’re ready to take the next step after learning what lean is or just need someone to talk to, our team is here for you. We understand what you’re going through, and we’re here to provide the support and care you deserve on your journey to recovery. You can call us anytime at (888) 707-3880 to speak with a compassionate specialist. At pH Wellness, we believe in your strength to heal. Feel free to contact us to learn more about how we can help you or your loved one start a new chapter.
Sources
- National Institutes of Health. (September 22, 2023). Lean/sizzurp ingredients, use, and coping with mental health. National Institutes of Health.
- Food and Drug Administration. Promethazine HCl and codeine phosphate oral solution Rx only. Food and Drug Administration.
- National Library of Medicine. (October 15, 2025). Codeine: MedlinePlus drug information. MedlinePlus.
- Centers for Disease Control and Prevention. (June 9, 2025). Understanding the opioid overdose epidemic. Centers for Disease Control and Prevention.
- National Institute on Drug Abuse. (August 21, 2024). Drug overdose deaths: facts and figures. National Institute on Drug Abuse.
- Substance Abuse and Mental Health Services Administration. (August 25, 2025). Medications for substance use disorders. Substance Abuse and Mental Health Services Administration.
- American Society of Addiction Medicine. (July 29, 2021). The ASAM national practice guideline for the treatment of opioid use disorder. American Society of Addiction Medicine.
- Substance Abuse and Mental Health Services Administration. (December 30, 2024). Helplines: mental health, drug, alcohol issues. Substance Abuse and Mental Health Services Administration.
