Lean is a popular drink mixture made by combining codeine cough syrup with Sprite and sometimes alcohol. The main component of Lean or “Purple Drank” is Codeine: a prescription opioid given for pain relief and cold and flu symptoms.

Purple Drank gets its title from the color of the mixture, as the codeine syrup used is typically purple. Leans origins date back to the 60’s in Houston, Texas.4 But in recent years, it has gained new popularity particularly within southern hip-hop scene.

What Is Lean Addiction?

Drug addiction covers a complex mixture of psychological and physical symptoms which can significantly impair self-control and cause a variety of lasting consequences. Lean dependency, like other opioids can occur fairly quickly: taking place just a few weeks after first using the drug.

Leans main ingredient codeine, affects the central nervous system by binding to pain receptors located in the spinal cord, muscles, organs and brain. The activation these receptors causes a chain effect which blocks sensations of pain while simultaneously activating dopamine: a drug involved in the bodies pleasure response.

As a neurotransmitter, dopamine plays a critical role in reinforcing behaviors by releasing in anticipation of pleasurable or rewarding events. Dopamine also plays an important part in regulating behavior and mood.

Drugs that interfere with the regulation of dopamine such as codeine can be very habit forming. People who pick up lean are commonly introduced to the drug at parties; overtime this pattern of use can change. Once addiction sets in, lean users can become more compulsive and reclusive in their use–spending less time with friends and family or choosing only to associate with other heavy users.

The Consequences of Lean Abuse

The dangers of drinking lean come primarily from codeine. While codeine lacks the potency of other opioids like hydrocodone or fentanyl, the risks when taken in large amounts are virtually the same.

Codeine, despite its unique chemical structure, is broken down as morphine in the body. As a result, the side effects of Lean use are consistent with most other opioids. They include:


  • Feeling relaxed or euphoric
  • Nervous System Depression
  • Dizziness
  • Constipation
  • Motor control impairment
  • Inability to concentrate
  • Nausea
  • Pupil dilation and blurry vision
  • Sleepiness
  • Trouble breathing and/or pressure in the chest
  • Seizures
  • Coma


  • Addiction
  • Withdrawal symptoms (when going without the drug)
  • Brain damage (a result of hypoxia or inadequate oxygen transmission to the brain)6
  • Liver and kidney disease
  • Muscle twitching and cramping

Is Lean Dangerous to Drink?

One grave consequence of opioid abuse is overdose. Because people drinking lean are not always aware that they are consuming an opioid, they run risk of drinking dangerous levels. A cup of lean can reach up to 25 times the recommended dose. At that level, permanent damage or even fatal overdose can occur.

A lesser-known danger of Lean comes from promethazine. Promethazine is a central nervous system depressant found in codeine cough syrup which can exaggerate the psychoactive effects of the high and has the potential to slow or even stop a person’s breathing.

DXM Cough Syrup “Robotripping”

DXM or dextromethorphan, is a substance used in over-the-counter cough medications like Robitussin, NyQuil and Theraflu Max D. When dextromethorphan is taken in larger doses, users feel effects similar to dissociates like PCP or Ketamine and hallucinogens like LSD.

Getting high off DXM is also called “robodosing” or “dexing”.

Given the wild popularity of lean among popular subcultures especially within the hip hop music scene of the south United States, street prices of codeine cough syrup have risen to astronomical levels. This has led many users to substitute codeine for “tussin” or DXM in the signature “Purple Drink.”

DXM, however, has its own risks. Individuals abusing dextromethorphan may experience symptoms such as:

  • Impaired judgement
  • Liver damage, (especially when abused alongside acetaminophen: a common ingredient in cold and flu syrups)
  • Serotonin toxicity when used alongside, opioids, alcohol or SSRI’s
  • Euphoria and hallucinations
  • Visual and perceptional impairment
  • Impaired motor functions
  • Slowed and difficult breathing

Lean Addiction Statistics

  • In 2011 4,449 people were hospitalized for DXM use.
  • In 2018, 75% of all overdoses involved an opioid like codeine.
  • In 2019, 9.8 million people abused prescription painkillers.

Treating Lean Addiction

Once lean addiction has been identified, the next step is cleansing the body of all traces of the drug. Those who have a long relationship with the drug are known to suffer the effects of withdrawal more intensely than others. The symptoms of codeine or Lean withdrawal vary from moderate to severe and include irritability, anxiety, cold and flu-like symptoms and difficulty breathing.

Getting Help

If you or a loved one are misusing codeine as part of a prescription or recreationally, it is possible that a dependency has developed. Determining whether treatment is necessary is just a phone call away. Once diagnosed, an addiction specialist can direct you to treatment services such as detox and drug rehabilitation programs.

Don't Wait Reach Out To Us Now