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What is Lean? A Comprehensive Guide

Clinically Reviewed by: Charee Marquez, LMFT

Lean, also known as “purple drank,” “sizzurp,” or “dirty Sprite,” is a recreational drug that has gained notoriety in recent years. It is a dangerous concoction that typically consists of prescription-strength cough syrup containing codeine, promethazine, carbonated soft drinks, and hard candy. Lean is often consumed for its sedative and euphoric effects, but it comes with significant risks to physical and mental health. In this guide, we will provide a thorough exploration of Lean, including its origins, composition, effects, and associated dangers. We will delve deep into the world of Lean to ensure you have a comprehensive understanding of this substance. At California Prime Recovery, a distinguished Drug and Alcohol Rehab and Mental Health Treatment Center in Fountain Valley, CA, we are committed to helping individuals overcome substance abuse and achieve lasting recovery. If you or someone you know is struggling with Lean abuse, we urge you to reach out to us today at 866-208-2390 for assistance and support on the path to recovery.

What Is Lean?

  1. Codeine-Containing Cough Syrup: At the heart of Lean lies a potent prescription-strength cough syrup that contains codeine, an opioid primarily intended to alleviate pain and suppress coughing. In therapeutic doses, codeine provides relief to individuals suffering from various ailments. However, when consumed in large quantities, often seen in Lean, it can induce powerful feelings of relaxation and euphoria, making it highly appealing to recreational users.
  2. Promethazine: Frequently found in cough syrups, promethazine is an antihistamine that not only complements the effects of codeine but also contributes significantly to the drowsiness associated with Lean. This sedative effect is what many individuals seek when abusing this concoction.
  3. Carbonated Soft Drinks: To make the potent syrup more palatable and easier to consume, Lean is mixed with carbonated soft drinks, commonly Sprite or Mountain Dew. This dilution process also plays a role in its appeal, as it masks the syrup’s bitterness and makes it more visually appealing.
  4. Hard Candy or Jolly Ranchers: To enhance the taste and overall experience, hard candy or Jolly Ranchers are often added to the mixture. These sugary additions not only sweeten the concoction but also contribute to the vibrant color that gives Lean its “purple drank” nickname.

The combination of these ingredients creates a visually distinctive purple or pink-tinted beverage that has garnered significant attention in popular culture.

Types and Dosages

The dosage of codeine in the cough syrup can vary, and it’s important to note that using cough syrup recreationally for its codeine content is considered misuse and is illegal.

Common components found in lean:

  1. Codeine: An opioid analgesic that is used for the treatment of pain and cough. Codeine is the primary ingredient in lean responsible for its psychoactive effects.

  2. Promethazine: An antihistamine with sedative properties often added to the cough syrup to enhance the relaxing effects of codeine and to counteract potential nausea and vomiting.

  3. Soda: The cough syrup is typically mixed with soda, creating a sweet and flavored concoction.

  4. Candy: Some variations of lean may include candy, which is dissolved in the mixture for added sweetness.

Dosages: The dosage of codeine in prescription cough syrups can vary. Commonly, codeine is available in concentrations of 10 mg, 15 mg, or 30 mg per 5 mL of syrup. The dosages can be written as “10/5,” “15/5,” or “30/5,” indicating the milligrams of codeine per 5 milliliters of syrup.


Prescription-strength cough syrups containing codeine and promethazine, the main ingredients in “lean,” are intended for specific medical uses. It’s important to note that using these medications for recreational purposes or outside of prescribed guidelines is illegal and poses serious health risks. Below are the medical uses for the individual components of lean:

  1. Codeine:

    • Pain Relief: Codeine is an opioid analgesic used for the relief of mild to moderate pain.
    • Cough Suppression: It is also used as a cough suppressant, particularly in cases where non-opioid cough medications are ineffective.
  2. Promethazine:

    • Antihistamine: Promethazine is an antihistamine that is used to relieve symptoms of allergies, such as itching, runny nose, and sneezing.
    • Sedation: Due to its sedative effects, promethazine is sometimes used to help manage anxiety or as a preoperative sedative.

When Does It Kick In?

Here’s a general timeline for the onset of effects:

  1. Codeine (Opioid Effects):

    • Onset: The onset of codeine effects typically begins within about 30 minutes to an hour after ingestion. This can include feelings of relaxation, euphoria, and pain relief.
    • Peak: The peak effects are usually reached within one to two hours.
    • Duration: The effects of codeine can last for about four to six hours.
  2. Promethazine (Sedative and Antihistamine Effects):

    • Onset: The sedative effects of promethazine may start within 20 to 30 minutes after ingestion.
    • Peak: These effects often peak within one to two hours.
    • Duration: The sedative effects can last for several hours.

How Long Does Lean Stay in Your System?

The half-life of a substance refers to the time it takes for half of the substance to be eliminated or metabolized by the body. The half-life of codeine and promethazine, the main components found in “lean,” can vary.


  • The half-life of codeine is approximately 2.5 to 3 hours on average. This means that it takes about 2.5 to 3 hours for half of the ingested codeine to be eliminated from the body. The complete elimination of codeine can take several half-lives.


  • The half-life of promethazine is around 10 to 19 hours. This indicates that it takes 10 to 19 hours for half of the promethazine to be eliminated from the body. Like codeine, complete elimination may take several half-lives.

The substances present in “lean” may be detectable depending on the type of test, the timeframe since consumption, and the specific substances being tested for.

  1. Urine Tests:

    • Codeine and promethazine can be detected in urine, typically within a few hours to a couple of days after use. The detection window may vary based on factors like the individual’s metabolism, dosage, and frequency of use.
  2. Blood Tests:

    • Both codeine and promethazine can be detected in blood tests. Blood tests are more immediate and can detect recent drug use, usually within a few hours to a day after consumption.
  3. Hair Tests:

    • Hair tests have a longer detection window and can identify drug use over an extended period, potentially up to 90 days or more. However, the specific detection time can vary.
  4. Saliva Tests:

    • Saliva tests can detect recent drug use, typically within a few hours to a couple of days. They are less commonly used than urine tests but provide a shorter detection window.

Brand Names and Nicknames for “Lean”

  • Brand Names: “Lean” itself is not a brand name but rather a colloquial term used to describe a recreational concoction made from prescription-strength cough syrup containing codeine and promethazine.
  • Nicknames: “Lean” is known by various street names, including Purple Drank, Sizzurp, Syrup, and Dirty Sprite.

How it works in the body

  • “Lean” combines codeine, an opioid analgesic, with promethazine, an antihistamine. Codeine works by binding to opioid receptors in the brain and spinal cord, reducing the perception of pain and producing feelings of euphoria. Promethazine enhances the sedative effects of codeine and can also help alleviate symptoms like nausea.

Alcohol use

  • Combining “lean” with alcohol is highly discouraged. Both substances depress the central nervous system, leading to increased sedation, drowsiness, and impaired coordination. This combination can result in serious health risks, including respiratory depression and overdose.

Storage and disposal

  • Storage: Prescription cough syrup containing codeine and promethazine should be stored in a secure place, away from children and pets, at room temperature, and protected from light.
  • Disposal: Unused medication should be properly disposed of to prevent accidental ingestion. Consult with a local pharmacy or healthcare provider for guidance on safe medication disposal.

Controlled Substance Classification

  • Codeine is classified as a Schedule II controlled substance when used in combination with other non-narcotic ingredients, such as promethazine. This classification is due to the potential for abuse, dependence, and the associated health risks. “Lean” is often misused recreationally, and obtaining and using prescription medications without a legitimate medical need is illegal and can have serious consequences.

Crucial Statistics on Lean Abuse

  • Hospitalization Rates: The misuse of Lean has led to a surge in hospitalizations across the United States. Between 2004 and 2010, there was a notable increase in emergency room visits related to Lean abuse. This trend highlights the seriousness of its consequences.
  • Youth Impact: Lean has a particularly concerning impact on young people. A study conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) reported that individuals aged 12 to 17 were more likely to abuse cough and cold medications containing codeine, one of the key components of Lean, compared to older age groups.
  • Risk of Overdose: Due to the opioid content in Lean, there is a considerable risk of overdose. Codeine overdoses can result in severe respiratory depression, coma, and even death. The National Institute on Drug Abuse (NIDA) warns about the dangers of abusing opioids like codeine, which can be exacerbated when combined with other substances, as is often the case with Lean.
  • Long-Term Health Consequences: Prolonged Lean abuse can lead to a range of health issues, including addiction, cognitive impairment, mental health disorders, dental problems, and weight gain. These consequences can have a lasting impact on an individual’s overall well-being.

What are the Side Effects of Lean?

The short-term and long-term effects of lean can be detrimental to both physical and mental health.

Short-term side effects of lean:

  1. Euphoria: Lean may induce feelings of relaxation and euphoria due to the effects of codeine, an opioid.
  2. Drowsiness: Opioids like codeine can cause sedation and drowsiness, making it difficult to stay alert.
  3. Impaired coordination: Lean can lead to poor motor skills and impaired coordination.
  4. Nausea and vomiting: Codeine can cause gastrointestinal distress, leading to nausea and vomiting.
  5. Slurred speech: The central nervous system depressant effects of lean can result in slurred speech.
  6. Respiratory depression: Opioids can suppress respiratory function, potentially leading to slowed breathing, which can be dangerous.

Long-term side effects of lean:

  1. Dependency and addiction: Regular use of lean can lead to the development of tolerance, dependence, and addiction to opioids.
  2. Mental health issues: Chronic use may contribute to or exacerbate mental health issues such as depression, anxiety, and cognitive impairment.
  3. Liver damage: The high sugar content and potential presence of acetaminophen in cough syrup can contribute to liver damage with prolonged use.
  4. Cardiovascular problems: Opioids can negatively impact cardiovascular health, leading to issues like low blood pressure and irregular heart rate.
  5. Gastrointestinal problems: Chronic use may result in constipation and other gastrointestinal issues.
  6. Increased risk of overdose: The combination of opioids, especially when abused, increases the risk of overdose, which can be fatal.

The Potential for Addiction

  • Highly Addictive Nature: Lean’s addictive potential is a significant concern. The codeine found in Lean is an opioid, a class of drugs known for their highly addictive properties. Regular use can lead to the development of tolerance, where individuals require increasing amounts of the substance to achieve the desired effects. This can quickly lead to dependence.
  • Tolerance Development: As tolerance develops, individuals may find themselves consuming larger and more dangerous quantities of Lean in an attempt to attain the same level of euphoria. This escalation in use can significantly increase the risks associated with Lean abuse.
  • Compulsive Use and Cravings: Addiction often brings about strong cravings for the substance and compulsive use, even when individuals are aware of the harmful consequences. This compulsive behavior can lead to a downward spiral, where obtaining and using Lean takes precedence over all other aspects of life.
  • Disruption of Life: Lean addiction can profoundly disrupt an individual’s life. Relationships may suffer as loved ones struggle to understand and cope with the person’s addiction. Responsibilities at work, school, and home may be neglected, leading to financial and personal hardships.

Seeking Help at California Prime Recovery

Recovery from Lean addiction is entirely possible with the right support and treatment. California Prime Recovery offers comprehensive drug and alcohol rehab programs tailored to individual needs. Here is how our center can assist you or your loved one on the journey to recovery:

  1. Evidence-Based Therapy: We provide evidence-based therapies and counseling to address the psychological and emotional aspects of addiction. Individual and group therapy sessions help clients understand the root causes of their substance abuse and develop effective coping strategies.
  2. Dual Diagnosis Treatment: For individuals with co-occurring mental health disorders, our dual diagnosis program offers integrated treatment to address both addiction and underlying mental health issues.
  3. Relapse Prevention: We equip clients with valuable skills and tools to prevent relapse and maintain long-term sobriety.
  4. Supportive Community: Our rehab center fosters a supportive and caring environment where clients can connect with peers who understand their struggles.
  5. Aftercare Planning: To ensure a smooth transition back into daily life, we provide comprehensive aftercare planning with ongoing support and resources for maintaining sobriety.

Seeking Treatment? We Can Help!

At California Prime Recovery, as an in-network provider we work with most insurance plans, such as:

If you or a loved one are struggling with mental health challenges or substance abuse, reach out to California Prime Recovery today. Our team of compassionate professionals is here to support your journey towards lasting well-being. Give us a call at 866-208-2390

Also, check out our blogs posted weekly on Medium.


Lean is composed of codeine-containing cough syrup, promethazine, carbonated soft drinks, and hard candy. Its danger lies in the potential for respiratory depression, addiction, cognitive impairment, and various physical and mental health issues.

While laws may vary by jurisdiction, possession and distribution of Lean are illegal in many areas due to its misuse of prescription-strength codeine.

Look for signs such as frequent consumption of cough syrup, behavioral changes, social withdrawal, and physical symptoms like slurred speech and impaired coordination.

Yes, Lean addiction can be effectively treated with the appropriate support and treatment. California Prime Recovery offers tailored rehab programs designed to address Lean addiction and promote lasting recovery.

If you or someone you know is struggling with Lean addiction, seek professional help immediately. Contact California Prime Recovery at 866-208-2390 for guidance and support on the path to sobriety.

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