Lean (Purple Drank)

Written by Tammy Worth
Medically Reviewed by Shruthi N, MD on May 08, 2025
6 min read

Lean is a mixture that usually contains a soft drink, cough syrup, and prescription medications. It’s also known as purple drank, syrup or sizzurp, and purple stuff, among other names.

Thought to have been created in Texas in the 1960s, lean became popular in the 1990s. According to data from the National Survey on Drug Use, the majority of people who drink it are teens and young adults ages 13 to 21 who were assigned male at birth.

Because lean is sweet and can be made at home using prescription and over-the-counter ingredients, some people think it’s safe to drink. But that isn’t the case. 

“People may be mixing it with Sprite or Jolly Ranchers to make it sweet and keep that purple color,” says Alta DeRoo, MD, chief medical officer for the Hazelden Betty Ford Foundation.   

“You have no idea what amount you are getting of each drug.”

Lean ingredients

The ingredients may be different each time it’s made. But lean usually contains: 

Codeine. A prescription opioid drug used to manage pain and calm coughing. It comes in tablet and syrup form, along with a liquid option that’s thinner than syrup. It may be prescribed alone or in combination with other drugs, such as acetaminophen and aspirin.

Promethazine. A prescription antihistamine that helps ease allergy symptoms, along with dizziness, motion sickness, and nausea. It comes in syrup or tablet form.

Dextromethorphan. A cough suppressant found in many over-the-counter cough syrups, alone or in combination with other drugs, such as acetaminophen. 

Soda. Often lemon-lime flavored.

Hard candy and alcohol might also be added.

 

Making lean isn’t illegal, but you may face legal consequences if you: 

  • Steal prescriptions to make lean 
  • Distribute lean to others 
  • Share lean with minors 

It doesn’t take long – usually no more than an hour – to start feeling drowsy, relaxed, or like your brain is foggy. 

Codeine, promethazine, and alcohol are depressants. That means they slow your central nervous system and brain function. The more codeine, promethazine, or alcohol lean contains, the quicker it sets in. Some people feel the effects after just a few minutes.

Short-term effects of lean

Other short-term effects of lean include: 

  • Dizziness
  • Blurred vision
  • Nausea, which can lead to vomiting 
  • Lack of coordination
  • Fatigue
  • Memory problems 
  • Poor judgment
  • Slowed breathing

Long-term effects of lean

Drinking lean often over a long period of time can lead to several health concerns, including:

  • Tooth decay because of the high sugar content
  • Weight gain
  • Vision issues, such as uncontrolled eye movement
  • Kidney or liver damage 
  • Cardiovascular problems
  • Issues with brain function

Yes. Both codeine and promethazine slow your heart rate and breathing, which could lead to death if used in high amounts or with other drugs.

“It’s rare that someone will just limit themselves to purple drank,” DeRoo says. “They are often doing other drugs or combining it with other benzodiazepines [like Xanax or Valium], which could be catastrophic. And heaven forbid they add another opioid on top of that, like unknowingly using fentanyl.”

Overdose symptoms

Symptoms of a lean overdose include: 

  • Loss of physical control or consciousness
  • A blue tint to fingernails or lips
  • Slow or difficult breathing
  • Cold, clammy skin
  • Confusion 
  • A weak pulse

What to do if someone has overdosed

“If you see someone who is passed out after using lean, engage them, call 911 and use CPR if you can,” says Olivera Bogunovic, MD, medical director of The Alcohol, Drug, and Addiction Outpatient Program at McLean Hospital. “You should have Narcan on hand in case of an overdose.”

Narcan is one brand-name version of the drug naloxone. Naloxone reverses the effects of opioids and helps you breathe normally if your breathing has slowed or stopped. 

There’s no need to worry about getting in trouble. First responders' only concern is to make sure people get the care they need.   

According to Bogunovic, you can become addicted to codeine, one of the main ingredients in lean, after taking it regularly for two weeks. 

You’re less likely to become addicted if you don’t drink lean very often. But you’re still at risk for harmful side effects whenever you do.

Signs of addiction to lean include: 

  • Sleeping more because the drug has sedative effects
  • Not participating in activities you normally enjoy
  • Losing weight
  • Spending a lot of time trying to get the drink
  • Having thoughts of self-harm or suicide
  • Isolating yourself from friends and family
  • Having unusual outbursts, increasing anxiety, or mood swings

If you think you or someone else might be addicted, the Substance Abuse Mental Health Services Administration (SAMHSA) can help. Call or text 988.

Withdrawal can happen when you become physically dependent on codeine. The symptoms can start within 24 hours of when you last used the drug and stick around for up to two weeks.

Because codeine is an opioid, the symptoms of withdrawal are like other opioids, including: 

  • Sweating
  • Yawning
  • A runny nose
  • Anxiety
  • Feelings of unhappiness or dissatisfaction
  • Insomnia

You could also have:

  • Restlessness
  • Muscle pain
  • Bone pain
  • Fever
  • Stomach issues like cramping, nausea, vomiting, or diarrhea
  • Rapid heart rate

There’s no rule that says you can’t attempt to stop drinking lean on your own, but it may be uncomfortable. When a licensed medical professional is supervising your withdrawal, they can prescribe drugs that ease symptoms without giving you the high of an opioid. 

Treatment might also include one-on-one or group counseling. Together, these steps lessen the likelihood that you’ll relapse or start using lean again.

Using illicit drugs, including lean, isn’t a good idea. But there are ways to make it less dangerous: 

Don’t drink alone. Always have someone with you who isn’t drinking lean. They can call 911 if you overdose.

Avoid using other drugs at the same time. This is known as polypharmacy use. Taking more than one drug at a time is never safe. With lean, it is particularly dangerous to mix other depressants like alcohol and benzodiazepines. 

Keep naloxone on hand. Make sure you know how to use it in case of an overdose.

 

Lean is a drink that usually contains codeine and promethazine. It’s also known as purple drank, syrup or sizzurp, and purple stuff, among other names. Though it may seem harmless, lean can be addictive, and it’s possible to overdose. If you’re going to drink lean, never mix it with other drugs or alcohol. If you have symptoms like anxiety, avoiding friends and family, or spending a lot of time trying to get more, consider reaching out to the Substance Abuse Mental Health Services Administration (SAMHSA). Call or text 988.

How does purple drank make you feel? 

Purple drank makes you feel high or euphoric. It can also make you feel like you or everything  around you is slowing down. 

What are the side effects of lean? 

Along with the high you get, side effects like nausea, dizziness, seizures, and memory loss can occur. Potential long-term effects include heart problems, tooth decay, and kidney and liver damage.