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Lean is an illicit substance that is made from codeine-based cough syrup, known by a variety of names. Lean gets its moniker due to the way the individual tends to lean to one side as they begin to feel the effects of the drink.

Lean drinkers can develop a dependence on the substance, and high doses can be extremely harmful.

Continue reading to learn more about the lean drink and its dangerous effects.

What substances are in a lean drink?

Lean is the name of a recreational drink composed of soda, such as Sprite, 7-Up, or Mountain Dew, plus an over-the-counter cough syrup that contains an antihistamine called promethazine, as well as other over-the-counter cough syrups containing codeine. The combination of ingredients, which often includes hard candy, results in a purple colored concoction that is consumed with the intent of achieving a dissociative euphoric high.

Codeine-containing medications are used to treat a variety of symptoms, including cough, diarrhea and low-level pain. Codeine is a Schedule II substance, meaning that it has a high potential for abuse, possibly resulting in addiction or dependence. In medications that contain 90 milligrams or less of codeine, the classification is Schedule III, designating a slightly lower risk of abuse.

Lean burst onto the party scene in the late 1990s when popular rap and hip hop artists — particularly based out of Houston — glamorized the drink in their lyrics and videos. These celebrities gave young people a false sense of safety by featuring lean-infused party references without any emphasis on the potentially harmful consequences of using the substance. Unfortunately, several artists eventually lost their lives due to the effects of this dangerous beverage.

Lean is known by a variety of slang terms, including:

Because the cough syrup is mixed with soda and fruity candy, the individual may not notice the sedating effects sneaking up on them, and may continue to consume more.

The effects of lean may last for 3-6 hours and include:

Lean remains a popular beverage among teens and young adults. Young people tend to combine the use of lean with other substances, such as marijuana or alcohol, to intensify the effects of the high. At high doses, lean can slow the central nervous system to the point where the heart and lungs will stop functioning, causing death, according to the National Institute on Drug Abuse.

Different versions of lean

In addition to the promethazine-based versions of lean, there are other cough syrups used in lean drinks that contain an ingredient called dextromethorphan, or DXM. These products are sold under the brand names like Robitussin Nighttime Cough DM and Delsym DM, as well as some generic products that feature both the promethazine and DXM ingredients.

In fact, DXM is available in over 140 products distributed as over-the-counter medications. When used in lean drinks, the effect is referred to as “robotripping,” a nod to the Robitussin cough syrup used in the drink.

When the DXM products are misused recreationally, they can cause dangerous adverse effects. At high doses, DXM causes effects similar to the hallucinogenic drug, PCP, causing psychosis, psychophysical dissociation, violent behaviors, high body temperature and even cardiac arrest.

Another version of lean uses codeine-infused prescription cough syrup instead of, or in addition to, the over-the-counter version that contains the promethazine or DXM. Even though cough syrups that contain codeine are more tightly controlled, they are available with a prescription and can be misused. Codeine is a lower-potency opioid that binds to the opioid receptors in the brain, which can increase the risk of developing physical dependence. However, because these codeine-infused cough syrups are harder to obtain, syrups containing DXM or promethazine have largely supplanted them for the purpose of making lean.

Signs of lean overdose

Lean drinks pose significant risks due to the sedating effects of the ingredients. Depending on the type of lean drink that is consumed, the effects will vary slightly. But all varieties of the lean concoctions, when consumed at high doses, pose an overdose risk because they are all central nervous system depressants.

Some of the warning signs of lean overdose include:

Lean overdose can lead to brain damage, organ damage, coma, or death.

Lean drinks may adversely interact with certain psychiatric medications, such as MAOI antidepressants, mood stabilizers, or benzodiazepines. Lean can also interact with herbal supplements, like melatonin or valerian root. These interactions can increase the risk of overdose.

Lean withdrawal symptoms

Knowing how to safely stop drinking lean is essential when deciding to enter recovery, since there is a risk of experiencing severe withdrawal symptoms if abruptly discontinued. For this reason, the withdrawal process should be closely monitored and managed by a medically trained provider. The provider can create a tapering schedule that helps ease the individual off lean safely.

To overcome lean use, it is necessary for the individual to make fundamental changes in how they respond to cravings, triggers, and stressors. Cognitive behavioral therapy can teach the individual how to change thought distortions, which can lead to healthy behavioral responses. A comprehensive treatment program provides the support and education so essential to achieving a sustained recovery.

If you or someone you care about is consuming lean drinks, there is help available. Reach out today.

Ashley Addiction Treatment, formerly Father Martin’s Ashley, is a nationally recognized nonprofit leader in integrated, evidence-based treatment for substance use disorders. Our programs are accredited by The Joint Commission, and result in frequent publications of ongoing research into effective treatment methodologies. We offer holistic care that encompasses the mind, body and spirit through inpatient and outpatient treatment, provide drug detox, relapse prevention plans, family wellness programs and a variety of other services tailored to each patient’s unique needs. Our driving principle — “everything for recovery” — reinforces our mission to transform and save lives through the science of medicine, the art of therapy and the compassion of spirituality, and is complemented by our philosophy of healing with respect and dignity. For information about our comprehensive programs, please call (866) 313-6307.