What Is Lean?

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A hand holds a red plastic cup at a party.

©Shutterstock/Tero Vesalainen

We’ve described the risks of misusing cough and cold medicines to get high. Prescription cough medicines that contain promethazine (an antihistamine) or codeine are sometimes combined with soda and candy in a drink called “lean” or “sizzurp.”

Lean is sometimes used at electronic dance music (EDM) parties, and a recent study found that half of the references to codeine use on Instagram were about lean.

Plus, last year in NIDA’s Chat Day during National Drug and Alcohol Facts Week®, teens had questions about lean. So, let’s look at the facts about it.

Some of lean’s effects come from misusing promethazine-codeine cough medicine in any form (syrup, gels, or capsules):

  • Codeine is an opioid (like morphine, oxycodone, and heroin). Misusing codeine—and that includes using lean—can cause a person’s heart rate and breathing to slow down.
  • High doses of codeine can lead to a deadly overdose, by stopping the heart and lungs from working completely.
  • Mixing codeine with alcohol or other drugs significantly increases that risk.

Other effects can include nausea, dizziness, impaired vision, memory loss, hallucinations, and seizures. And misusing codeine over and over can lead to tolerance and addiction.

Does your family know the risks of misusing opioids? NIDA’s free booklet can help.

Find Help Near You

Use the SAMHSA Treatment Locator to find substance use or other mental health services in your area. If you are in an emergency situation, this toll-free, 24-hour hotline can help you get through this difficult time: call 1-800-273-TALK, or visit the Suicide Prevention Lifeline. We also have step by step guides on what to do to help yourself, a friend or a family member.

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