Lean (drug)

The term lean refers to the tendency for users to have difficulty standing up straight while under the influence of the drug.Richard Klemme, [http://www.tsbp.state.tx.us/Newsletter/Promethazine8.htm USE OF PROMETHAZINE WITH CODEINE SYRUP: COUGH/COLD EPIDEMIC OR SIGNIFICANT ABUSE?] {{webarchive |url=https://web.archive.org/web/20080516114703/http://www.tsbp.state.tx.us/Newsletter/Promethazine8.htm |date=May 16, 2008 }}, Texas State Board of Pharmacy Newsletter, Volume XXV, Number 2, Spring 2001. The name "lean" refers to "users’ propensity of having difficulty in standing up straight." "Purple drank" references its typically purple hue, as the cough syrups employed are often purple in color, and an African-American Vernacular English term for an alcoholic beverage or intoxicating drink. Other names include "syrup/sizzurp", "jelly", "Tussin/Tuss{{'"}}, "barre", "Wock'{{-"}}, "Act'{{-"}}, "Texas tea", "mud", "dirty Sprite", and "tsikuni".Bryan Robinson, [https://abcnews.go.com/Health/LegalCenter/story?id=1045329&page=1 Cough Syrup Abuse in Texas Takes Center Stage] {{Webarchive|url=https://web.archive.org/web/20220329084018/https://abcnews.go.com/Health/LegalCenter/story?id=1045329&page=1 |date=March 29, 2022 }}, ABC News, August 17, 2005{{Cite web |title=What is Lean (Purple Drank), How It's Made, Side Effects and Dangers |url=https://drugabuse.com/dextromethorphan/lean-purple-drank/ |access-date=June 4, 2020 |archive-date=January 23, 2021 |archive-url=https://web.archive.org/web/20210123065941/https://drugabuse.com/dextromethorphan/lean-purple-drank/ |url-status=live }}Shaheem Reid, [http://www.mtv.com/news/articles/1582520/20080228/lil_wayne.jhtml Lil Wayne On Syrup: 'Everybody Wants Me To Stop ... It Ain't That Easy'] {{Webarchive|url=https://web.archive.org/web/20101222184338/http://www.mtv.com/news/articles/1582520/20080228/lil_wayne.jhtml |date=December 22, 2010 }}, MTV.com, February 28, 2008{{cite web |url=http://www.wcyb.com/news/dirty-sprite-gains-popularity-among-teens/28236066 |title="Dirty Sprite" gains popularity among teens | News - Home |access-date=2015-10-19 |url-status=dead |archive-url=https://web.archive.org/web/20151026062850/http://www.wcyb.com/news/dirty-sprite-gains-popularity-among-teens/28236066 |archive-date=October 26, 2015 |df=mdy-all}}{{Cite web |last=PA |first=The Ranch |date=2019-11-04 |title=Sipping On Some Nonsense: What Is Lean? |url=https://www.recoveryranchpa.com/addiction-blog/what-is-lean/ |access-date=2022-02-25 |website=The Ranch PA |language=en-US |archive-date=March 20, 2022 |archive-url=https://web.archive.org/web/20220320104107/https://www.recoveryranchpa.com/addiction-blog/what-is-lean/ |url-status=live }}{{cite web|last=Skelton|first=Eric|url=https://www.complex.com/music/lil-yachty-poland-song-review|title=Lil Yachty Took the WoOoOOoOoock to Poland|work=Complex|date=October 6, 2022|accessdate=October 12, 2022}}{{cite web |last1=Marso |first1=Andy |title=Pharmacy board recommends tracking 'sizzurp' ingredient |url=https://www.cjonline.com/story/news/politics/state/2014/07/14/pharmacy-board-recommends-tracking-sizzurp-ingredient/16663107007/ |website=The Topeka Capital-Journal |access-date=1 February 2024}} In areas where lean had not yet been introduced, codeine-based cough syrup mixed with pills was called "juice and beans". Lean is also sometimes referred to by its color in slang, usually purple (or "purp{{'"}}), but can also be red, green, or yellow based on the ingredients used.{{Cn|date=February 2025}}

File:Lean drug ingredients.jpg-promethazine cough syrup, Jolly Rancher candies, and Sprite. Note the label on the bottled syrup, printed with instructions on how to prepare the lean. Some of the syrup has been decanted into a plastic container.]]

File:Coughsyrup-promethcode.jpg

Typically, the base for lean is a strong prescription cold medicine, specifically cough syrup that contains both promethazine and codeine. Other preparations use codeine/guaifenasin, hydrocodone/chlorphenamine, hydrocodone/APAP, and hydrocodone/homatropine. Over-the-counter cold medicines that contain dextromethorphan (often paired with guaifenasin or acetaminophen) as the active ingredient have also been used, as they do not require acquiring a prescription.{{Cite web |url=https://www.mayoclinic.org/drugs-supplements/dextromethorphan-oral-route/description/drg-20068661 |title=Dextromethorphan (Oral Route) Description and Brand Names - Mayo Clinic |website=www.mayoclinic.org |access-date=2019-08-19 |archive-date=March 29, 2022 |archive-url=https://web.archive.org/web/20220329122752/https://www.mayoclinic.org/drugs-supplements/dextromethorphan-oral-route/description/drg-20068661 |url-status=live }}{{Cite web |url=https://www.usatoday.com/story/news/nation/2014/01/23/sizzurp-cough-syrup-drug/4793865/ |title=Sizzurp: What you need to know about cough syrup high |last=Painter |first=Kim |website=USA TODAY |language=en |access-date=2019-08-19 |archive-date=March 29, 2022 |archive-url=https://web.archive.org/web/20220329123918/https://www.usatoday.com/story/news/nation/2014/01/23/sizzurp-cough-syrup-drug/4793865/ |url-status=live }}

To create a drinkable mixture, the cough syrup is combined with soft drinks, especially fruit-flavored drinks such as Sprite, Mountain Dew, or Fanta, and is typically served in two foam cups.{{Cite web |url=https://www.tmz.com/2010/09/02/t-i-arrest-sizzurp-drugs-controlled-substance-tiny-codeine/ |title=T.I. Arrest -- Sippin' on Sizzurp? |website=TMZ |date=September 2, 2010 |language=en |access-date=2019-08-19 |archive-date=April 5, 2022 |archive-url=https://web.archive.org/web/20220405141113/https://www.tmz.com/2010/09/02/t-i-arrest-sizzurp-drugs-controlled-substance-tiny-codeine/ |url-status=live }} A hard candy, usually a Jolly Rancher, may be added to give the mixture a sweeter flavor. Masking the undesired taste may impair judgment of the potency, which is a factor in overdosing.{{Cn|date=February 2025}}

The physiological effects of lean on the user are to produce mild "euphoric side effects", which are accompanied by "motor-skill impairment, lethargy, drowsiness, and a dissociative feeling from all other parts of the body."{{cite news |newspaper=The Daily Beast |first=Melissa |last=Leon |date=March 17, 2013 |url=http://www.thedailybeast.com/articles/2013/03/17/lil-wayne-hospitalization-what-the-hell-is-sizzurp.html |title=Lil Wayne Hospitalization: What the Hell Is Sizzurp? |access-date=January 20, 2014 |archive-date=May 4, 2017 |archive-url=https://web.archive.org/web/20170504171545/http://www.thedailybeast.com/articles/2013/03/17/lil-wayne-hospitalization-what-the-hell-is-sizzurp.html |url-status=live }} It has been suggested that the super-sweet combination of soda, cough syrup, and Jolly Ranchers provides a pleasing flavor and mouthfeel that lingers on the user's tongue for an extended duration. This phenomenon is often appealing to first-time users. Lean is often used in combination with alcohol and/or other drugs.

When taken in prescribed quantities, codeine-promethazine is quite safe,{{cite news |title=Doctor explains sizzurp's powerful high -- and deadly side effects |date=March 18, 2013 |first=Amina |last=Khan |url=https://www.latimes.com/science/la-xpm-2013-mar-18-la-sci-sn-sizzurp-side-effects-lil-wayne-20130318-story.html |access-date=January 20, 2014 |archive-date=February 21, 2014 |archive-url=https://web.archive.org/web/20140221070606/http://articles.latimes.com/2013/mar/18/science/la-sci-sn-sizzurp-side-effects-lil-wayne-20130318 |url-status=live }} but dangers arise in higher doses since promethazine is a depressant of the central nervous system (CNS), and codeine is a respiratory depressant. When codeine is taken in very large amounts, it can cause one to stop breathing. Using alcohol and other drugs alongside lean increases the chance of respiratory depression. It seems that the concoction does not cause seizures itself, but increases their likelihood in those susceptible to them. The drink includes a massive amount of the opiate codeine, and it has been suggested that promethazine may heighten the euphoric effects of codeine.

The addictive nature of the drink means that trying to discontinue regular usage can bring about symptoms of withdrawal. In a 2008 interview with MTV News, Lil Wayne described the withdrawal as feeling "like death in your stomach when you stop. Everybody wants me to stop all this and all that. It ain't that easy."{{cite news |title=LIL WAYNE ON SYRUP: 'EVERYBODY WANTS ME TO STOP ... IT AIN'T THAT EASY' |first=Shaheem |last=Reid |date=February 28, 2008 |url=http://www.mtv.com/news/1582520/lil-wayne-on-syrup-everybody-wants-me-to-stop-it-aint-that-easy/ |newspaper=MTV |access-date=November 13, 2020 |archive-date=April 12, 2022 |archive-url=https://web.archive.org/web/20220412134113/http://www.mtv.com/news/1582520/lil-wayne-on-syrup-everybody-wants-me-to-stop-it-aint-that-easy/ |url-status=dead }}

Respiratory depression is a potentially serious or fatal adverse drug reaction associated with the use of codeine, but mainly the danger lies in the much more potent and CNS-depressing phenothiazine-related antihistamine promethazine. This depression is dose-related and is the mechanism for the potentially fatal consequences of overdose: respiratory or cardiac arrest. As with most CNS depressants, mixing with alcohol greatly increases the risk of respiratory failure and other complications.{{cite web |url=http://www.dao.health.wa.gov.au/DesktopModules/Bring2mind/DMX/Download.aspx?Command=Core_Download&EntryId=439&PortalId=0&TabId=211 |title=Alcohol Interactions with Other Drugs |year=1999 |publisher=Alcohol and Other Drugs Program Public Health Division, Health Department of Western Australia |access-date=June 4, 2013 |archive-url=https://web.archive.org/web/20160118023337/http://www.dao.health.wa.gov.au/DesktopModules/Bring2mind/DMX/Download.aspx?Command=Core_Download&EntryId=439&PortalId=0&TabId=211 |archive-date=January 18, 2016 |url-status=dead}}

Lean is thought to have developed in Houston around the 1960s, when blues musicians would take Robitussin and cut it with beer. Later, when wine coolers came onto the market, they substituted for beer. These blues musicians lived in Houston's Fifth Ward, Third Ward, and South Park neighborhoods and the practice was taken up by the generation of rappers growing up in the same parts of the city. In the 1980s and 1990s the formula changed to using codeine promethazine cough syrup, somewhat like the glutethimide and codeine combination that was popular from the 1970s up to the early 1990s.{{cite web |title=Learn all about the long, lean history of "sizzurp" with this 7-minute audio primer |publisher=A.V. Club |url=http://www.avclub.com/article/learn-all-about-the-long-lean-history-of-sizzurp-w-95448 |first=Marah |last=Eakin |date=March 26, 2013 |access-date=January 20, 2014 |archive-date=August 17, 2017 |archive-url=https://web.archive.org/web/20170817170018/http://www.avclub.com/article/learn-all-about-the-long-lean-history-of-sizzurp-w-95448 |url-status=dead }} Codeine-based cough syrups were also turned to as an alternative to pentazocine/tripelennamine ("T's and blues") after the pharmaceutical industry added naloxone to its constitutent drugs, effectively blocking their potential for abuse.{{cite news |last=Spencer |first=Jim |date=September 19, 1984 |title=Abuse of 'juice': The burgeoning ills of cough syrup |trans-title= |url= |language= |work=Chicago Tribune |location= |access-date= |via= |quote=}}

Lean remained a local phenomenon in Houston until the 1990s, when the American rapper DJ Screw released several tunes mentioning the drink in his mixtapes, which were extremely popular in the Houston area. DJ Screw's music was particularly appropriate for Houston's climate. Due to the heat and expanse of the Houston area residents spent long drives in their cars, "the music that most appropriately complements that has always been the music of DJ Screw, it's slowed down—and when I say slowed down I mean he would record sessions in his apartment with rappers freestyling over beats and he would make these big mixtapes and then he would actually slow them down even further on his cassette recorder." DJ Screw's invoking lean in his lyrics and his use of slow tempos had caused his style to be characterized "[a]s if the song itself has taken too much codeine promethazine". Rappers far beyond Houston would come to adopt aspects of DJ Screw's unique style, but not before he died of a codeine overdose in 2000.{{cite news |last1=Strauss |first1=Neil |date=23 November 2000 |title=THE POP LIFE; Rap Is Slower Around Houston |url=https://www.nytimes.com/2000/11/23/arts/the-pop-life-rap-is-slower-around-houston.html |access-date=13 April 2017 |newspaper=The New York Times}}

File:Future_Summer_Sixteen_Tour.jpg publicly spoke about quitting lean after learning about how his music influenced teenagers to try the drug.{{Cite magazine |url=https://www.rollingstone.com/music/music-features/future-the-wizrd-profile-779220/ |title=Future Changed Rap for a Generation. He Doesn't Know How to Feel About It |first=Charles |last=Holmes |magazine=Rolling Stone |date=January 17, 2019 |access-date=January 28, 2020 |archive-url=https://web.archive.org/web/20190524062906/https://www.rollingstone.com/music/music-features/future-the-wizrd-profile-779220/ |archive-date=May 24, 2019}}]]

Houston producer DJ Screw popularized the concoction, which is widely attributed as a source of inspiration for the chopped-and-screwed style of hip hop music. The promethazine and codeine concoction first gained popularity in the underground hip hop scene in Houston,{{cite book |last=Corcoran |first=Michael Joseph |title=All Over the Map: True Heroes of Texas Music |edition=1st |year=2005 |publisher=University of Texas Press |location=Austin |isbn=978-0-292-70976-8 |pages=23–26 |chapter=The Geto Boys and DJ Screw: Where the Dirty South Began}} where musician Big Hawk said it was consumed as early as the 1960s and 1970s, becoming more widely used in the early 1990s.Joseph Patel, [http://www.mtv.com/bands/h/hip_hop_week/chopped_screwed/index2.jhtml Chopped & Screwed: A History] {{Webarchive|url=https://web.archive.org/web/20070311071048/http://www.mtv.com/bands/h/hip_hop_week/chopped_screwed/index2.jhtml |date=March 11, 2007 }}, page 2, MTV.com. Accessed January 7, 2010. Because of usage by rap artists in Houston, it became more popular in the 1990s.Schiller, Dane. "[http://www.chron.com/news/houston-texas/article/Purple-Drank-scheme-allegedly-made-millions-for-2225214.php Purple Drank scheme allegedly made millions for smuggling ring] {{Webarchive|url=https://web.archive.org/web/20220412134126/https://www.chron.com/news/houston-texas/article/Purple-Drank-scheme-allegedly-made-millions-for-2225214.php |date=April 12, 2022 }}." Houston Chronicle. Wednesday October 19, 2011. Retrieved on October 23, 2011. Its use later spread to other States in the South. In June 2000, Three 6 Mafia's single "Sippin' on Some Syrup", featuring UGK, brought the term purple drank to a nationwide audience.{{cite news |first=Yolanda |last=Walker |title=Drug-laced cough syrup tempts Texas teens |url=http://www.wfaa.com/sharedcontent/dws/wfaa/latestnews/stories/wfaa061020_lj_syrup.5a02f76f.html |publisher=WFAA |date=October 20, 2006| access-date= October 28, 2006 |archive-url = https://web.archive.org/web/20070125160550/http://www.wfaa.com/sharedcontent/dws/wfaa/latestnews/stories/wfaa061020_lj_syrup.5a02f76f.html |archive-date = January 25, 2007}}

In 2004, the University of Texas at Austin found that 8.3% of secondary school students in Texas had taken codeine syrup to get high. The Drug Enforcement Administration reports busts involving syrup across the Southern United States, particularly in Texas and Florida. As of 2011, the price of lean in Houston was twice the price it is in Los Angeles.

In a 2019 interview, American rapper Future spoke about quitting lean and stated that he was afraid that his fans would believe his music has changed if he had publicly admitted to quitting earlier. Future expressed disappointment after American rapper Juice Wrld told him that he was influenced by his music to try lean when he was young. Future stated "It's like, 'Oh shit.' How many other sixth-graders did I influence to drink lean?" The two artists had released a collaborative mixtape titled Wrld on Drugs in October 2018. Lil Nas X's hit song "Old Town Road" includes the line "Lean all in my bladder", though Lil Nas X has stated he does not endorse the drug.{{Cite web |url=https://www.cosmopolitan.com/entertainment/music/a28497104/old-town-road-lyrics-meaning-lil-nas-x-billy-ray-cyrus/ |title=The Real Meaning of the "Old Town Road" Lyrics |date=January 24, 2020 |access-date=January 28, 2020 |website=Cosmopolitan |first=Haleigh |last=Mauro |archive-date=April 12, 2022 |archive-url=https://web.archive.org/web/20220412134120/https://www.cosmopolitan.com/entertainment/music/a28497104/old-town-road-lyrics-meaning-lil-nas-x-billy-ray-cyrus/ |url-status=live }}

DJ Screw, who popularized the codeine-based drink, died of a codeine–promethazine, Valium, and PCP overdose on November 16, 2000, several months after the video of Three 6 Mafia's single debuted.{{cite news |first=Eric |last=Demby |title=Codeine Overdose Killed DJ Screw, Medical Examiner Says |url=http://www.mtv.com/news/articles/1437883/20010111/story.jhtml |publisher=MTV.com |date=January 11, 2001 |access-date=October 28, 2006 |archive-date=December 20, 2008 |archive-url=https://web.archive.org/web/20081220215849/http://www.mtv.com/news/articles/1437883/20010111/story.jhtml |url-status=dead }}

Big Moe, a DJ Screw protégé whose albums City of Syrup and Purple World were based on the drink and who has been described as having "rapped obsessively about the drug",Kristie Rieken, [http://www.chron.com/disp/story.mpl/front/5515791.html Cough syrup found in Pimp C's hotel had no label] {{Webarchive|url=https://web.archive.org/web/20110612163635/http://www.chron.com/disp/story.mpl/front/5515791.html |date=June 12, 2011 }}, Associated Press, February 5, 2008 died at age 33 on October 14, 2007, after suffering a heart attack one week earlier that left him in a coma.[http://www.contactmusic.com/news.nsf/article/rapper%20big%20moe%20dies_1046665 DJs – Rapper Big Moe Dies] {{Webarchive|url=https://web.archive.org/web/20090408062829/http://www.contactmusic.com/news.nsf/article/rapper%20big%20moe%20dies_1046665 |date=April 8, 2009 }}, contactmusic.com, October 15, 2007 There was speculation that lean may have contributed to his death.Leslie Casimir, [http://www.chron.com/disp/story.mpl/front/5230362.html Rapper's death leads teens to re-evaluate lifestyle; Fans and friends wonder whether drug was a factor in his heart attack] {{Webarchive|url=https://web.archive.org/web/20100506040256/http://www.chron.com/disp/story.mpl/front/5230362.html |date=May 6, 2010 }}, Houston Chronicle, October 20, 2007[http://www.chron.com/disp/story.mpl/front/5214956.html Houston rappers remember Big Moe] {{Webarchive|url=https://web.archive.org/web/20110805155729/http://www.chron.com/disp/story.mpl/front/5214956.html |date=August 5, 2011 }}, by Eyder Peralta, Houston Chronicle, October 16, 2007

Pimp C, a widely influential rapper from Port Arthur, Texas and member of the rap duo UGK, was found dead on December 4, 2007, at the Mondrian Hotel in West Hollywood, California. The Los Angeles County Coroner's Office reported that the rapper's death was "due to promethazine-codeine effects and other unestablished factors." Ed Winter, assistant chief of the Coroner's Office, said the levels of the medication were elevated, but not enough to deem the death an overdose. However, Pimp C had a history of sleep apnea, a condition that causes one to stop breathing for short periods during sleep. A spokesman for the coroner's office said that the combination of sleep apnea and cough medication probably suppressed Pimp C's breathing long enough to bring on his death.{{cite news |title=Cough syrup cited in rapper Pimp C's death |url=http://www.latimes.com/news/printedition/california/la-me-pimpc5feb05,1,2095205.story |work=Los Angeles Times |date=February 5, 2008 |access-date=March 15, 2008 |archive-date=February 12, 2008 |archive-url=https://web.archive.org/web/20080212120306/http://www.latimes.com/news/printedition/california/la-me-pimpc5feb05,1,2095205.story |url-status=live }}

Fredo Santana, an American rapper who frequently made references to the drink in his music, died of a seizure on January 19, 2018. According to TMZ, he had been suffering from liver and kidney problems, which were believed to be the result of his addiction.{{cite news |title=Rapper Fredo Santana Dead from Fatal Seizure |url=http://www.tmz.com/2018/01/20/fredo-santana-dead-dies-seizure/ |publisher=TMZ.com |date=January 20, 2018 |access-date=January 20, 2018 |archive-date=January 21, 2018 |archive-url=https://web.archive.org/web/20180121010023/http://www.tmz.com/2018/01/20/fredo-santana-dead-dies-seizure/ |url-status=live }}

In September 2006, Terrence Kiel, a San Diego Chargers player, was arrested during practice for the possession with intent to sell prescription cough syrup for use in making the drink.{{cite news |newspaper=USA Today |first=Donna |last=Leinwand |title=DEA warns of soft drink-cough syrup mix |url=https://www.usatoday.com/news/nation/2006-10-18-lean_x.htm?csp=34 |date=October 18, 2006 |access-date=October 23, 2006 |archive-date=November 28, 2006 |archive-url=https://web.archive.org/web/20061128201409/http://www.usatoday.com/news/nation/2006-10-18-lean_x.htm?csp=34 |url-status=live }} Kiel was caught trying to ship a case of syrup to a friend via FedEx. Kiel was charged with two felony counts of transporting a controlled substance and three counts of possession for sale of a controlled substance.[https://www.usatoday.com/sports/football/nfl/chargers/2006-09-27-kiel_x.htm Chargers safety Kiel arrested on drug charges] {{Webarchive|url=https://web.archive.org/web/20090719134514/http://www.usatoday.com/sports/football/nfl/chargers/2006-09-27-kiel_x.htm |date=July 19, 2009 }}, USA Today, September 28, 2006

On July 8, 2008, Johnny Jolly, a Green Bay Packers player, was pulled over in his car by the police for playing excessively loud music in a nightclub parking lot. The officers found a Dr Pepper bottle in a holder next to two Styrofoam cups containing soda and ice.{{cite web |url=https://bleacherreport.com/articles/421758-purple-drank-and-the-nfl |title=Purple Drank and the NFL: Johnny Jolly Isn't the Only One Getting Caught |publisher=Bleacher Report |access-date=2022-03-03 |archive-date=March 4, 2022 |archive-url=https://web.archive.org/web/20220304012929/https://bleacherreport.com/articles/421758-purple-drank-and-the-nfl |url-status=live }} The case was dismissed,[http://www.jsonline.com/sports/packers/50962557.html Case against Jolly dismissed] {{Webarchive|url=https://web.archive.org/web/20220812200539/https://archive.jsonline.com/sports/packers/50962557.html/ |date=August 12, 2022 }}, "Milwaukee Journal Sentinel", July 16, 2009 but charges were refiled in December 2009 after the Houston Police Department acquired new equipment that allowed the police to test the evidence again. Jolly faced a possible maximum sentence of up to 20 years in jail, but as a first time offender he would be eligible for probation.{{cite web |url=http://www.espnmilwaukee.com/includes/blog/index.php?action=blog&blog_id=20&post_id=1379 |title=540 ESPN Milwaukee |publisher=Espnmilwaukee.com |access-date=January 4, 2010 |archive-date=December 20, 2009 |archive-url=https://web.archive.org/web/20091220034813/http://www.espnmilwaukee.com/includes/blog/index.php?action=blog&blog_id=20&post_id=1379 |url-status=live }}

On July 5, 2010, former Oakland Raiders quarterback JaMarcus Russell was arrested at his home in Mobile, Alabama, for possession of codeine syrup without a prescription. He was arrested as part of an undercover narcotics investigation. Russell was booked into city jail and released soon afterwards after making his bail.[http://sportsillustrated.cnn.com/2010/football/nfl/07/05/russell.arrest.ap/index.html?eref=sihp 2010-07-05] {{webarchive |url=https://web.archive.org/web/20100708213508/http://sportsillustrated.cnn.com/2010/football/nfl/07/05/russell.arrest.ap/index.html?eref=sihp |date=July 8, 2010 }}

On June 11, 2013, just days after being robbed at gunpoint in San Francisco, rapper 2 Chainz was arrested at Los Angeles International Airport on charges of possessing promethazine and codeine (the primary ingredients of lean) along with marijuana.{{cite web |url=http://news.radio.com/2013/06/11/2-chainz-arrested-for-marijuana-possession-at-los-angeles-airport/ |title=2013-11-06 |publisher=News.radio.com |date=June 11, 2013 |access-date=April 10, 2014 |archive-date=March 10, 2018 |archive-url=https://web.archive.org/web/20180310025310/http://news.radio.com/2013/06/11/2-chainz-arrested-for-marijuana-possession-at-los-angeles-airport/ |url-status=live }}

Mac Miller, who died of a drug overdose not involving lean, spoke openly of his addiction to lean.{{Cite web |url=https://www.simplemost.com/what-is-lean-the-cough-syrup-drink/ |title=Here's What You Need To Know About Lean—The Cough Syrup Drink That Mac Miller Spoke About Before His Death |last=Streit |first=Kate |date=2018-09-14 |website=Simplemost |language=en-US |access-date=2019-07-30 |archive-date=January 23, 2022 |archive-url=https://web.archive.org/web/20220123214143/https://www.simplemost.com/what-is-lean-the-cough-syrup-drink/ |url-status=live }}

On April 7, 2015, Swedish rapper Yung Lean, while living in Miami Beach, Florida, and recording his second studio album Warlord, was hospitalized at Mount Sinai Medical Center due to an overdose stemming from an addiction to Xanax, cocaine, and lean.{{Cite web |title=Yung Lean's Second Chance |url=https://www.thefader.com/2016/06/16/yung-lean-warlord-interview |access-date=2022-02-09 |website=The FADER |language=en |archive-date=June 15, 2020 |archive-url=https://web.archive.org/web/20200615095845/https://www.thefader.com/2016/06/16/yung-lean-warlord-interview |url-status=live }}

Several legal commercial products loosely based on the concept of "purple drank" are marketed in the United States. In June 2008, Innovative Beverage Group, a Houston, Texas-based company, released a beverage called "Drank". The commercial product contains no codeine or promethazine, but claims to "Slow Your Roll" with a combination of herbal ingredients such as valerian root and rose hips as well as the hormone melatonin.{{cite news |publisher=Yahoo |title='Slow Your Roll' With DRANK From Innovative Beverage Group – the World's First Extreme Lifestyle Relaxation Beverage |url=http://biz.yahoo.com/pz/080610/144371.html |date=June 10, 2008 |access-date=September 16, 2008 |url-status=dead |archive-url=https://web.archive.org/web/20081202151813/http://biz.yahoo.com/pz/080610/144371.html |archive-date=December 2, 2008}}[http://blogs.villagevoice.com/forkintheroad/archives/2008/06/adventures_in_p.php Adventures in Press Releases: The Anti-Energy Drink] {{webarchive |url=https://web.archive.org/web/20090404133443/http://blogs.villagevoice.com/forkintheroad/archives/2008/06/adventures_in_p.php |date=April 4, 2009 }} By Sarah DiGregorio in Edible News, June 4, 2008

Similar "anti-energy" or relaxation drinks on the commercial market use the names "Purple Stuff", "Sippin Syrup", and "Lean".[http://www.thegrio.com/2009/09/sippin-on-some-syrup.php 'Sippin Syrup' being sold in stores creates controversy] {{Webarchive|url=https://web.archive.org/web/20120225222201/http://www.thegrio.com/2009/09/sippin-on-some-syrup.php |date=February 25, 2012 }}, theGrio website, September 25, 2009. Retrieved November 27, 2009.Jemimah Noonoo, [http://www.commercialalert.org/issues/education/soft-drinks/anti-energy-drink-fuels-concerns-over-marketing Anti-Energy Drink Fuels Concerns Over Marketing] {{webarchive |url=https://web.archive.org/web/20100706104356/http://www.commercialalert.org/issues/education/soft-drinks/anti-energy-drink-fuels-concerns-over-marketing |date=July 6, 2010 }}, Houston Chronicle, November 28, 2008; retrieved from commercialalert.org website on November 27, 2009Boyce Watkins, [http://www.bvonmoney.com/2009/09/29/company-makes-money-selling-sippin-syrup-in-grocery-stores/ Company Makes Money from Deadly Urban Trend: "Sipping Syrup"] {{Webarchive |url=https://web.archive.org/web/20201102065455/http://www.bvonmoney.com/2009/09/29/company-makes-money-selling-sippin-syrup-in-grocery-stores/ |date=November 2, 2020 }}, AOL Black Voices, September 29, 2009

These commercial products have been criticized for their potential to serve as gateways to the dangerous illegal concoction.Kim Horner, [http://www.dallasnews.com/sharedcontent/dws/dn/latestnews/stories/DN-drank_18met.ART0.Central.Edition1.4bab510.html Anti-energy drink hard for some mental health experts to swallow] {{Webarchive|url=https://web.archive.org/web/20101118124829/http://www.dallasnews.com/sharedcontent/dws/dn/latestnews/stories/DN-drank_18met.ART0.Central.Edition1.4bab510.html |date=November 18, 2010 }}, Dallas Morning News, February 18, 2010 The marketing push has been described as akin to the making of candy cigarettes.

• Ayahuasca
• Benadryl challenge
• Coca wine
• Recreational use of dextromethorphan

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