The Comeback Drink: 'Lean' or the Purple Elixir

Louise Stanger is a speaker, educator, licensed clinician, social worker, certified daring way facilitator and interventionist who uses an invitational intervention approach to work with complicated mental health, substance abuse, chronic pain and process addiction clients.

In a recent Miami New Times story published in July, a Homeland Security SWAT team raided the house of Harrison Garcia, an aspiring hip hop music producer. Agents scoured the Miami mansion, slit open mattresses, dumped valuable goods on the floor.

They discovered a litany of marijuana and firearms amongst other things. But it’s not what they found that was the true surprise - it’s what they planned the raid around and eventually confiscated: cough syrup.

Why cough syrup? The prescription-strength medication mixes with soda and Jolly Ranchers candy to become “purple drank,” a concoction popularized in hip-hop culture in the 1990s.

The drink has landed with such a loud cultural bang that it’s been featured in rap lyrics from mega-watt stars like Lil Wayne to Chris Brown and has reportedly been name-dropped by Justin Bieber and DJ Khaled. Three 6 Mafia, the hip-hop group from Memphis, brought slang for the drink into the mainstream with their song “Sippin On Some Syrup,” a nod to slang terms “sizzurp” and “lean.”

According to the Miami New Times, hip hop and purple drink found its roots in 1960s Houston. “Blues musicians began pouring Robitussin [a common cough medicine] into their beers.” The drink evolved over the years and when hip hop artists began blowing up in the 1980s, the culture had already been fomented and made its way into the mainstream.

What may seem like a benign drink can cause serious harm. Because cough syrup has codeine, an opioid, and promethazine, an antihistamine, the synergistic effects of these substances mixed with alcohol can cause dizziness, nausea, impaired vision, seizures, and rash and confusion, according to the U.S. National Library of Medicine. Opioids such as codeine, classified as the same as highly potent ones such as fentanyl and carfentanil, are highly addictive, suppress breathing, and can cause respiratory failure, which was the case for DJ Screw, a music artist who overdosed on the drink.

Although the preferred (and popular) method for consumption is from stacked styrofoam cups, it can still be difficult for folks to identify the content of what someone is drinking, especially since purple drank resembles grape juice or passion fruit. This puts particular pressure on companies and professionals hired to keep a hip hop artist or football player safe. Security teams, business and wealth managers, personal assistants, and fellow players have to keep a keen eye out for substances like purple drank.

Rappers are not the only ones who have fallen prey to lean – the purple drink. Sports stars have reportedly been arrested for possession of purple drank. For instance, in 2005 JaMarcus Russell, a quarterback for the Oakland Raiders, was found with a codeine-based cough syrup. In 2006, Terrence Kiel of the San Diego Chargers was arrested for attempting to send a shipment of cough syrup to a friend. There are many more cases like these.

Unfortunately, another group that has taken to purple drank and consuming over-the-counter cough syrup to get high are teens. Young adults, impressionable due to lack of experience, emulate people in the spotlight. Hip hop artists, celebrities and sports stars - all complicit in extolling the virtues of consuming the syrupy drink - hold favor in the eye of younger generations.

As such, “one ongoing National Institute of Health-funded study found that about 5 percent of 50,000 surveyed 8th, 10th and 12th-graders abused cough syrup in the past year.” Moreover, teens are experimenting with consuming large amounts of cough syrup to get high on dextromethorphan, or DXM, a common ingredient in household cough medicines which can cause hallucinogenic trips.

According to a study in 2008 cited in Web MD, one in ten American teenagers has abused products with DXM to get high, making it more popular in that age group than cocaine, ecstasy, LSD and meth. Perhaps the most alarming fact is that DXM is found in nearly half of all over-the-counter cough medicines so it’s cheap, easy and legal for teens to acquire. And its purple color can be hard for parents to spot as a dangerous drink.

Reports show purple drank was widely abused in the early 2000s and gradually fell off. However, there has been a resurgence since as early as 2011, prompting law enforcement crackdowns like the one mentioned in the opening.

If you suspect a loved one or young adult is abusing the drink, the first clue is drinking from stacked styrofoam cups - the preferred method of consumption. Also look for these signs:

  • Constricted pupils, droopy, uncontrolled eye movement
  • Raspy voice & slurred speech
  • Drowsiness
  • Loss of balance & coordination
  • Dental problems
  • Paleness or constipation

As parent and grandparent - in addition to being a social worker, clinician and interventionist - knowing about the slippery slope that purple drank can take a loved one on is important. Whether you are on a sound stage, performing at a rock concert, playing on the field or having fun with your teenage friends, purple drank can lead to serious consequences.

Behavioral health care professionals and treatment providers are adept at treating addiction caused by the opioid substances in purple drank. It’s important for managers, coaches, concert venues, sports arenas, schools, educators, parents and communities to be vigilant about teaching about lean and its negative consequences and monitoring behaviors in a proactive preventative fashion through randomized drug testing, education and public health awareness campaigns.

To learn more about Louise Stanger and her interventions and other resources, visit her website.

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