Recently, you may have heard of the drink “Lean” or “Purple Drank.” This is possible because of its recent surge in popularity, such as in memes and involvements such as reports suggesting it was a major factor in Lil Wayne’s ongoing hospitalizations for seizures. 

Understandably, you may have wondered what lean is. Lean consists of (usually prescription) cough syrup, soda, hard candy, and sometimes alcohol. The nickname “lean” refers to the position it often puts you at after drinking.

Lean usage began in the 80’s, and rappers, such as Lil Wayne, have been singing about it since the 90’s. Today, lean is also referenced in music, particularly in the genre vaporwave which sometimes borrows imagery from the drink such as that of colorful 90s milkshake cups and hazy purple fluid, and in memes.

When taken, lean causes a feeling of relaxation and euphoria which can create a feeling that you’re floating away from your body. Lean slows your brain activity by acting on your central nervous system. 

Lean can be illegal. When codeine, an opioid found in prescription cough syrups and major ingredient known for causing a relaxed feeling and dangerously depressing the central nervous system and a Schedule II controlled substance, is used in lean, it is illegal in all cases.

However, lean can also be legal. DXM cough syrup is available without a prescription, and contains dextromethorphan instead of codeine, a legally marketed cough suppressant that is neither a controlled substance nor a regulated chemical under the Controlled Substances Act.

When used in the place of codeine, dextromethorphan can cause a “hallucinogenic” effect when doses much larger than the usual 120 mg recommended for DXM cough syrup are used. Dextromethorphan misuse may also be known by names such as “robo-tripping” or “dexing.”

When alcohol is added to lean, the risk of overdose with either DXM or codeine is increased. More severe symptoms may also occur, including drowsiness, poor breathing and worsened judgment.  

Lean may cause liver damage when used in the long term. Acetaminophen is a common ingredient in cough medications which is known for causing liver damage when more than the recommended dosage is consumed or when taken with alcohol.

Lean can also have a significant impact on mental health, as the ingredients it contains may cause tolerance and will create a need for more (dependence) as well as withdrawals in their absence. Some withdrawal symptoms include trouble sleeping, sweating, and irritability.

In summary, lean is a sometimes illegal, highly addictive mixture of codeine or DXM, soda, and hard candy which is already dangerous for your liver and mental health and can be made more dangerous when combined with alcohol. 

In short, you should stay away from it if you haven’t already tried it. If you have tried it and you are addicted, you should consider seeking help by talking to your healthcare provider, keeping in mind that patient confidentiality laws will prevent them from reporting you to law enforcement.