Lean Addiction: Definition, Causes, Symptoms, Effects, and Treatment Methods.

Lean addiction is the dependency and addiction on a recreational drug made from prescription-strength cough syrup, often containing codeine and promethazine.

The causes of lean addiction include easy access to cough syrup and its misuse to escape stress or anxiety. Symptoms include drowsiness, nausea, slurred speech, and addiction cravings. Effects lead to respiratory issues, liver damage, and even death in severe cases.

Some effective treatment options include detoxification, counseling, cognitive-behavioral therapy (CBT), support groups, and medication-assisted treatment to manage withdrawal symptoms.

What is Lean Addiction?

Lean addiction is a dependency on a drug made from cough syrup containing codeine, a mild opioid, and promethazine, an antihistamine. Lean, often mixed with soft drinks and candy for flavor, produces euphoric and sedative effects. Its opioid component creates a high similar to other narcotics, leading to a high potential for addiction. Continuous use of lean results in dependency, where individuals crave lean to avoid withdrawal symptoms.

Lean, or "purple drank", or "sizzurp," originated in the southern U.S., particularly in Houston, Texas, during the 1990s. Popularized by hip-hop artists, it became a symbol of a free and easy party culture. Over time, its misuse spread across the country as it was glamorized in music and social media. Lean addiction, regardless of its recreational reputation, is dangerous due to its opioid content.

In the United States opioid addiction, including codeine-based products like lean, has reached alarming levels, according to research published by the National Institute on Drug Abuse. In 2021, an estimated 2.5 million Americans struggled with opioid misuse. Globally opioid use disorders affect over 16 million people, over 2.1 million in the United States, according to the research by Alexander M. Dydyk; Nitesh K. Jain; and Mohit Gupta.

What are the Other Terms for Purple Drank?

The other terms and street names for purple dranks or lean are Sizzurp, Purple Tonic, Dirty Sprite, Syrup, Texas Tea, and Barre. The drink is also sometimes referred to as Purple Jelly, Drank, or simply Juice. These terms highlight the drink's distinctive purple color and its association with a relaxed, sedative state, which has been popularized among people who like getting high.

How Common is Lean Addiction?

Lean addiction has become increasingly common, because approximately 66% of lean users in the US fall within the age group of 13–21, with a majority of users being male (75%), according to recent research by Orrin D. Ware. Research also shows that 33% of White, 29% of Black/African American, and 28% of Hispanic individuals reported lean use, often in conjunction with alcohol and cannabis consumption. 66% of users met the criteria for severe lean use disorder, indicating a growing trend of addiction among young populations.

What are the Causes of Lean Addiction?

The causes of lean addiction include euphoria and relaxation, use of prescribed opioids, tolerance to lean drinks, influence of celebrities, and self-medication.

The details for these causes are below. 

• Euphoria and Relaxation: Lean contains codeine, an opioid that induces a calming, euphoric feeling. The immediate relaxation and pleasure make users crave the drug, contributing to addiction.

• Use of Prescribed Opioids: The use of prescribed opioids is a significant risk factor for addiction. Lean is often made from cough syrup containing prescribed opioids like codeine. Some users misuse these medications, initially intended for legitimate medical purposes, which later turns into dependency.

• Tolerance to Lean Drinks: With regular lean use, the body builds tolerance and requires larger doses to achieve the same effects. This leads to increased consumption and a higher risk of addiction. 

• Influence of Celebrities: The glamorization of lean in music and pop culture, particularly by celebrities, has fueled its popularity and misuse, according to research by Dr. Melissa Welbey. Young people are particularly influenced by celebrities, which increases the likelihood of substance abuse.

• Self-Medication: Some individuals use lean as self-medication to cope with stress, anxiety, or emotional pain, leading to a dangerous pattern of self-medication, according to research published by the National Library of Medicine. The research indicates that people with mental health issues are more likely to turn to substances like lean for temporary relief, increasing the risk of addiction.

What are the Symptoms of Lean Addiction?

The symptoms of lean addiction include increased tolerance, nausea, slurred speech, drowsiness, and other physical, emotional, and behavioral changes.

The symptoms of lean addiction are listed below.

• Increased Tolerance: Increased tolerance is a common symptom of opioid addiction. As the body adjusts to lean, larger doses are needed to achieve the same effects. This is a key indicator of dependency and addiction.

• Nausea: Regular lean use upsets the stomach, causing nausea and vomiting. The research, “The impact of opioid analgesics on the gastrointestinal tract function and the current management possibilities” by Wojciech Leppert published in the National Library of Medicine highlights that opioids often disrupt digestive function, leading to these symptoms.

• Slurred Speech: Lean slows down the central nervous system, causing difficulty with speech and coordination. A study published in the National Library of Medicine “Effects of a mu-opioid receptor agonist (codeine phosphate) on visuo-motor coordination and dynamic visual acuity in man” describes how opioids like codeine impair cognitive and motor functions.

• Drowsiness: The sedative effects of lean result in excessive sleepiness, making it difficult to stay alert or focused. Drowsiness is a frequent symptom of opioid abuse, according to the research “Opioid Analgesia and Opioid-Induced Adverse Effects: A Review published by Medicinal Chemistry and Pharmacological Activities of Opioid Drugs in October 2021.

• Social Withdrawal: Users begin to isolate themselves from friends and family as their addiction deepens. They avoid situations where people notice or question them about their addiction.

• Erratic Behavior: Erratic behavior like mood swings and impulsivity are typical as lean affects decision-making and emotional regulation.

• Cravings: Cravings are a primary symptom of opioid addiction. Addicted individuals experience strong urges to consume lean, especially when attempting to quit or reduce use according to the research published in MDPI by Alok K. Paul in October 2021.

• Anxiety: Anxiety and agitation often accompany addiction, especially when the drug isn’t available. Research Prescription opioid use linked to mood disorders led by Dr Janni Leung published by the University of Queensland Australia shows that opioids trigger anxiety disorders.

• Mood Swings: Lean use causes abrupt shifts in mood, from euphoria to depression, as it interferes with brain chemicals.

• Emotional Numbness: Emotional numbness is a state in which a person feels detached from their emotions. Individuals addicted to lean may feel detached or emotionally flat, as lean dampens emotional responses.

What are the Effects of Lean Addiction?

The effects of lean addiction are classified into two categories: short-term effects and long-term effects. Both have serious implications for an individual’s physical and mental well-being.

Short-Term Effects

The short-term effects of lean addiction are listed below:

• Euphoria: Opioids trigger dopamine release, contributing to feelings of euphoria. Lean contains codeine, an opioid that produces a feeling of intense pleasure and relaxation. This sense of euphoria is one of the main reasons people become addicted, as they seek to repeatedly experience this high.

• Blurred Vision: Lean impairs coordination and sensory processing, leading to blurred vision and difficulty focusing. This is a common side effect due to the depressant nature of codeine and promethazine.

• Dental Decay: The high sugar content in the soda and candy often mixed with lean, along with the dry mouth caused by the drug, leads to significant dental problems, including tooth decay and gum disease, according to the study “Lean Addiction and Abuse” published by the addiction center USA.

Long-Term Effects

The long-term effects of lean addiction are listed below:

• Behavioral Changes: Lean use leads to aggression, mood swings, and impulsivity due to its impact on brain chemistry.

• Sexual Dysfunction: Prolonged use disrupts hormone levels, causing issues like decreased libido and erectile dysfunction.

• Organ Damage: Chronic consumption harms the liver, kidneys, and heart, potentially leading to organ failure.

• Seizures: Lean increases the risk of seizures by affecting the central nervous system.

• Respiratory Issues: Lean causes chronic breathing problems and respiratory failure over time.

What are the Effects of Mixing Alcohol and Other Drugs?

The effects of mixing lean with alcohol or drugs like cannabis lead to severe drowsiness, respiratory depression, and increased overdose potential. 83% of lean users mix it with alcohol, and 46% with cannabis, according to research published in the National Library of Medicine. This combination increases emergency room visits, organ damage, and fatalities.37% of users engaging in dangerous behaviors, such as driving under the influence, contributed to an increase in emergency room visits and fatalities.

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Who is at Risk of Lean Addiction?

People at risk of lean addiction are teenagers and young adults with mental health problems like depression and anxiety, particularly those aged 13 to 21. Individuals often use lean as a form of self-medication and increase their risk of addiction.  Individuals who start using Lean at a younger age or consume it regularly face a greater likelihood of developing addiction, as early initiation and frequent use are strong predictors of long-term substance abuse.

What are the Treatment Options for Lean Addiction?

The treatment options for lean addiction include detoxification, behavioral therapies, support groups, medications, and lifestyle changes.

Below are the mentioned treatment options.

• Detoxification: Detoxification is the initial step that involves safely removing lean from the body under medical supervision. The process usually lasts from a few days to a week, depending on the seriousness of the addiction. During the detoxification process medical support helps manage withdrawal, the process is often uncomfortable due to symptoms like nausea, insomnia, and intense cravings. The challenges may require follow-up treatment to ensure long-term recovery.

• Behavioral Therapies: Behavioral therapies, such as Cognitive Behavioral Therapy (CBT), help address the psychological aspects of addiction. Treatment takes weeks or months, with ongoing sessions as needed. Behavioral Therapy offers personalized strategies and emotional guidance, though it may demand a significant time commitment.

• Support Groups: Support groups like Narcotics Anonymous (NA) create a community for shared experiences and accountability. Recovery through support groups is a long process with regular meetings. Support groups encourage a sense of belonging, but bring feelings of stigma or challenges in finding the right group dynamic.

• Medications: Medications are used to ease withdrawal symptoms and cravings associated with lean addiction. Medications are prescribed for weeks or months, depending on the individual's needs. Medications make the recovery process smoother, though they may come with side effects and require continuous medical oversight.

• Lifestyle Changes: Lifestyle changes like doing regular exercise, having a nutritious diet, and following mindfulness, supports long-term recovery. The timeframe for these changes varies, as it takes time to establish new routines. Lifestyle changes improve overall well-being and reduce relapse risk, but maintaining these habits is challenging in the long run

How to Prevent Lean Addiction?

To prevent lean addiction, raise awareness about the dangers of lean, particularly among teenagers and young adults to discourage its use. Early interventions, such as counseling for individuals at risk or displaying signs of substance misuse, are crucial in preventing addiction from developing. Avoiding social situations where lean is present reduces exposure and temptation. Promoting healthy coping mechanisms like physical activity, mindfulness, and stress management provides alternative ways to deal with emotional challenges, reducing the likelihood of turning to substances like lean.

How Lean Addiction Relate to Other Substance Addictions?

Lean addiction relates to other substance addictions because they share several similarities, such as lean contains codeine, an opioid that causes euphoria and relaxation, leading to a high potential for abuse like other opioid use disorders. Alcohol and other depressants, including lean, slow down the central nervous system, impairing motor skills, cognition, and respiratory function. Users often develop tolerance over time, requiring larger doses to achieve the same effect, which is common in addictions to substances like heroin or prescription painkillers.

The comparison of lean addiction with other substance addictions is explained below.

Can Lean and Opioids Lead to Feelings of Euphoria?

Yes, lean and opioids lead to euphoria, though they have some differences. Lean is a drink made from codeine-based cough syrup mixed with soda, which produces a mild opioid effect that induces relaxation and euphoria, especially popular in certain social circles. Opioids are of a broader category, including prescription painkillers and illicit drugs like heroin and fentanyl, all of which lead to intense euphoria and sedation due to their effect on the brain's reward system.

The similarity between lean and opioids is that both lean and opioids affect opioid receptors in the brain, resulting in pleasure and relaxation that quickly lead to dependency.Opioid addiction develops faster and more severely with stronger opioids like heroin or fentanyl, which have a higher potential for overdose and acute health risks compared to lean’s slower-acting effects.

Do Lean and Fentanyl Have the Potential to Cause Respiratory Depression?

Yes, lean and fentanyl cause respiratory depression, a dangerous slowing of breathing due to their effects on the central nervous system. Lean is a drink containing codeine, an opioid found in some prescription cough syrups, when consumed in high amounts, it depresses respiratory function if mixed with alcohol or other depressants. Fentanyl is a synthetic opioid that is 50 to 100 times stronger than morphine. Fentanyl is used medically for severe pain but has a high risk of overdose due to its potency.

Lean and fentanyl impact opioid receptors in the brain, leading to reduced respiratory rate as a side effect. Fentanyl addiction, even in small doses, causes fatal respiratory depression due to fentanyl’s extreme potency. Lean, typically requires larger or repeated doses to reach a similar level of respiratory suppression. Lean and fentanyl both have life-threatening potential, fentanyl poses a far greater risk of sudden and severe respiratory depression.

Do Lean and Heroin Act on Opioid Receptors in the Brain?

Yes, lean and heroin affect opioid receptors in the brain, producing feelings of euphoria and pain relief. Lean is a drink made from codeine-based cough syrup mixed with soda, providing a mild opioid effect through the activation of opioid receptors. Heroin is an illegal, highly potent opioid derived from morphine, which binds strongly to the receptors in the brain, creating intense and rapid euphoria.

Both substances lead to similar effects by interacting with opioid receptors, heroin addiction is far more intense and poses a higher risk of severe dependency, overdose, and rapid health decline. Lean requires frequent, high-volume consumption to match even a fraction of heroin’s effects. Lean and heroin lead to tolerance, dependence, and withdrawal symptoms due to their opioid-based action on the brain’s reward pathways.