Lean/purple drank
Lean is usually made with cough medicines containing codeine, an opioid. Some versions contain other ingredients such as promethazine (an antihistamine) or dextromethorphan (DXM, a cough suppressant).
People use lean because it can cause feelings of relaxation, euphoria and drowsiness. It can also cause serious side effects, including slowed breathing, loss of consciousness, dependence and overdose.
Codeine is an opioid, the same family of drugs as oxycodone, heroin and morphine. Any opioid can lead to physical dependence, as well as withdrawal when you stop taking it.
People often make lean with cough medicine sourced illegally, so it can be difficult to know exactly what it contains or how strong it is. Just because an ingredient is found in a medicine, or the product is packaged as a medicine, it does not mean it’s safe to use.
Effects of lean
The effects will vary depending on the ingredients and strength, but it may cause:
- Feelings of relaxation or euphoria
- Drowsiness, sleepiness and sedation
- Dizziness, unsteadiness, or difficulty with balance
- Nausea and vomiting
- Restlessness or feelings of unease
- Changes in perception, such as a distorted sense of time
- Hallucinations or dissociative experiences, particularly when it contains DXM
- Reduced control over movements and coordination
- Sweating, a dry mouth, increased heart rate and raised body temperature
- Slowed, shallow, or abnormal breathing, which can be life-threatening
- Serious complications including liver damage, kidney failure, stomach irritation, and gastrointestinal bleeding
Taking large amounts of lean, or mixing it with substances such as alcohol, benzodiazepines (such as diazepam) or other opioids, can increase the risk of overdose, unconsciousness, and dangerously slow breathing.
High-dose codeine use during pregnancy can cause withdrawal symptoms in newborn babies.
Some people use codeine to cope with stress, anxiety or depression. Using drugs to manage difficult emotions can increase the risk of dependence and addiction.
Long-term misuse of codeine can worsen mental health and may contribute to anxiety and depression. If you become dependent, you may experience withdrawal symptoms when you stop using it.
Lean and the law
The substances used to make lean each have different legal controls.
Codeine is a controlled medicine. Depending on the product and circumstances, possessing or supplying codeine unlawfully may be a criminal offence and can result in penalties including fines or imprisonment. There are also laws around drug driving while under the influence of codeine.
Promethazine is a sedating (drowsy) antihistamine medication available on prescription and over the counter. Medicines containing promethazine must be used as directed by a healthcare professional.
Dextromethorphan (DXM) is a cough suppressant found in some over-the-counter cold and flu medicines. It is not a controlled drug, but misuse can be dangerous.
Although promethazine and DXM are legal to buy and possess when part of a legitimate medicine, pharmacists may refuse a sale if they suspect misuse.
Misuse can lead to health risks including hallucinations, impaired judgment, and other serious effects. Driving after taking DXM/promethazine or any medicine can be an offence if it impairs your ability to drive safely.
Keep yourself safer
- Think about how your current mood or wellbeing might affect your experience.
- Start low and go slow. The strength of lean can vary, so the effects are unpredictable and there is a risk of overdose.
- Avoid using lean alone, as having someone available can help in an emergency. You can also let a trusted friend or family member know your plans in case you need support.
- Don’t mix lean with alcohol, cannabis or other medications.
- Don’t drive, cycle, or operate machinery after using.
- After you have used lean, take time to rest and let your body recover. Stay hydrated and eat nutritious, easy-to-digest foods.
- Avoid taking other drugs while recovering, as this can increase strain on the body and further increase health risks.
What to do if someone's unconscious or having trouble breathing
- Call 999 immediately. The ambulance will only involve police if a death is reported, or if the paramedics are at risk.
- Use naloxone, the opioid overdose reversal drug. It can reverse the effects of opioid overdose and should be given while waiting for emergency help.
- Put them in the recovery position: On their side, airway open (see this quick NHS guide if you need a reminder).
- Stay with them until help arrives.
Remember: If you or your mates are using lean, you can pick up free naloxone from your local Change Grow Live or other local drug service.
Advice and support
If you want to take steps to address your drug use, don’t be afraid to reach out for help. You’re not alone and there's nothing to be ashamed of. There is lots of help and support available. Speak to your doctor about how you’re feeling and speak to supportive friends, family members, or other trusted adults if you can.
Advice and support are always available from your local Change Grow Live service. If you’re struggling with drugs or alcohol, we’re here to help.
You can also use our webchat to speak to someone and get advice straight away.