What Is Lean?

We’ve described the risks of misusing cough and cold medicines to get high. Prescription cough medicines that contain promethazine (an antihistamine) or codeine are sometimes combined with soda and candy in a drink called “lean” or “sizzurp.”

Lean is sometimes used at electronic dance music (EDM) parties, and a recent study found that half of the references to codeine use on Instagram were about lean.

Some of lean’s effects come from misusing promethazine-codeine cough medicine in any form (syrup, gels, or capsules):

• Codeine is an opioid (like morphine, oxycodone, and heroin). Misusing codeine—and that includes using lean—can cause a person’s heart rate and breathing to slow down.
• High doses of codeine can lead to a deadly overdose, by stopping the heart and lungs from working completely.
• Mixing codeine with alcohol or other drugs significantly increases that risk.

Other effects can include nausea, dizziness, impaired vision, memory loss, hallucinations, and seizures. And misusing codeine over and over can lead to tolerance and addiction.