Lean Drink | What is Lean Drink – OTC Medicine Abuse

What is Lean Drink?

A Lean Drink, also known as syrup, sizzurp, purple drank, barre, is derived from an Over-the-counter (OTC) medicine that can be sold directly to people without a prescription. OTC medicines treat a variety of illnesses and their symptoms including pain, coughs and colds, diarrhea, constipation, acne, and others. Lean Drink (OTC medicines) have active ingredients with the potential for misuse at higher-than-recommended dosages. Abuse of OTC drugs occurs when the maximum dose is exceeded by very large amounts, sometimes an entire bottle or more can be consumed.  This is known as Lean Drink Abuse.

How do people use Lean Drink (How to make lean drink)?

Misuse of an OTC medicine means – Lean Drink:

• taking medicine in a way or dose other than directed on the package
• taking medicine for the effect it causes- for example, to get high
• mixing OTC medicines together to create new products

What are some misused OTC medicines used to make Lean Drinks?

Parents and loved ones may be concerned that their child or significant other is abusing Lean Drink. Lean the drink is derived from some over the counter medicines, in some cases, or prescribed medications.  Many teenagers think drinking lean is harmless.

‘Lean’ is a drink made with prescribed codeine-based cough mixture. It originated in Houston and has been Popularized by the Hip Hop Culture

The two most common OTC drug ingredients that make up lean drinks:

Dextromethorphan (DXM) – Lean Drink

Dextromethorphan (DXM) is a cough suppressant found in many OTC cold medicines used to make lean drinks. The most common Lean Drink sources of abused DXM are “extra-strength” cough syrup, tablets and gel capsules.  Dextromethorphan (DXM), a cough suppressant and expectorant found in many OTC cold medicines. It may produce euphoria and dissociative effects or even hallucinations when taken in quantities greater than the recommended therapeutic dose.

OTC medications that contain DXM often also contain antihistamines and decongestants. Lean Drinks containing DXM may be swallowed in its original form or may be mixed with soda for flavor, called “robo-tripping” or “skittling.” Users sometimes inject it. These medicines are often misused in combination with other drugs, such as alcohol and marijuana.

Loperamide – Lean Drink

The Lean Drink made up of Loperamide is often misused along with DXM Lean Drinks.  Loperamide is an anti-diarrheal that is available in tablet, capsule, or liquid form. When misusing loperamide, people swallow large quantities of the medicine. It is unclear how often this drug is misused.

Promethazine-codeine cough syrup – Prescription Medicine – Lean Drink

Lean Drinks made fromPromethazine-codeine cough syrup, a medication that contains codeine, an opioid that acts as a cough suppressant and can also produce relaxation and euphoria when consumed at a higher-thanprescribed dose. It also contains promethazine HCl, an antihistamine that additionally acts as a sedative. Although only available by prescription, promethazine-codeine cough syrup is sometimes diverted for abuse.

Lean Drinks Related: “Behind-the-Counter” Medications

Lean Drink made from Pseudoephedrine, a nasal decongestant found in many OTC cold medicines, can be used to make methamphetamine. For this reason, products containing pseudoephedrine are sold “behind the counter” nationwide. A prescription is not needed in most states, but in states that do require a prescription, there are limits on how much a person can buy each month. In some states, only people 18 years of age or older can buy pseudoephedrine.

Effects of Lean – How does Lean (OTC medicine abuse) affect the brain?

Lean affects the brain in many ways. Many people do not realize that the harmless looking bottle in their medicine cabinet can actually cause sever harm and addiction, which may lead to death.

DXM

DXM is an opioid without effects on pain reduction or addiction and does not act on the opioid receptors. When taken in large doses, DXM causes a depressant effect and sometimes a hallucinogenic effect, similar to PCP and ketamine. Repeatedly seeking to experience that feeling can lead to addiction-a chronic relapsing brain condition characterized by inability to stop using a drug despite damaging consequences to a person’s life and health.

Loperamide

Loperamide is an opioid designed not to enter the brain. However, when taken in large amounts and combined with other substances, it may cause the drug to act in a similar way to other opioids. Other opioids, such as certain prescription pain relievers and heroin, bind to and activate opioid receptors in many areas of the brain, especially those involved in feelings of pain and pleasure. Opioid receptors are also located in the brain stem, which controls important processes, such as blood pressure, arousal, and breathing.

Side Effects of Lean?

Lean – DXM
Short-term effects of DXM misuse can range from mild stimulation to alcohol- or marijuana-like intoxication. At high doses, a person may have hallucinations or feelings of physical distortion, extreme panic, paranoia, anxiety, and aggression.

Other health effects from DXM misuse can include the following:

• hyperexcitability
• poor motor control
• lack of energy
• stomach pain
• vision changes
• slurred speech
• increased blood pressure
• sweating

Misuse of DXM products containing acetaminophen can cause liver damage.

Lean – Loperamide
In the short-term, Lean made from loperamide is sometimes misused to lessen cravings and withdrawal symptoms; however, it can cause euphoria, similar to other opioids.

Lean can also lead to fainting, stomach pain, constipation, eye changes, and loss of consciousness. It can cause the heart to beat erratically or rapidly, or cause kidney problems. These effects may increase if taken with other medicines that interact with loperamide. Other effects have not been well studied and reports are mixed, but the physical consequences of loperamide misuse can be severe.

Can a person overdose on Lean?

Absolutely, a person can overdose on Lean.  Lean, also known syrup, sizzurp, purple drank, barre, contains DXM or loperamide, and in some cases both! A Lean overdose may occur when a person takes much more than the prescription for DXM or Loperamide, in and attempt to get that euphoric feeling, to produce a life-threatening reaction or death (Read more on NIH Intentional vs. Unintentional Overdose Deaths webpage).

Lean is like any other opioids, when people overdose on Lean,  (DXM or loperamide), their breathing often slows or stops. This can decrease the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can have short- and long-term mental effects and effects on the nervous system, including coma and permanent brain damage and death.

When abused, lean, “promethazine-codeine cough syrup” presents a high risk of fatal overdose due to its effect of depressing the central nervous system, which can slow or stop the heart and lungs. Mixing with alcohol greatly increases this risk. Promethazine-codeine cough syrup has been linked to the overdose deaths of a few prominent musicians.

“Robo-Tripping” or “Skittling,” the common names of DXM Extra Strength can cause severe damage to the liver and may lead to overdose or death.  When used in combination with alcohol at the same time, known as “purple drank,” which is particularly risky and can lead to overdose.

How can Lean overdose be treated – OTC medicine overdoses treatment?

A person who has overdosed on Lean or any other opioid needs immediate medical attention. Call 911. If the person has stopped breathing or if breathing is weak, begin CPR. DXM overdoses can also be treated with naloxone. Read more about naloxone at NIH Naloxone webpage.

How does Lean Drink use lead to addiction?

DXM, Promethazine-Codeine Cough Syrup, when taken in higher quantities or when such symptoms aren’t present, they may affect the brain in ways very similar to illicit drugs. As with other drugs, repeated use of Lean can cause long-term changes in the brain’s reward circuit and other brain systems, which may lead to addiction. The reward circuit eventually adapts to the excess dopamine brought on by the drug. As a result, people take stronger and more frequent doses to achieve the same high and feel relief from initial withdrawal.

When taken in high doses, DXM acts on the same cell receptors as dissociative hallucinogenic drugs like PCP or ketamine. Users describe effects ranging from mild stimulation to alcohol- or marijuana-like intoxication, and at high doses, sensations of physical distortion and hallucinations. Codeine attaches to the same cell receptors targeted by illegal opioids like heroin. Consuming more than the daily recommended therapeutic dose of promethazine-codeine cough syrup can produce euphoria similar to that produced by other opioid drugs; people addicted to codeine may consume several times the recommended, safe amount. Also, both codeine and promethazine HCl act as depressants of the central nervous system, producing sedating or calming effects. When abused, both codeine and DXM directly or indirectly cause a pleasurable increase in the amount of dopamine in the brain’s reward pathway. Repeatedly seeking to experience that feeling can lead to addiction—a chronic relapsing brain disease characterized by inability to stop using a drug despite damaging consequences to a person’s life and health.

Opioid Withdrawal Symptoms

These symptoms include:

• muscle and bone pain
• sleep problems
• diarrhea and vomiting
• cold flashes with goosebumps
• uncontrollable leg movements
• severe cravings

Points to Remember About Lean

• Over-the-counter (OTC) medicines are those that can be sold directly to people without a prescription. Those that have the potential for misuse include:
  • Dextromethorphan (DXM), a cough suppressant found in many OTC cold medicines
  • Loperamide, an anti-diarrheal
• When misusing DXM, people swallow large quantities of the medicine, sometimes mixing it with soda for flavor, called “robo-tripping” or “skittling.” Loperamide may also be swallowed.
• Short-term effects of DXM misuse can range from mild stimulation to alcohol-or marijuana-like intoxication. Loperamide misuse can cause euphoria, similar to other opioids, or lessen cravings and withdrawal symptoms, but other effects have not been well studied and reports are mixed.
• A person can overdose on cold medicines containing DXM or loperamide.
• Overdose can be treated with CPR and certain medications depending on the person’s symptoms, but the most important step to take is to call 911.
• Misuse of DXM or loperamide can lead to addiction.
• There are no medications to treat DXM or loperamide addiction. Behavioral therapies, such as cognitive-behavioral therapy and contingency management, may be helpful.

If You or a Loved One Have a Lean, syrup, sizzurp, purple drank, barre, or lean Addiction, Get Help Today!