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What to Know About Purple Drank Use

Naveed Saleh, MD, MS, is a medical writer and editor covering new treatments and trending health news.

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

Purple drank is the moniker given to the recreational drug that is created by mixing large doses of prescription cough syrup (most commonly promethazine-codeine products, which are classically a deep purple color) with a carbonated soft drink and hard candy.  

Today, cough medicines with codeine are classified as Schedule V drugs, making them legal only with a prescription. With the emergence of dangerous drug cocktails like purple drank in the 1990s, however, the potential for misuse was brought into the spotlight.

Also Known As: Purple drank is also known as sizzurp, purple stuff, lean, drank, barre, Texas tea, Tsikuni, purple jelly, Memphis mud, and purple Sprite.

Drug Class: The primary drug ingredient in purple drank is codeine, which is classified as an opioid, whereas promethazine, another drug in the cocktail, is an antihistamine.

Common Side Effects: Purple drank is known to cause euphoria, nausea, dizziness, impaired vision, memory loss, hallucinations, and seizures.

How to Recognize Purple Drank

This potential “killer” cough syrup is cut with soda and sometimes candy or even alcohol—giving it a signature saccharine taste and purple color. It is typically served in a styrofoam cup.

What Does Purple Drank Do?

People typically sip purple drank to experience the reported euphoria and dissociation from one’s body. It’s often called a “swooning euphoria”—promethazine acts as a sedative and codeine creates a feeling of euphoria—and these effects last between three to six hours.

Purple drank also goes by the name “lean” because similar to being very drunk, people often literally have to lean on something to stand up once the effects take place.  

What the Experts Say

Purple drank become popular partly due to the glamorization of sizzurp and its euphoric effects among many celebrities and in numerous hip hop songs and videos.

Purple drank has been responsible for the hospitalization and death of many people, including several celebrity singers, rappers, and professional athletes.   For example, the singer and rapper Mac Miller, who later died of a drug overdose, had spoken about his own addiction to purple drank.

Compared to other recreational drugs, the ease of obtaining the ingredients and the drug’s relatively low cost to make it more accessible than other recreational drugs.

While it’s unclear how many people misuse prescription cough syrups in the form of drug cocktails like purple drank, we do know that many teens turn to cough and cold medication to get high, including 2.8% of 8 th graders, 3.3% of 10 th graders, and 3.4% of 12 th graders, according to the 2018 Monitoring the Future Report.  

Preventative Measures

In 2014, pharmaceutical company Actavis decided to stop producing and selling its prescription-only promethazine-codeine syrup product (nicknamed “Prometh”) due to the rise in recreational use.

Unfortunately, this move did not deter its use. In fact, people have reportedly stockpiled the promethazine-codeine cough syrup and it remains to be seen whether people seeking a similar high will come up with another way to concoct a cocktail replete with promethazine and opioids.

For instance, drank can be brewed from over-the-counter cough syrups containing dextromethorphan (DXM), which is similar to the dissociative anesthetics ketamine (Special K) and phencyclidine (PCP).

Like its chemical brethren, when taken in excess, dextromethorphan can cause hallucinations and out-of-body (dissociative) experiences; it also causes adverse effects like increased heart rate, hypertension, and diaphoresis (profuse sweating).  

Common Side Effects

Because there is really no way to know the soda-to-syrup ratio in any given serving, overdose risk is high with drug cocktails like purple drank. Each ingredient is associated with various side effects.

Promethazine

When used as prescribed, promethazine acts as an antihistamine, antiemetic (anti-vomiting), and sedative.   Alone, promethazine doesn’t usually cause euphoria unless mixed with other depressants like codeine and alcohol as in mixtures like purple drank.

When taken in large doses, promethazine can cause:  

  • Abnormal heart rhythm
  • Changes in blood pressure
  • Dry skin and mucous membranes
  • Hallucinations
  • Seizures
  • Severe breathing problems

Codeine

Codeine is a drug that is metabolized by the body into morphine. In prescription cough syrup, codeine works to suppress a cough. Morphine and other opioids can also cause feelings of elation, analgesia, and euphoria as well as dangerous side effects, including:  

  • Brain damage
  • Dizziness
  • Redness of the arms, face, neck, and upper chest
  • Shortness of breath
  • Stopping of the heart

Depressants

Purple drank is composed of multiple depressants which can synergize to cause:

  • Coma
  • Hypotension (dangerously low blood pressure)
  • Respiratory depression
  • Somnolence (sleepiness)
  • Stupor
  • Sudden death  

Furthermore, when other central nervous depressants are thrown into the mix—like barbiturates, narcotics, and tricyclic antidepressants—repercussions are particularly grim.

From a scientific perspective, it’s difficult to pinpoint exactly how much purple drank it takes to kill someone. From a medical perspective, it’s safe to say that imbibing any amount of purple drank is dangerous.

Signs of Use

Beyond finding empty bottles of cough syrup, styrofoam cups, soda, and candy among your loved one’s belongings, it’s important to watch out for any changes in personality and behavior. Changes might include being irritable, changes in sleep patterns, a loss of interest in school or social activities, or a sudden change in friends.

Spotting the Signs of Overdose

If you suspect someone has overdosed on sizzurp, call 911 immediately or the national toll-free Poison Help hotline (800-222-1222).

  • Bluish-colored fingernails and lips
  • Breathing problems (slow and labored breathing, shallow breathing, no breathing)
  • Cold, clammy skin
  • Coma
  • Confusion
  • Dizziness
  • Drowsiness
  • Fatigue
  • Lightheadedness
  • Loss of consciousness
  • High or low blood pressure
  • Muscle twitches
  • Tiny pupils
  • Spasms of the stomach and intestines
  • Weakness
  • Weak pulse

Myths & Common Questions

Many people have a false perception that something is “cool” because celebrities are involved (or it is part of the lyrics of a favorite song), but there is nothing cool about the potentially life-threatening dangers of purple drank.

What’s more, just because the ingredients involved are “legal” or sold over-the-counter in a pharmacy, it does not make it safe to drink. When not used as directed on the label or exactly prescribed, cough medicine (and other over-the-counter) drugs can be harmful to your health.

Commercial Products

A number of commercial products have emerged that are inspired by purple drank and include herbal ingredients such as melatonin, rose hips, and valerian. These products are often marketed as relaxation aids and sometimes use similar-sounding names such as “Lean” or “Purple Stuff.” Such products have been criticized for serving as a potential “gateway” to illicit drug use.  

It can be difficult to know what these products actually contain and the potential effects these substances may have. Always talk to your doctor before using such products, since herbal ingredients can lead to potentially serious interactions and side effects.

Tolerance, Dependence, and Withdrawal

Codeine is a habit-forming opioid pain reliever, which means taking more than prescribed can easily lead to dependence and potentially addiction.   It is possible to build a tolerance to this potent cough syrup cocktail, which puts you at a greater risk for overdose as well.

How Long Does Purple Drank Stay in Your System?

How long promethazine with codeine cough syrup will remain in your body depends on several factors, including dosage, how often you use the medication, your age, weight, and metabolism, as well as your hydration and activity levels.

While there is no exact drug test or timeline for purple drank, here is an estimated detection window for codeine according to drug test type:

  • Urine: 2 to 3 days
  • Blood: Up to 24 hours
  • Saliva: 1 to 4 days
  • Hair follicle: Up to 2 to 3 months (but will not register until 2 to 3 weeks after use)

Addiction

Developing an addiction to purple drank is possible—but it won’t happen overnight. Factors like genetics, environment, underlying mental health as well as the frequency of use all play a role in whether or not someone develops an addiction.

Withdrawal

If someone you care about builds a tolerance to sizzurp—and then suddenly stops taking the potent cocktail, they may experience symptoms of withdrawal, including:  

  • Anxiety
  • Chills or goosebumps
  • Diarrhea
  • Faster heartbeat
  • Irritability
  • Loss of appetite
  • Muscle aches
  • Nausea and vomiting
  • Runny nose
  • Sleep problems
  • Sweating
  • Teary eyes
  • Yawning

Withdrawal from purple drank use can be very uncomfortable, but it is not life-threatening. Although complications can occur that pose a potential danger. For example, vomiting and diarrhea can cause dehydration as well as chemical and mineral disturbances in your body.

Overdose is also possible if you quit and then take the same dose of the drug again. Your body will no longer be able to tolerate the amount you used to take.

How to Get Help

If you or a loved one is misusing cough syrup, please seek help and consult with a primary care physician, nurse practitioner, or mental health professional who can refer you to an addiction specialist.

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

You may need long-term recovery support or addiction treatment following withdrawal to stay off this drug cocktail, including:

  • Inpatient treatment
  • Intensive outpatient treatment
  • Life skills training
  • Maintenance medication
  • Outpatient therapy
  • Relapse prevention
  • Support groups (Narcotics Anonymous or SMART Recovery)

Remember: There’s no shame in getting help; it’s one of the bravest things you can do.

Purple drank (aka lean or sizzurp) is made from prescription cough syrup and can be fatal. Learn about side effects, signs of use, and how to get help.

The Dangers Of Laced Marijuana You Need To Know About

Thursday, December 3, 2015 | By jpemeraldcoast

Marijuana is the most commonly used drug nationwide. Its growing popularity and legalization have also led to talk of laced marijuana, which is cannabis that has had other substances added to it such as meth, cocaine, PCP and ecstasy.

Fortunately, laced marijuana isn’t as common as talking on the street would have you believe. Although uncommon, the dangers are real. Knowing what to look for and what to do if you or your friends encounter laced marijuana is important

How Common Is Laced Marijuana?

It’s hard to say how common laced marijuana is because users rarely admit they’ve encountered it unless they end up in the emergency room from it.

Nationwide, 5.6 percent of adults over age 26 have used marijuana in the past month. That number jumps to 19.1 percent for people over age 18 who have used in the past month. Among those who have used marijuana recently, it is likely that only a very small percentage have encountered laced marijuana.

Authorities in Texas, Arizona, Florida and other southern states in the U.S. have reported an increase in users of “fry,” a type of marijuana-laced cigarette. Fry isn’t new to the market, but use seems to be increasing. Marijuana blunts are dipped in codeine-based cough syrup or embalming fluid mixed with PCP.

Laced weed is more commonly reported when it has the potential to cause overdoses. In Vancouver, Canada, police reported seizing a stash of fentanyl-laced weed during a fentanyl-ring drug bust. Fentanyl is a synthetic narcotic that is highly addictive and easily causes an overdose. Police publicized their findings of laced weed to warn recreational drug users, especially casual pot smokers, to avoid buying weed in certain parts of Vancouver where the laced marijuana may show up on the streets. Smokers who had never been exposed to fentanyl were in serious danger of overdosing.

The Dangers of Laced Marijuana

As the Canadian report demonstrates, officials are growing increasingly concerned over laced marijuana. It’s still uncommon, but the dangers are real. The dangers of laced marijuana include:

  • Overdose: The fentanyl-laced marijuana bust shows the increasing danger of unwitting overdoses from recreational drug use. Although someone may smoke marijuana only once or twice a year, the wrong joint could send them to the emergency room or the morgue, depending on which drug is used to lace the marijuana. You can’t tell by looking at laced marijuana that there’s something in it, so you can easily overdose if it’s laced without knowing it.
  • Aggression: Marijuana laced with PCP can cause psychotic and dangerous behavior. People can commit violent crimes while under the influence of PCP. Add marijuana’s hallucinogenic effects to the mix and you’ve got a volatile cocktail of chemicals. Users often don’t remember what they did after smoking PCP-laced marijuana. Instead of relaxing, they can become unmanageable and violent.
  • Breathing and heart problems: PCP and other drugs used to lace marijuana can causes changes in breathing and heart rate. Often a rapid heartbeat and elevated blood pressure accompany the most commonly used lacing drugs such as PCP, cocaine, and meth. Damage to your heart and lungs can occur.
  • Psychotic behavior: Because the high is so strong from laced marijuana, psychotic symptoms can be bizarre and last longer than usual. This can result in being diagnosed with schizophrenia or other mental illnesses when you don’t actually have them.
  • Addiction: Marijuana by itself is highly addictive. Weed sold today is a lot stronger than that smoked by your parents or grandparents. Growers have selectively bred marijuana to increase the amount of THC, the active ingredient in the plant. Add to that a potent cocktail of other highly addictive drugs like fentanyl, meth, cocaine or even heroin, and laced weed is even more addictive than regular weed. The chances of addiction increase from laced marijuana.

The Signs and Symptoms of Laced Marijuana

Smoking laced weeds create different symptoms than plain marijuana. Most users report that they know they’ve smoked something other than marijuana within 15 or 20 minutes after finishing a joint. The sensations are different.

Each drug used to lace marijuana causes different symptoms. These include:

  • PCP-laced marijuana: Marijuana laced with PCP causes a wide range of symptoms including severe hallucinations, impaired coordination, slurred speech, aggressive or violent behavior, disorientation, paranoia, and seizures. If too much is smoked, the person can fall into a coma and die.
  • Embalming fluid: PCP’s street name, “embalming fluid,” causes a lot of confusion. Some kids think that lacing their weed with actual embalming fluid can increase their high. True embalming fluid contains formaldehyde, a cancer-causing chemical. Anyone actually smoking weed laced with embalming fluid will damage their lungs, nasal passages, and even their brain. Actual embalming fluid is also used as a solvent to mix the PCP into a liquid “dip.” Blunts are dipped into this mixture to lace them with PCP. The resulting concoction causes severe paranoia, hallucinations, and violent behavior. Embalming fluid also accumulates in the spinal column and can stop growth in young children.
  • Fentanyl: Fentanyl-laced marijuana is especially dangerous because it enters the brain faster than typical medical applications via a patch or lozenge. Clammy skin slowed heartbeat, seizures, and severe drowsiness are all signs of a fentanyl overdose. If you suspect that someone has accidentally smoked fentanyl-laced marijuana, get them to a hospital immediately. Too much fentanyl can actually stop the heart and brain functions, and it’s easy to overdose on it when it’s mixed with marijuana.
  • Codeine-laced cough syrup: A specific, intentionally laced type of marijuana is called fry. Dealers take a blunt and dip it into codeine-laced cough syrup or embalming fluid mixed with PCP. The resulting marijuana is laced with additional drugs, and although users say it tastes and smells terrible, it results in a very powerful high. Fry smokers use the drug in groups because the resulting violence, paranoia, panic and occasional loss of consciousness can be dangerous. Users also experience strong hallucinations.

Anytime someone has a seizure or passes out and you can’t wake them up, call 9-1-1 and request help. Don’t wait for the person to wake up. An overdose of laced marijuana can be fatal, especially if someone has taken a drug they’re not used to. Breathing difficulties, trouble waking up and seizures are all signs that the brain has been affected and the person may be in serious trouble.

How to Tell If Marijuana Is Laced

Aside from fry smokers, who know that what they’re buying is laced, some dealers won’t say when marijuana is laced. Others get marijuana from friends who may not know if the drug is laced or not. To protect yourself, you need to know what to look for to tell if marijuana is laced.

  • Smell it: Fresh marijuana smells green, like plants, grass or leaves. If it smells harsh, like gasoline, nail polish remover or other chemicals, it may have been laced.
  • Look at it: Look for blue or white crystals. These are signs that marijuana may have been laced. Brown crystals can be natural to certain types of marijuana, but blue or white can indicate that other drugs have been added to it.
  • Test it: The only way to really know for sure whether your marijuana is laced or not is to buy a drug testing kit. Kits can test for cocaine and meth, but not for other drugs, so just be aware that they can’t catch everything.

If you’re ever in any doubt about marijuana, throw it out. It’s better to be safe than to be sorry. Trust your instincts. They’re usually right. If you think you’ve got a bad batch of laced weed, don’t take chances. Get rid of it.

You may even consider giving up marijuana for good. Marijuana is dangerous. It’s highly addictive and often a gateway into taking harder drugs. Once you get used to smoking marijuana, it’s easy to dabble in other drugs, and you could eventually become addicted. The transformation from recreational drug user to a serious addict is faster than you may think.

Although many people today seem to think that it’s no more harmful than a glass of wine, experts say that marijuana causes long-term brain changes that can reduce your intelligence, disrupt memory and change how your brain works. Studies have shown that smoking marijuana can reduce your I.Q. by 8 points. Most people would agree that you need brainpower to be a success in life. Don’t do anything to jeopardize your natural-born intelligence.

Will You Encounter Laced Marijuana?

Fortunately, laced marijuana is still a rarity. Most dealers aren’t giving product away for free, and lacing takes away drugs they can sell on their own. Although there are rumors that dealers lace marijuana to get users hooked more rapidly and strongly to their products, it’s economically unlikely they’d cut into their profits.

Some types of laced marijuana, such as the previously mentioned fry, are on the rise throughout the southern United States. Canada has seen pockets of marijuana laced with opiates including fentanyl and heroin, but it is reasonably rare. PCP-laced marijuana is more common throughout the United States.

Incidences of laced marijuana tend to occur in pockets. Sometimes, one person tries laced weed and recommends it to their friends. A dealer may get in a bad batch, or someone may share laced marijuana with friends. This may make the problem seem worse than it really is.

Whether or not laced marijuana remains scarce is unknown. Like fashion and music, drugs follow trends, too. Lacing drugs have been around for a long time, whether it’s laced marijuana, heroin or cocaine.

Get Help for Your Marijuana Addiction

We’re not making light of smoking marijuana, nor advocating safe marijuana use. There’s no such thing. The marijuana on the street today is many times stronger and more addictive than marijuana in the past. Some experts even want to classify it as a new and different drug because it’s so powerful.

Any use of illegal drugs or abuse of legal, prescription, and over-the-counter medications can be fatal. Drugs not only mess up your body, but they mess up your life. A casual marijuana habit can turn into a serious habit, addiction or multiple addictions over time.

At JourneyPure Emerald Coast, we can help you with a marijuana addiction, chemical dependency, and even mental health challenges. Our structured yet flexible setting helps people recover from addiction.

JourneyPure Emerald Coast offers traditional recovery programs mixed with experiential activities that help people recover from their addiction. Individual and group therapy helps clients discover some of the underlying causes of their addiction, while 12-step meetings help people embrace the ‘spiritual awakening’ necessary for sobriety.

Our comfortable facility, low client-to-staff ratio, and compassionate staff can help you recover and claim your life once again. If you’re tired of struggling with drug addiction, marijuana addiction and more, give us a call. We understand how you feel and are here to answer any questions you may have.

Learn more about our marijuana addiction treatment or contact JourneyPure Emerald Coast for help.

How common is laced marijuana? What are the dangers? Regardless, officials are growing increasingly concerned over this growing trend.