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.1Today, 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, 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 lean on something to stand up once these effects take place.1
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.1
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 8th graders, 3.3% of 10th graders, and 3.4% of 12th graders, according to the 2018 Monitoring the Future Report.2
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).3
Common Side Effects
Because there is really no way to know the soda-to-syrup ration, 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.4 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:4
- 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:5
- 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 death6
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 in a pharmacy, it does not make it safe to drink. When not used as directed on the label or exactly prescribed, cough medicine (or other over-the-counter) drugs can be harmful to your health.
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.5 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:7
- 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 and 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.
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.
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