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Substance misuse

Lean: Understanding the risks

A group of young adults sit together on a bed in a cosy bedroom. One holds a glass in their hands. Overlaid is text that reads: "Drugs Awareness Poster Hub".

Substance misuse is an issue which cuts across our organisation and we have worked with frontline staff at our Young People’s Substance Misuse service to produce downloadable resources that anyone working with young people, or who would like to know more about emerging trends, can download, print off and share.

What is lean?

Lean is a drink typically made from a cocktail of substances including; codeine, promethazine, paracetamol and dextromethorphan. Lean contains codeine which is an opiate. This is a highly addictive substance.

Lean may commonly be called: ‘Purple Drank’, ‘Dirty Sprite’, or ‘Sizzurp’

A person who is physically dependent on codeine should seek medical advice. Codeine and other drugs should only ever be used in line with medical advice and guidelines. Codeine is only available on prescription, when not in combination with another substance.

There is no safe level of drug use. It is important to be careful when taking any type of drug.

The Law

  • Codeine is a Class B substance controlled under the Misuse of Drugs Act. A Class B substance is illegal to buy or supply.
  • Being in possession of codeine, if not prescribed, can result in 5 years in prison and an unlimited fine.
  • Supplying codeine illegally can result in a prison sentence of 14 years and an unlimited fine.

Ten things you need to know

  1. If you prepare or use lean you cannot be sure how strong the mixture is. As a result there is a high risk of overdose, which can be fatal.
  2. If you drink lean prepared by others you don’t really know what drugs it might contain or what effect it may have.
  3. Codeine can lower blood pressure and can cause difficulty breathing. This can lead to a person stopping breathing which can result in death.
  4. Using codeine whilst pregnant can lead to the new born baby experiencing symptoms of withdrawal after birth.
  5. Using lean together with alcohol or other drugs is very dangerous, and can have unpredictable effects, especially when used with other central nervous system depressants such as benzodiazepines, alcohol or other opioids, as they also slow breathing and heart rate.
  6. Lean can cause both psychological and physical dependence if used regularly. The codeine in lean is an addictive substance and you may experience unpleasant symptoms when use is stopped.
  7. Lean may contain promethazine, which is an antihistamine, promethazine can cause sedation.
  8. Lean may also contain paracetamol and/or Ibuprofen which can cause kidney failure, liver failure and bleeding from the stomach all of which can be fatal.
  9. The sedative effective of lean can affect your ability to operate machinery or drive safely and could be very dangerous to you and others, resulting in police action and legal consequences.
  10. Using lean can have a negative effect on your mental health.

Symptoms of codeine overdose

Symptoms of codeine overdose include difficulty in breathing , low heart rate, blue appearance to lips and extremities, drowsiness , confusion, dizziness, cold and
clammy skin, unresponsiveness, or coma.

If you have used Lean or are withdrawing from Lean and you’re feeling unwell, or notice someone else is unwell whilst using, after using or after stopping using Lean, then seek medical attention urgently. Contact 111 for urgent medical advice or 999 in an emergency.

Symptoms of withdrawal

Codeine withdrawal symptoms can include tremors, anxiety, yawning, sweating, runny nose, sleep disturbance, nausea, goosebumps, restlessness, diarrhea, abdominal cramps, difficulty sleeping and muscle spasms.

Catch22 Young People’s Substance Misuse services offer free and confidential advice and support to young people aged between 11 and 25. We can provide you with information about the risks and effects of alcohol or drugs. We are here to listen and can work with you to achieve the changes you would like to make in your life.