Lean

Sedative

In America, lean is typically where cough syrup containing codeine or promethazine is mixed with a fizzy drink or boiled sweets. These cough syrups can’t be purchased over the counter in the UK, so here, the phrase ‘lean’ typically refers to liquid medicines (such as cough syrups) being mixed together. This is sometimes combined with codeine and/or promethazine tablets, and is then added to soft drinks, alcoholic drinks, or boiled sweets.

Also known as:

Purple drank
Barre
Sizzurp
Syrup

What does lean look like?

How lean looks will depend on what’s been mixed together. Generally speaking, lean is a syrupy liquid which is usually purple in colour.

How is lean taken?

Orally, by drinking it.

How can lean make me feel?

How lean can make you feel will depend on what’s been mixed together. Generally speaking, drinking lean can make you feel:

Relaxed
Uneasy or restless
Euphoric
Sleepy
Nauseous
Dizzy/unsteady on your feet (hence the name ’lean’)

Lean can also cause:

An out of body experience
Sweating
Hallucinations
Your sense of time to become distorted
A lack of control over your movements
Raised heart rate or temperature
A dry mouth

How long do the effects last?

It depends on several factors, including what’s been mixed together to make the lean, as well as your age, weight and metabolism, what you have already taken, the purity of the drug, and the dose.

Generally speaking, the effects start within 30-60 minutes, and can last up to six hours. Wait at least two hours between doses if you can.

Many over the counter medications contain paracetamol. It’s important not to take anymore than 500mg to 1000mg of paracetamol every four to six hours, with a maximum of 4000mg in any 24 hour period.

What happens to my body if I drink lean regularly?

Drinking lean frequently can be very dangerous. Long term risks of regularly consuming lean include:

Seizures
Organ damage
Dental decay
Declining mental health

How to reduce harm while drinking lean

We recognise that some ways of using drugs carry less risk than others, and by providing information which supports people to make informed decisions, we can help people to minimise harm.

Before you start, check:

Is now the right time? How you’re feeling when you use cannabis can impact the effects you may experience, so consider checking in with yourself and thinking about whether now is a good time for you.
Do I know what I’m taking? Researching what you’re planning to take, what the ingredients are, what the effects can be and how to reduce harm can help to keep you safe. It’s important to monitor how much paracetamol is in the medications being used, too.
Have I contacted a friend or family member? In case you need help while you’re taking cannabis, consider telling someone your plans.

While you're using:

Start low, go slow

Strength will vary depending on what’s been mixed together and the quantities. Even if you drink lean regularly, starting with a small amount and waiting at least two hours before your next dose can help to reduce the risk of overdose.

It's best not to use if you're alone

It's best not to drink lean if there’s nobody around that you could call for help. If you’re drinking lean with others, a buddy system (where one person drinks first and waits until the peak effects have worn off before the other person drinks) makes it more likely that someone can help if someone overdoses.

Consider ingredients

Try not to mix too many ingredients together when making lean. Adding multiple medications together increases your risk of harm. It's also important to check how much paracetamol is in the medications you’re using. Paracetamol overdose can result in permanent liver damage, and in some cases, can lead to death.

Try not to mix

It’s best not to mix lean with alcohol, or drink it while taking other drugs, as this can increase your risk of overdose. It’s especially important to avoid Nos (nitrous oxide) and benzodiazepines if drinking lean.

Remember lean can make you sleepy

If you’re drinking lean, it’s important not to drive or operate machinery, and to stay away from potentially dangerous areas like roads, rooftops, or rivers.

Go at your own pace

Everyone responds differently to drugs - trying to keep up with others puts you at greater risk of overdosing. It’s easier to lose track of time when you’re drinking lean, so taking a screenshot of the time or setting a timer on your phone each time you have a dose can help you to space out your doses.

The recovery position

The recovery position helps to prevent someone unconscious from choking on vomit. If someone is unconscious, putting them in the recovery position, getting help if needed, and staying with them will help to reduce the risk of harm.

After drinking lean:

Looking after and being kind to yourself is important - get plenty of sleep and rest, and try to avoid taking any other drugs to give your body time to recover
Refuelling will help your recovery - this includes drinking plenty of water and eating something nutritious which is soft on your stomach and not too rich

And always remember - if you’re feeling low and feel you can’t talk to a friend or family member, contact us for help through our webchat or find your local service.

What do I do if I think someone has overdosed?

If someone passes out or falls asleep and you can’t wake them up after drinking lean, put them in the recovery position (or on their side) and get help fast by calling 999, telling emergency services what you know.

Symptoms of overdose include:

They don’t wake up when you talk loudly to them or shake them by the shoulders
Difficulty walking
Confusion
Dizziness
Difficulty breathing, making snoring sounds, or breathing noisily
Difficulty speaking
Bluish (on lighter skin), greyish (on darker skin), or pale tingeing of the knees, hands and lips
Pale, cold and clammy skin

If you suspect someone has overdosed, it’s always best to administer naloxone. Naloxone reverses the effects of opioid drugs like heroin, morphine and fentanyl. Drugs bought illicitly can contain a mixture of substances, including opioids, so use naloxone if you have it. If someone hasn’t overdosed on opioids, naloxone won’t harm them.

You can get a naloxone kit and training on how to use it from your local WithYou service.

More information about naloxone, including how to use it.

Withdrawal signs, symptoms, and what to do

If your body develops a tolerance to lean, you may feel you need to take more to get the same effects. This is particularly true if codeine has been used.

You can become dependent on lean, and depending on the ingredients used, regular use can lead to physical withdrawal symptoms when you try to stop or cut back.

If you’re dependent on lean, we can help you cut down safely.

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Looking for support?

If you’re concerned about your benzodiazepine use, or if you’re worried about someone you know, we’re WithYou. We provide free, confidential and non-judgemental support and advice. Please don’t hesitate to reach out:

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