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What is in Cough Syrup aka Lean?

Updated: May 16, 2023

Did you know lean is just liquid heroin?


Do you ever wonder what is in lean?


Or, wonder why is lean so popular?


Cough syrup with codeine and promethazine is called lean because it causes individuals to become sluggish and sleepy.


In this article we will uncover the following:

  • What is cough syrup used for?

  • What are popular ingredients in cough syrup?

  • What are opioids?

  • What are opiates?

  • Why is drinking lean bad?

  • Hip Hop artists that have suffered or died from “sippin” lean


What is cough syrup used for?

As the name mentions, cough syrup is used as a temporary relief for symptoms such as:

  • coughing

  • sneezing

  • runny nose

These symptoms generally stem from the common cold, allergies, and other upper respiratory illnesses. Cough syrups contain ingredients that help loosen mucus build up and suppress coughs and relive runny/stuffy nose symptoms.


What are popular ingredients in cough syrup?

Some common and popular ingredients found in cough syrup are:

  • Dextromethorphan

  • Codeine

  • Promethazine



Dextromethorphan comes in many forms of usage. Dextromethorphan is used as a cough suppressant. It works by decreasing activity in a specific part of your brain to decrease coughing urges. A typical over-the-counter dose consists of 15 to 30 mg taken three to four times each day. Dextromethorphan is only effective to temporarily relieve cough symptoms but does not treat the root cause of symptoms.


Dextromethorphan is often used to get “high”. It is a non-opioid derivative of morphine that has similar properties to opioid medicines. When taken, dextromethorphan can cause euphoric and hallucinogenic effects. The increased usage of dextromethorphan in higher doses has been shown to cause dependency. This dependency in conjunction with decreasing brain function takes a toll on the body. Dextromethorphan dependency can cause the following:

  • addiction

  • withdrawal symptoms when not taking

  • increased tolerance

  • neglect of personal care in favor of substance

  • coma

  • seizures

  • difficulty breathing

  • nausea and vomiting

  • overdose and/or death

When taken, dextromethorphan effects the same cell receptors as drugs like PCP (Phencyclidine) and ketamine.


Codeine is an opiate pain reliever. Opiates are naturally occurring chemical compounds that are used for pain relief. Although many individuals use opioids and opiates interchangeably, they are different. Codeine is often used with other medicines, such as promethazine, to relieve symptoms such as coughing, sneezing, and runny/stuffy noses.




Codeine works by changing your brain and nervous system response and how it responds to pain and coughing. Codeine comes in the form of a tablet, capsule, or liquid solution. A typical codeine dose consists of 15 to 60 mg up to every 4 hours as needed. Codeine is only effective to temporarily relieve pain and cough symptoms but does not treat the root cause of symptoms.


Codeine is also often used to get “high”. When taken, codeine produces a euphoric visual and auditory response that often results in the individual becoming drowsy. Codeine has shown to be habit forming and causes dependency. Opiate and opioid dependency has a harmful effect on the body and can massively decrease proper function. Codeine has harmful side effects such as the following:

  • addiction

  • seizures

  • changes in heartbeat

  • rash, itching, and/or hives

  • decreased sexual desire

  • erectile disfunction

  • irregular menstruation

  • nausea and vomiting

  • muscle disfunction (stiffness or twitching)

  • fever and sweats

  • loss of appetite

  • withdrawals

  • motor skill disfunction

  • difficulty breathing

  • overdose and/or death


Promethazine is a phenothiazine used to treat the symptoms of allergic reactions of many types. Phenothiazines are used to treat severe mental and emotional disorders, such as schizophrenia, and other psychotic disorders. Additionally, promethazine is used to symptoms such as the following:

  • nausea and vomiting

  • cold symptoms

  • pain



Promethazine comes in the form of a tablet or syrup for oral consumption and a suppository to be used in the anus. A typical promethazine dose is between 12.5 and 25 mg taken 1 to 2 times daily. Promethazine is only effective to temporarily relieve pain and cough symptoms but does not treat the root cause of symptoms.


Promethazine is often used to get “high”. When taken, promethazine can trigger your body’s pleasure system resulting in euphoric and hallucinogenic effects. Because of this high, promethazine is often abused and forms addiction and dependency. Promethazine dependency and side effects can cause the following:

  • seizures

  • fever and sweating

  • twitching

  • decreased awareness

  • incoherence

  • difficulty breathing

  • skin yellowing

  • unbalanced emotions

  • hallucinations and nightmares

  • loss of appetite

  • withdrawals

  • stiff muscles

  • unusual bruising or breathing

  • overdose and/or death

Promethazine works by blocking acetylcholine receptors, a natural substance in the body. Acetylcholine receptors assist in muscle and brain function and helps regulate balance.


What are opioids?

Opioids are a class of narcotic drugs that are synthetic or created in a lab by scientists. Opioids contain chemicals that help relax the body or reduce pain. Opioids are highly addictive because of the euphoric feel from taking the substance. Opioids bind to opioid receptors on cells located in brain, spinal cord, and other bodily organs. Opioid receptors are a part of the opioid system, which is the body’s internal system for pain, pleasure, and addictive behaviors.



Some popular opioids are the following:

  • Hydrocodone (Vicodin)

  • Oxycodone (Oxycontin, Percocet)

  • Methadone (Dolophine)

  • Fentanyl/fentanil

Fentanyl is the most powerful and deadly opioid.


What are Opiates?

Opiates are chemical compounds that are naturally found in opium poppy plants. Opioids contain chemical properties that help relax the body or reduce pain. Like opioids, opiates are highly addictive because of the euphoric feel they produce and bind to opioid receptors on cells in the body.



Some popular opiates are the following:

  • Opium

  • Morphine

  • Codeine

  • Heroin


Why is Drinking Lean Bad?

Essentially, drinking lean is the same as injection drug users using heroine. Using drugs such as dextromethorphan, codeine, and promethazine can create traumatic experiences to your body that can result in many adverse health conditions. Once dependency or addiction is formed from using these drugs, withdrawals are typically severe and can often lead to death. Drinking lean has been popularized to be something cool but can take you hostage and kill you, no matter your age.


How Lean Killed Hip Hop

Notable Hip Hop artists that have suffered or died from drinking lean:



And many more. Please stop drinking and glamorizing lean and if you have any complications from doing so, please go see a doctor immediately.


If you or someone you know is struggling from addiction, seek help immediately. The government has free services and resources to help any individual. You can call 1-800-662-4357 or go to their website https://www.samhsa.gov/find-help/national-helpline




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