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Nevada News: An Odd Diversion
Reprinted form the April 2008 Nevada State Board of Pharmacy Newsletter.
Odd as it may seem, one of fastest climbing products on the list of diversion is promethazine with codeine syrup. The illicit recreational use of this product was popularized by a Houston, TX, music producer named DJ Screw who attributed the recreational use of the medication as the inspiration for the “chopped and screwed” subgenre of hip-hop music that originated in the southern United States. The concoction was introduced to a nationwide audience in June of 2000 by the Grammy and Academy Award-winning group Three 6 Mafia with lyrical references to the term “purple stuff” in the hit single entitled “Sippin On Some Sizzurp.”
The purple hue to the concoction comes from the dyes in the cough syrup, and commonly is referred to as Purple Drank or Drank, Sizzurp, and Southern Lean, or Lean. The vernacular use of the new terminology might read, “2 - 4 ounces of Drank will make you lean.” The original mixture is an equal ratio of promethazine with codeine syrup and soda pop with a Jolly Rancher candy added for further flavoring. Alarmingly, the original mixture is evolving into a more dangerous combination by substituting the soda pop for alcohol, and by adding other ground opiates and benzodiazepines to the drink. Ron Peters, a professor at the University of Texas School of Public Health in Houston reported in a 2004 study that 30% of teens in the city had used the illicit purple concoction at least once.
Deaths have been attributed to the use of Purple Drank. DJ Screw died of a suspected codeine-alcohol overdose on November 15, 2000, several months after the video to Three 6 Mafia’s single debuted. More recently, rapper Pimp C’s December 2007 death was determined by the Los Angeles County Coroner’s office as an accidental overdose of promethazine with codeine syrup in conjunction with a preexisting medical condition (sleep apnea).
The popularity of the promethazine with codeine concoction has spurred experimentation with other prescription cough medications as well such as Tussionex® and Tussigon®. It may be prudent for you to be more cognizant of your cough medication inventory.
