Cough syrup abuse isn’t new. What is new, however, is the use of this medicine in a potentially lethal drug called lean. Here’s what you need to know.

It’s called ‘lean’ because that’s what this mix of codeine-based cough syrup, alcohol, soda and candy makes you do: lean to the side. But that’s not why users enjoy it. Fatima Farred, a certified recovery coach and founder of the Ubuntu Addiction Community Trust’s Schools Programme, explains that the codeine in cough syrup is an opiate, derived from the poppy plant. Although it’s not a particularly strong opiate, it’s not unlike morphine, according to – which means that users can look forward to a euphoric, dreamy state. That’s when things are going well. When they’re not, users may experience hallucinations, dizziness, slowed breathing and heart rate, and impaired vision. These risks are heightened by the interaction between codeine and alcohol, and so users may also suffer from brain fog, delayed reaction times and drowsiness. Added to this, seizures are common in at-risk individuals.

In fact, it’s said that American rapper, Lil Wayne’s frequent hospitalisation for seizures may

be attributed to his use of the drug – interesting, because the hip hop fraternity is largely responsible for glamorising lean (which they also call Purple Drank, Sizzurp and Dirty Sprite).

This is one of the reasons for its growing popularity, especially among the youth and school learners who, according to Farred, form the largest part of the user base in southern Africa. After all, when the likes of Justin Bieber and Rob Kardashian are tweeting its praises, the idea of trying it out becomes more than just a little attractive, even though the drug has been implicated in the deaths of celebrities like Fredo Santana, Big Moe, Pimp C and DJ Screw.

One of the reasons lean is so dangerous is that codeine is highly addictive. This makes withdrawal a painful process – especially as the user needs increasingly larger doses in order

to achieve the same high. Farred warns that codeine abuse might also lead to damage to the heart and liver, and could also affect other internal organs. That’s all rather scary – but what’s more frightening still is the readily available nature of the drug. A spokesperson for iNova Pharmaceuticals said, ‘Over-the-counter medicines are safe and effective when used as directed, but taking too much of them – on purpose or by accident, can lead to abuse.’ Although the South African Health Products Regulatory Authority introduced restrictions on over-the-counter products containing codeine back in 2015 specifically to address this issue, the drug remains easy to purchase. Indeed, iNova calls the ‘misuse of prescription and over-the-counter codeine-containing products a global public health issue’.

  • How to know if your child is misusing cough syrup? Signs to look out for, according to Farred, include:
  • loss of appetite
  • oversleeping
  • change in appearance
  • dilated pupils
  • weight loss. notes that other signs of use include drowsiness, frequent, sudden trips to the bathroom and a lack of motivation or interest in hobbies. Look out, too, for empty Styrofoam cups, which are usually used to imbibe the drug – or empty cough syrup bottles.

If you’ve spotted any of these signs, SANCA (the South African National Council on Alcoholism and Drug Dependence) may be able to help. Farred also recommends seeking help from an inpatient rehabilitation for adolescents, or an outpatient programme.

Jet Club members have free access to our medical careline. For advice or support on any aspect of drug abuse, call

Personal health advisor
SA & Namibia
0800 00 45 45

Botswana, Lesotho & Swaziland
+2711 991 8258

For more information or where to get help for drug addiction:

+2711 892 3829
+276 525 1701

IS COUGH SYRUP ADDICTIVE? IS COUGH SYRUP ADDICTIVE? Reviewed by Michelle Pienaar on October 20, 2020 Rating: 5
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