Yet another death being possibly related to chronic drug abuse or opioid overdose is in the media, as 27 year old rapper Fredo Santana was found dead Saturday. We don’t know yet for certain what happened, but his long standing abuse of prescription cough syrup has brought the famed Purple Lean (also called Drank, Sizzurp, Syzurp, Dirty Sprite, Purple Jelly, Texas Oil, Muddy Cup) back to the media’s attention.
What the heck is Drank?
In the 1990’s in Texas, somebody got the not-so-bright idea of mixing codeine/promethazine cough syrup with a soft drink and adding Jolly Ranchers to up the sweetness. For some reason, the conception is often put into styrofoam cups. It became popularized through hip-hop music culture, and has managed to stand the test of time, despite reports of famous rappers having seizures, overdosing, and dying using the purple concoction. Pictures and videos of Lil Wayne and Justin Beiber with Drank in hand continue to glorify the dangerous habit among teens and young adults.
It’s Just Cough Syrup, Right?
Well, yeah. And that’s the problem. “Cough syrup” makes it sound tame and OK. It sounds safe. It doesn’t sound scary like “opioid.” But that is what it is. The cough syrup used in Drank contains codeine (an opioid) mixed with promethazine (an antihistamine).
What Does Drank do? What makes it so popular?
This combination can cause a high including euphoria, motor skill impairment, sedation, and dissociative feelings (a disconnection from thoughts, feelings, body). Higher doses cause heart rate and breathing rate to drop, and can result in respiratory arrest (stop breathing), cardiac arrest (heart attack), coma, and death.
In some cases, it gets mixed with other drugs or alcohol, which magnifies the risks on breathing and heart rate, and at lower doses.
Mixing the syrup into a soda also makes it easier to lose track of how much you’ve had to drink. Kinda like the Long Island Ice Tea effect- they taste like a sweet ice tea, and before you realize it you’ve pounded down several and are super drunk. Except with Sizzurp, you’re rapidly heading toward an opioid overdose.
The drugs in this cough syrup are addictive.
Is it legal?
Well, again, yeah- assuming a doctor prescribed the cough syrup. Phenergan with Codeine (or generic versions of promethazine with codeine) is a very effective cough syrup that has been used for decades. It is not, however, legal to sell it to someone else. Most people don’t realize it, but there are federal and state laws the also make it illegal to give someone else your prescription medication (although this is pretty common practice).
Why isn’t it made illegal?
Just like other opioids normally used for pain management that are being abused, it isn’t the drug that is necessarily the problem. Cough syrups stronger than over the counter syrups are needed to treat severe coughs. Getting rid of useful drugs keeps us from treating sick people. There are concerns that with the current real fears of opioid abuse, doctors will trend toward under treating real pain again, like back in the 1990s. That under treatment of pain created significant long term problems leading to the “Pain is the 5th Vital Sign” movement, in an attempt to better treat pain.
A major underlying problem with Sizzurp and all opioid abuse is overprescribing and access to large amounts of drug. It’s easy to find pictures online of Drank users with multiple bottles of codeine with promethazine cough syrup. Minimizing how much prescription cough syrup is prescribed at a time together with DEA monitoring of prescribing volumes from providers can help reign in prescribing habits.
What Can I Do As A Parent?
- Get rid of left over prescription cough syrup when the cough being treated is gone helps reduce the teen access.
- Watch for warning signs of drug or alcohol abuse in your kids (Here)
- Keep open lines of communication with your kids, so they feel comfortable approaching you about drugs and alcohol questions
- Keep your kids involved in sports and other activities, reducing their time and chance to hang out with the wrong people and get into trouble
- Know who you kids hang out with
To learn more about drug abuse and teens, go here
Next weeks: Over-the-counter cough syrup abuse dangers.