Lean.
Also known as “Purple Drank”, “Sizzurp” or “Dirty Sprite”, Lean is a drink made by mixing prescription-strength cough syrup with fizzy drinks, and sometimes sweets or alcohol. It can look harmless, but it carries serious health risks and is illegal to possess or supply without a prescription. This guide explains what to look out for, how to talk to your child, and where to get help.
Lean contains codeine, an opioid. There is no safe amount.
What is Lean?
Lean is usually made from cough or cold medicine containing codeine, often alongside promethazine, an antihistamine that causes drowsiness. It is mixed with a fizzy drink and sometimes boiled sweets to make it taste sweet, and may be mixed with alcohol.
Codeine is an opioid, in the same family of drugs as morphine and heroin. Taken in large amounts it causes a slowed-down, “floaty” feeling, which is part of why it is used recreationally.
Lean is often glamorised in music, music videos and on social media, and because it is made from medicine some young people believe it is safe. It isn’t. Because it is home-made, no one knows how strong it is, which makes overdose a real risk.
Health risks and long-term effects.
Lean affects the brain and body in ways that can be life-threatening, even the first time someone tries it.
Addiction
Codeine is an opioid and can lead to physical and psychological dependence. Stopping can cause withdrawal symptoms such as sweating, shaking, anxiety, sickness and trouble sleeping.
Slowed breathing
High doses can slow breathing to dangerous levels. This is the main cause of death from opioid overdose.
Mixing is dangerous
Combining Lean with alcohol, sleeping tablets, benzodiazepines or other drugs greatly increases the risk of overdose and death.
Organ damage
Regular use can harm the liver, kidneys and bladder. Some cough and cold products also contain paracetamol, which can cause serious liver damage in large amounts.
Mental health
Users may experience hallucinations, confusion, low mood and mood swings, and it can make existing mental health difficulties worse.
Unknown strength
Because Lean is home-made, the amount of codeine in each drink is unknown. If someone else made it, they can’t be sure what is in it.
Signs to look out for
Many of these signs can have other explanations, especially in teenagers. On their own they are not proof, but if you notice several together, it is worth having a calm conversation.
Physical signs
- Drowsiness, nodding off or seeming “out of it”
- Slurred speech or poor coordination
- Very small (pinpoint) pupils
- Itching, constipation or feeling sick
- Changes in sleep or appetite
Changes in behaviour
- Losing interest in school, hobbies or friends
- Secretive behaviour or a new friendship group
- Mood swings, irritability or low mood
- Asking for money or money going missing
- Talking about or sharing Lean content online
Things you might find
- Empty cough or cold medicine bottles
- Medicine missing from the cupboard
- Double-stacked polystyrene or plastic cups
- Large bags of boiled sweets
- Purple or pink sticky stains
Signs of an overdose
999 Call an ambulanceCall 999 straight away if someone has taken Lean and shows any of these signs:
- !Slow, shallow or difficult breathing, or snoring-like sounds
- !Blue or grey lips or fingertips
- !Cold, clammy skin
- !Extreme drowsiness, confusion or dizziness
- !Can’t be woken or won’t respond
For urgent advice when it isn’t an emergency, call NHS 111.
What to do
- Call 999 and tell them what you think has been taken. Be honest: paramedics are there to help, not to judge.
- If they are breathing but unresponsive, put them in the recovery position, on their side, so they don’t choke.
- Stay with them and keep checking their breathing until help arrives.
- If they stop breathing, the 999 call handler will talk you through CPR.
- Keep any bottles, cups or packaging to show the paramedics.
Don’t let them “sleep it off”, give them coffee, put them in a cold shower or try to make them sick.
Talking to your child
The most protective thing you can do is keep talking. Young people who feel they can be honest with a trusted adult are more likely to come to you if something goes wrong.
Choose your moment. Talking side by side, in the car, on a walk or while cooking, often feels less pressured than a face-to-face “talk”. A song, video or news story can be a natural way in.
Stay calm and listen. Ask what they’ve heard about Lean and what their friends think. Try not to lecture, shout or overreact, even if what they tell you is worrying.
Be honest about the risks. Explain that “it’s only cough medicine” is a myth, and that mixing it with alcohol or other drugs can stop someone breathing.
Make a safety plan. Make sure they know to call 999 if a friend is unwell, and that they can always call you to collect them, no questions asked in the moment.
The law and the UK picture.
Codeine is a Class B drug under the Misuse of Drugs Act. Possessing or supplying it without a prescription is illegal in the UK, and sharing or selling Lean to friends counts as supply.
A drugs conviction can affect a young person’s education, job prospects and ability to travel. If your child is in trouble with the law, Release offers free, confidential legal advice (see below).
Get support
Early support can prevent long-term health problems and legal consequences. All of these services are free and confidential. Young people’s services can be contacted by young people themselves, and most also support worried parents and carers.
National, any time
FRANK
Honest, confidential information and advice about drugs for young people and parents. Call, text or use the online chat.
0300 123 6600 · text 82111Visit website →Urgent medical adviceNHS 111
For urgent advice when it isn’t an emergency. In an emergency, always call 999.
111Visit website →For young peopleChildline
Free, confidential support for under-19s about anything that’s worrying them, by phone or online.
0800 1111Visit website →For worried adultsNSPCC Helpline
Advice for parents and carers who are worried about a child’s safety or wellbeing.
0808 800 5000Visit website →For familiesAddiction Family Support
Phone and email support for parents and family members affected by someone else’s drug or alcohol use.
0300 888 3853Visit website →Legal adviceRelease
Free, confidential advice on drugs and the law for young people and their families.
020 7324 2989Visit website →London
Wize Up Havering (Change Grow Live)
Free drug and alcohol support for young people in Havering and their families. Monday to Friday, 9am to 5pm, with evening appointments on request.
07920 807 726Visit website →Every London boroughFind your local young people’s service
Each London borough has its own free young people’s drug and alcohol service. Enter your postcode on FRANK to find yours.
Search by postcode →For familiesFamilies Anonymous
Support meetings for parents, family and friends worried about someone’s drug use, including groups across London and online.
020 7498 4680Visit website →Kent
We Are With You: Kent for Young People
Free, confidential support for young people in Kent worried about their own or someone else’s drug or alcohol use. Young people can self-refer, and parents can make a referral.
01795 500881Visit website →MedwayMedway young people’s service
Medway has its own service, separate from Kent. Enter your postcode on FRANK to find it.
Search by postcode →For familiesAdfam
Information for families and a directory of local family support groups across Kent and the rest of England.
Find a family group →Essex
Essex Young People’s Drug and Alcohol Service (The Children’s Society)
Covers Essex, apart from Southend and Thurrock. Young people can self-refer, and appointments can be arranged locally.
01245 493311Visit website →SouthendSouthend Young Person Drug and Alcohol Service (Open Road)
Support for young people in Southend. Parents and carers of under-18s can refer online.
01702 431889Visit website →ThurrockThurrock Young Person Drug and Alcohol Service (Open Road)
Support for young people under 18 in Thurrock, and young adults moving on from the service.
Visit website →Sources
- Catch22: Lean, understanding the risks
- Mayo Clinic: Codeine (oral route)
- PubMed: research on codeine and respiratory depression
- NHS: Common questions about codeine
- GOV.UK: Children’s substance misuse treatment statistics 2024 to 2025
- GOV.UK: Codeine linctus reclassified to prescription-only
- NHS: Advice for the families of drug users
- FRANK: Honest information about drugs
This guide is for general information and does not replace medical advice. Service details were checked in October 2026 and may change. If you are worried about a child’s immediate safety, call 999.
