What to know about lean—the cough syrup drink that Mac Miller spoke about before his death

On Sept. 7, rapper Mac Miller was found dead of an apparent drug overdose at just 26 years old. Although an official cause of death has not yet been revealed pending toxicology test results, Miller had long struggled with addiction issues.

In 2013, the rapper opened up in an interview with Vibe about his addiction to lean, a mix of prescription codeine (often found in cough syrups) mixed with soda, such as Sprite, and candy, such as Jolly Ranchers.

“It’s rough,” Miller told the publication about the period in which he was struggling with his addiction. “My music was getting to the point where you couldn’t even understand what I was saying on records anymore. I was just, like, mumbling.”

Miller is far from the only celebrity who has struggled with a lean addition. In the wake of his death, fellow rapper Shad Moss (formerly known as Bow Wow) opened up on Twitter about his own addiction to the drug, which is popular in the hip-hop community.

In a series of tweets, Moss shared how using lean badly impacted his life and urged today’s youth not to follow in his footsteps:

Moss revealed that he almost died from his lean addiction and said that he still struggles with stomach issues today due to the drug’s effects.

What Is ‘Lean’?

Also known as “syrup,” “purple drank,” and “sizzurp,” lean first became popular in Houston, where people would mix codeine-promethazine cough syrup with soda to make a cocktail for the high it produced. Codeine is a prescription opioid, which is used as a pain reliever, and promethazine is an antihistamine. Both drugs have sedative effects and can produce feelings of drowsiness, mild euphoria and a sensation of being out of one’s body. These effects can be intensified when the drugs are used with other substances, such as marijuana and alcohol.

Used in this way, codeine has a high potential for abuse and addiction. Some of the negative side effects of lean include nausea, blurred vision, dizziness, memory problems and seizures.

Long-term, the drug can also lead to tooth decay, weight gain, urinary tract infections and constipation. Lean also suppresses the central nervous system, including respiration and motor function, and can lead to breathing problems, especially for those with existing respiratory problems such as asthma.

Popularity In The Hip-Hop Community

Originally emerging from the hip-hop scene in Houston as far back as the 1950s, lean eventually spread throughout the South. In 2000, Memphis-based band Three 6 Mafia introduced their song, “Sippin’ on Some Syrup,” an ode to the drug. That same year, DJ Screw, a pioneer of lean’s integration into hip-hop culture, died of an overdose from the drug at the age of 29.

Still, other high-profile rappers continued to promote lean in their music, such as Lil Wayne, who rapped about syrup in “Me and My Drank.” He began to suffer from recurrent seizures, which many suspected were linked to his consumption of lean. In 2008, Lil Wayne spoke to MTV about how difficult it was for him to quit the drug despite its negative consequences.

“Do your history, do your research,” he said. “It ain’t that easy — feels like death in your stomach when you stop doing that sh–. You gotta learn how to stop, you gotta go through detox. You gotta do all kinds of stuff.”

In addition to DJ Screw, lean was also implicated in the deaths of other prominent names in the hip-hop world, including rapper Pimp C and producer A$AP Yams.

How You Can Help

If you or someone you love is struggling with codeine dependence, you can contact the Substance Abuse and Mental Health Services Administration National Helpline at 1-800-662-HELP (4357). The helpline is free, confidential and available 24/7 for 365 days per year. They offer treatment referrals and information.