You might have heard of a street drug called lean. One of the primary ingredients in this substance is Promethazine. Available by prescription as a medication for allergies, in recent years Promethazine has been abused recreationally, resulting in an increasing number of overdose incidents involving the drug. Is Promethazine addictive?
How Promethazine is Used
Promethazine belongs to the drug class called phenothiazines. Its prescription uses include the treatment of allergic reactions and cold symptoms. In combination with other medications, it is used to treat anaphylaxis (severe allergic reactions). Promethazine has a sedative effect, so it is also used to relax patients before surgery. In addition, Promethazine helps treat symptoms of upset stomach, so it is used for post-surgical nausea, as well as motion sickness.
If Promethazine is used as directed for the reasons above, then its potential for addiction is low. However, the answer to the question “is promethazine addictive” becomes more complicated when Promethazine is combined with other medications. These combinations contain medications that are addictive. One combination medication, Promethazine with codeine, is sometimes prescribed as a cough medicine. The codeine in the mixture is an opioid and is addictive. Promethazine, while used for its antihistamine properties, also enhances the effects of the codeine when the two are mixed. This increases its addictive properties. Promethazine may also be combined with dextromethorphan, pseudoephedrine, or paracetamol in prescription medications.
Side Effects of Promethazine
As with most prescription drugs, Promethazine has many side effects that must be monitored for severity. Medline Plus provides a full list of side effects, including those that are considered dangerous. Some of these side effects make Promethazine attractive as a recreational drug. These include drowsiness, dizziness, listlessness, and abnormally happy mood. Its sedative properties and its use to enhance the effects of other substances, such as opiates, make the side effects of Promethazine desirable to drug abusers. Severe side effects of Promethazine include slowed breathing, fainting and loss of consciousness, loss of coordination, and abnormal excitement.
How Promethazine is Abused
Promethazine has become popular as a recreational drug and its level of abuse has increased. Probably the most well known abuse of Promethazine is when the combination syrup of Promethazine and codeine is combined with other sedatives, such as alcohol, and mixed together with soda and candy into a purple-colored drink, commonly called “purple drank.” Also referred to as “lean,”, “barre,” or “sizzurp,” this concoction has become popular among young adults, who spread the word about it on social media. The mixture has become known for its euphoric effects, including the feeling that the person is floating out of their body, as well as for the deep feeling of relaxation that the potion provides. Also contributing to its popularity is how easy the promethazine/codeine combination is to obtain, making it a “cheap high.”
People who already abuse other prescription drugs also misuse Promethazine, particularly those who are dependent on opioids or another substance abuse condition. The mixture of sedating substances, including Promethazine, lends itself to a high rate of repeated abuse, possible addiction, substance-induced mental health conditions, and a growing number of fatalities. A 2021 study of promethazine abuse reports found that out of a total number of promethazine-related incidents reported, about 36% were related to promethazine misuse or abuse, and 55% of those cases were fatal. Opioids were the most common drugs combined with Promethazine, but other drugs commonly used in combination included benzodiazepines, antidepressants, and antipsychotic medications.
What To Do if You Suspect Promethazine Abuse
So is Promethazine addictive? The answer is, it can be, if it is misused or abused under the right circumstances. By combining Promethazine with opioids, benzodiazepines, or other drugs that are already addictive, Promethazine can add to the addictive properties of these drugs and cause the abuser to repeat the combination. This is especially dangerous if Promethazine is combined with strong opioids such as fentanyl.
Symptoms of promethazine overdose include but are not limited to the following:
- Slow breathing or difficulty breathing
- Dizziness, lightheadedness, or fainting
- Loss of consciousness
- Fast heartbeat (tachycardia)
- Tightened muscles and a loss of coordination
- Abnormal levels of excitement or delirium
If these symptoms are observed, emergency medical services should be contacted right away.
Get Help for Promethazine Addiction
Promethazine abuse can lead to just as much harm as other addictive drugs, so if you know someone who abuses Promethazine, convince them to get help as soon as possible. Ray Recovery offers both intensive and less intensive outpatient treatment programs for people who have problems abusing prescription drugs like Promethazine. Partial hospitalization programs are also available for those with more complicated treatment needs. Contact Ray Recovery at 888.839.2606 to find out what kind of help is available for promethazine abuse.
