By Dr. Rani Whitfield, Tha Hip Hop Doc
“It taste great doc! I don’t even drink on that Henn anymore. You should try it; taste better than any
margarita I’ve ever had. Just give me a
cream soda or some fruit punch, mix it with that purple, and it’s on!”
This was only part of a conversation I had with a patient
who tried in every way possible to get me to write him a prescription for a
pint of “lean,” “purple” or what we call in the medical community, Promethazine
with codeine (PC).
The street value for a pint of undiluted PC is $500, but
more often this pint is “cut” with Karo syrup by the local street pharmacists
to “stretch it out.” A gallon of PC
“stretched out” can generate well over $3600 dollars on the streets.
In addition to being lucrative for the street pharmacists,
the presence of “dat syrup,” “sizzurp” or “lean” was made popular by DJ Screw
and the Houston Hip-Hop culture, and it became a common social drink among young African-Americans all across the nation.
References to PC are common in songs like Three 6 Mafia’s
“Sippin’ on Some Sizzurp” and Lil Wayne’s freestyle rap “Live From 504.” As
popularity increases for PC, the question arises, Why are people obsessed with PC?
Answer: It’s the codeine!
Codeine, a commonly prescribed and effective drug used to
treat pain, diarrhea and to suppress cough, is the most widely used and
naturally occurring opiod or narcotic (medicines that produce pleasure and
calmness) in the world. It comes from
the opium poppy, and is related to morphine and heroin.
Codeine is also the base material for the production of two
other narcotics, hydrocodone and dihydrocodeine. Compared to morphine, codeine produces less
pain relief, and is usually taken by mouth in liquid or tablet form. It is
often combined with aspirin or acetaminophen (Tylenol) to enhance its affects
on the body. Promethazine, which does not contain codeine, is the generic name
for a sedating, anti-nausea chemical this is often combined with codeine in
cough syrups.
The combination of promethazine with codeine to control
cough and cold symptoms is very effective when used properly, but can become
addictive and dangerous when misused because of the codeine. Most Americans take their medications
responsibly, however in 2003, approximately 15 million people in the United
States reported using a prescription drug for non-medical reasons at least once
during the year.
Prescription drug abuse has become a problem for several
reasons. Use of prescription drugs is viewed as safe because a doctor
prescribed it; it is readily accessible in home medicine cabinets; and
medicines that normally need a prescription can now be purchased online without
seeing a doctor, thus lessening the chance that one could get caught by the
authorities for purchasing and using an illegal substance.
The three types of drugs commonly misused or abused in this
country include:
- opioids - which are
prescribed for pain relief
- central nervous system
depressants - often referred to as sedatives or tranquilizers
(i.e. barbiturates and benzodiazepines) which are prescribed for anxiety
or sleep problems
- stimulants - which
are prescribed for attention-deficit hyperactivity disorder (ADHD), the
sleep disorder narcolepsy, or obesity
Symptoms of overdose on opiods like
codeine include constipation, slow breathing, seizures, dizziness,
weakness, confusion, tiredness, cold and clammy skin, small or constricted
pupils, loss of consciousness, coma and possibly death!
To experience the
effects of codeine, the human body must convert the drug to morphine. The
effects of codeine start 10 to 30 minutes after ingestion, peak within one to
two hours, and may last four to six hours, depending on how much is taken. Within
two to three weeks of repetitive use, a physical and psychological addiction
may develop. Misuse will lead to an apathetic, dulling-type effect, a lack of
co-ordination and dulled responses.
The effects of the
misuse of prescription drugs are not limited to just those that are of middle
or lower income, there are popular artists that have also suffered the
repercussions of misusing these drugs.
The cause of death
for Robert Earl Davis, Jr., also known as DJ Screw, at age 30 was attributed to
the result of combining PC with marijuana and alcohol.
Unfounded rumors have
circulated about Pimp C’s death being related to an overdose of PC, however the
autopsy results show that the PC only contributed to his death. Pimp C had a
condition called sleep apnea (which we will talk about in my next article) that
did not mix well with the cough syrup. Together, they caused his death.
The bottom line is
that, recreational use of PC is dangerous, addictive, potentially life
threatening, and illegal to use without a prescription. Be careful what you
sip…it could be your last.
Dr. Rani Whitfield is a board certified Family
Practice and Sports Medicine Physician living in Baton Rouge, LA. He is affectionately known as “Tha Hip Hop
Doc”as he uses music and medicine to educate young people on health issues. For
more information, go to www.h2doc.com or www.blackaids.org. You can email Tha Hip
Hop Doc at DrRani@h2doc.com