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Codeine Cough Syrup (Promethazine, Linctus, Purple Lean)

Codeine Cough Syrup

Codeine Cough Syrup

Codeine is a powerful cough suppressant. There are currently more effective derivatives of codeine that can do just as good of a job without causing side effects and without the risk of addiction. However, because of its history as one of the most effective cough suppressants it continues to be used for this purpose.




In many countries you can find bottles of codeine cough syrup that somehow flout the laws of the land. These are sold freely over-the-counter. Because of the internet, the spread of information, the growing online drug communities and the fact that people are ordering these in large quantities online, governments of the world have woken up to this problem and are cutting down on them.

However, even in 2017/2018 you can still buy codeine cough syrups in many countries around the world. These contain small doses of codeine per serving, but the rest of the ingredients are often harmless, so people have taken to consuming full bottles to get a recreational fix.

What is Promethazine with Codeine?

Promethazine with Codeine
This is a cough syrup often found in the United States, where is has gained a following amongst the hip-hop community and is often taken as a recreational drug. Promethazine is an antihistamine that helps with the spread of illness and makes the patient sleepy and sedate; codeine is a pain killer and a cough suppressant. Together these drugs make for an effective medicine as well as a powerful recreational drug.

Bottles of Promethazine and Codeine are often added to sweet and sugary sodas and then drug like alcohol. Such drinks have been known as “Lean” or “Purple Sizzup”.

What is Codeine Linctus?

Codeine linctus is a cough syrup that is available over the counter in the United Kingdom. Technically, it is a controlled drug and should not be sold without a prescription. However, for many years at the time of writing pharmacies in the country have been ignoring these laws and freely selling it to customers.

Providing those customers have been asked a series of questions and an experienced pharmacist has been consulted, then this seems to be okay. However, they have been prosecuted for willingly handing out bottles to customers who clearly have problems.

Only people from the UK are able to buy these bottles of codeine linctus online. You can not order from the US or elsewhere and if the person selling the bottles agrees to ship to these locations then there is a good chance they are breaking the law.

Does Promethazine Have Codeine in It?

No. Promethazine cough syrup might (check the label) but the substance itself is completely different from codeine. The former is an antihistamine, the latter is an opiate. In fact, on its own Promethazine has little (if any) recreational value. Only when it is combined with codeine does it become enticing to recreational users.

Buying Codeine Over the Counter: OTC Codeine

All addictions can be dangerous because of the effect they can have on an addict’s social life, career and physical health. With codeine there are other concerns as well. One of these is that addicts may feel the need to use widely available OTC products that also contain acetaminophen/paracetamol and/or ibuprofen, drugs that can actually be more damaging than codeine when used in high doses.

Another issue is that codeine is not always widely available as a street drug, but more potent opiates are (including heroin), so desperate addicts often use something else when codeine is not available.

Sticking with the OTC codeine theme, the following problems are why this is so dangerous and why codeine addiction is so common in the UK, the US and indeed all over the world.

Codeine and Paracetamol/Tylenol: CWE, Danger and Addiction

In many counties you can purchase combinations of codeine and acetaminophen, which is known as paracetamol in the United Kingdom. This drug is considered to be an effective painkiller and it is widely used. It is cheap and available over-the-counter. However, it can cause serious liver damage in doses higher than 1 gram. In fact, some reports suggest that the toxic dose is much smaller.




The codeine in these drugs is often equivalent to just 16mg (such as co-codamol). That means that a user would need to consume an overdose of acetaminophen in order to get even a moderate codeine high. That’s why these combinations are available as pharmacists know that no one will be that desperate.

However, what they have overlooked is that there is a way to get rid of the acetaminophen in these tablets. This is something that many desperate addicts are doing. They are still putting themselves in danger. There is a huge chance of overdose and death even if they just make a small mistake. Because of this, we don’t want to describe the process here and will not recommend it to anyone.

If you are the parent or guardian of an addict or someone you suspect is using, then look out for preparations of cloudy liquid left in the fridge; for large orders of acetaminophen containing drugs; and for other signs.

Ibuprofen and Codeine

Ibuprofen and Codeine

People who don’t want to risk the consumption of acetaminophen will often take a combination of ibuprofen and codeine. As an NSAID it is considered to be less risky and less damaging. Some preparations, such as Nurofen Plus in the UK, contain around 12mg per 200mg of ibuprofen. When you consider that ibuprofen can be given in doses as high as 600mg, this means that they can get a small recreational dose of codeine without overdosing on ibuprofen.

However, addicts are not looking for a small recreational dose. They want to consume a lot, an in doing so they may be taking large quantities of ibuprofen. In the past it was thought that the only severe side effects related to kidney damage, stomach damage and other digestive distress. But recent studies have suggested that ibuprofen could cause serious heart problems, which makes an overdose on these drugs just as dangerous as acetaminophen containing drugs.

Addicts tend not to care though and they are willing to put themselves at risk. They need to be informed about the danger they are putting themselves in. As a guardian you need to understand what could be happening behind your back. They will often buy boxes of these medications online and from different stores in order to avoid suspicion. In fact, they may even ask a friend or loved one to buy them. So, if you are asked, then be on your guard, because they may need you help. Even though they probably won’t admit to it.

Codeine Sulfate vs Codeine Phosphate

Codeine Sulfate vs Codeine Phosphate

These two substances are both codeine salts. They are different on a molecular level, but in regards to the effects that they have on your body they are the same. Different preparations are preferred in different countries and for different reasons. You might find a different tablet in the US than in the UK; you may also find that a bottle of codeine cough syrup contains a different salt than a codeine tablet.