Sippin’ Syrup: Killing Us Softly

It taste great doc! I dont even drink on that Henn anymore. You should try it; taste better than any margarita Ive 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 cetaminophen (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

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