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Journal Article

Citation

Ahmed H. Lancet Psychiatry 2020; 7(9): 737-738.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1016/S2215-0366(20)30345-X

PMID

32828158

Abstract

The misuse of cough syrup in the form of a substance called lean has been reported in the literature since the late 1990s among adolescents in the USA. Lean, also called double cup and dirty sprite, among other street names, contains a mixture of a carbonated drink combined with higher-than-prescribed concentrations of codeine and promethazine cough syrup. The substance provides the user with a sedative effect. Since its invention, this substance has been widely associated with hip-hop culture and the music industry, although evidence suggests a more varied pattern of use across social groups, with misuse increasingly reported around the world, including in the UK.3

Research around the non-medicinal use of cough syrup in adolescents has focused primarily on the prevalence of misuse and the addictive consequences.with little focus on the underlying causes for consumption. Investigating the underlying causes is important because substance misuse can be a presenting feature of undiagnosed mental illness in adolescents. One such illness that requires greater awareness among the young urban civilian population is post-traumatic stress disorder.

Large inner-city boroughs in England are often faced with a high incidence of violent crime, with many adolescents witnessing or experiencing extreme violence, one of several causes of post-traumatic stress disorder. Many of these young people do not seek mental health support for several reasons, some of which include a preference for self-reliance, stigma associated with mental illness, a sense of expected resilience, and the suboptimal design and mistrust of support services. Without treatment these adolescents live in a constant state of threat, contributing towards their own subsequent violent behaviour as well as insomnia and other symptoms of post-traumatic stress disorder. To try to help overcome these symptoms many adolescents subsequently develop substance misuse problems. The misuse of lean, shown to be most common in urban areas, has been associated...


Language: en

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