What is Promethazine?

Promethazine is an antihistamine and antiemetic, most commonly used for the treatment of allergic reactions and motion sickness. In some cases, this medication is used as a sedative before major surgical procedures. Because this medication is easily accessible and often sold over-the-counter, the rates of promethazine abuse are highest among teenagers and young adults.

An 11-year-long study conducted from 2002 to 2012 found that annual exposure rates were highest among children between the ages of 10 and 19 years of age. It was also discovered that promethazine is less commonly abused on its own and more commonly abused when combined with an opioid narcotic like codeine. According to the US Department of Health and Human Services, promethazine-codeine cough syrup is very frequently abused. The study published by the National Institute on Drug Abuse suggests, “Promethazine-codeine cough syrup, a medication that contains codeine, an opioid that acts as a cough suppressant and can also produce relaxation and euphoria when consumed at a higher-than-prescribed dose. It also contains promethazine HCl, an antihistamine that additionally acts as a sedative. Although only available by prescription, promethazine-codeine cough syrup is sometimes diverted for abuse.” Over the course of the past several decades, combining promethazine-codeine cough syrup with soda has gained popularity because of repeated references in mainstream music. This combination is frequently called “purple drank,” “sizzurp” and “lean.”

While many adolescents mistakenly believe that this medication is safe to abuse because it was originally prescribed by a medical professional, there is a long list of potential risks involved when it comes to promethazine abuse. If you have been abusing promethazine in any form for any period of time, seeking professional care in a medically monitored detox facility is a necessary first step on the lifelong road to recovery. Princeton Detox and Recovery Center effectively treats all symptoms associated with promethazine withdrawal as soon as they arise.

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Risks of Promethazine Abuse

Common and serious risks of promethazine abuse include:

  • Extreme nausea and vomiting – Most individuals who abuse promethazine in high doses experience significant gastrointestinal and digestive issues.
  • A lack of coordination – Because promethazine is a central nervous depressant it significantly slows cognitive functioning and response times when abused. Individuals who abuse this medication consistently might find that their coordination becomes permanently impaired. They might feel dizzy and unstable, and find that they have a difficult time standing up straight – or standing up at all.
  • Memory loss – Not only does promethazine-codeine cough syrup cause temporary memory loss (black outs) but consistently abusing this chemical substance can negatively affect memory long-term.
  • Hallucinations – When taken in very high doses promethazine can lead to visual and auditory hallucinations, which can in turn lead to paranoia and panic attacks.
  • Abnormal heartbeat and changes to blood pressure – Promethazine enters the blood stream and has an overall effect on the cardiovascular system.
  • Seizures – Seizures are common when promethazine-codeine cough syrup is taken in high doses. Seizures are also a potential symptom of promethazine withdrawal.
  • Fatal overdose – This is especially common when promethazine-codeine cough syrup is being abused. Both promethazine and codeine act as central nervous system depressants, and taking more than intended can slow or completely stop the lungs and the heart. Respiratory depression is not uncommon and it is often fatal.

These are only several examples of the more common risk factors involved with repetitive promethazine use. If you have been actively abusing this chemical substance in any form, seeking professional help from a reputable treatment center is of the utmost importance.

Promethazine Abuse – Signs and Symptoms

If you believe that you (or someone close to you) may be struggling with a promethazine abuse disorder, there are several telltale signs and symptoms to look for. According to an article titled, “What to Know About Purple Drank Use,” there are many symptoms exclusive to promethazine-codeine cough syrup abuse.

Symptoms of Promethazine abuse include:

  • Finding empty cough syrup bottles in the trash or stashed throughout the house
  • Finding other potential “sizzurp” ingredients like soda and candy
  • Irritability and aggression
  • Mood swings
  • A loss of interest in activities that were previously enjoyed
  • Changes to social circles
  • Disrupted sleep patterns
  • A lack of attention paid to personal hygiene
  • Social isolation from family members and close friends
  • Apparent sleepiness/drowsiness
  • An obvious lack of coordination
  • Searching through medicine cabinets (looking for cough syrup)
  • Experiencing withdrawal symptoms when promethazine is not readily available

Promethazine Withdrawal

When it comes to promethazine on its own, the symptoms of withdrawal are typically very mild and can be easily treated with over-the-counter pain medications. However, symptoms associated with promethazine-codeine cough syrup withdrawal can be severe. Codeine is a habit-forming pain medication, and those that consistently take this medication tend to develop a physical tolerance rather quickly – when tolerance builds, higher doses are taken, and the symptoms of withdrawal continue to grow in severity.

Common symptoms associated with promethazine-codeine cough syrup withdrawal include:

  • Insomnia and other sleep-related issues
  • Hypersensitivity to light and sound
  • Intense and persistent headaches
  • Body tremors and uncontrollable shaking
  • Severe stomach cramping
  • Flu-like symptoms, including runny nose, watery eyes, fatigue, general aches and pain, nausea and vomiting

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Our Simple & Straightforward Admissions Process

If you have been abusing promethazine for any length of time, seeing professional medical detox is a necessary first step on every individualized journey of recovery. Princeton Detox and Recovery Center offers a multi-phased approach to effective addiction treatment, serving men and women of all ages in the Tri-State Area and throughout the remainder of the United States. Our recovery program begins with medically monitored detox in a safe, structured and supportive environment. We believe that medical detox should focus on more than physical stabilization – it should provide clients with a thorough introduction to all of the skills and tools they need in order to stay sober long-term. Our promethazine detox program focuses on providing each client with a safe and pain-free withdrawal while thoroughly exploring the underlying causes of addiction and laying a solid foundation for continued success in sobriety.

We understand that committing to addiction treatment is a major decision in and of itself, and that attempting to deal with all of the finer details can seem somewhat overwhelming. At Princeton Detox and Recovery Center we have carefully developed a simple and straightforward admissions process, geared towards eliminating stress and facilitating a seamless transition into our program as quickly as possible. Simply give us a call for a free, no obligation insurance benefit check and a brief, over-the-phone pre-assessment. We believe that quality clinical care should be readily available to anyone that needs it. For this reason, we work closely with most major regional and national insurance providers and if you are currently insured there is a good chance that all of our provided services are covered in full. The brief pre-assessment helps us confidently determine which level of clinical care is the most appropriate for you and your unique needs. If we determine that medically monitored detox is necessary we begin developing viable travel plans and setting up a date and time for intake.

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There is no reason to continue suffering at the hands of a promethazine addiction. If you or a loved one is ready to begin the personal journey of healing and overcome substance abuse and dependence once and for all, simply give us a call today, we are available 24/7. We look forward to speaking with you and answering any additional recovery-related questions that you might have.

Amanda Hilzer

Reviewed for accuracy by: our Executive Director:


Amanda graduated from Lehigh University with both an undergraduate degree in Psychology and a Master’s of Education degree in Counseling Psychology and has worked in the field of substance use disorder treatment and mental health treatment as a counselor and as a clinical manager for over 14 years.