51˶

Wuzzup with Sizzurp and Justin Bieber's Other Behaviors?

MedpageToday
I wasn't too surprised when the news broke that Justin Bieber had been arrested for drag racing and DUI. It's just  the next chapter in the downward spiral the 19-year-old teenage heartthrob seems to be stuck in.

Troubles during last year's European tour, such as scuffling with paparazzi, became more pronounced when Bieber headed to South America. There he was accused of for spray-painting graffiti in Rio de Janeiro, and had a taken of him sleeping in bed at a brothel.

Things weren't much better back at his Calabasas, Calif. mansion. Last week, Los Angeles County deputies raided his home with a search warrant looking for evidence related to felony vandalism charges. Bieber's next door neighbor's home had been "egged," resulting in $20,000 worth of damage.

that officers found a "treasure trove of drugs" during the raid. They also reported a large number of elaborately decorated styrofoam cups -- the preferred cup used when drinking a narcotic-laced concoction called Sizzurp.

Bieber's arrest occurred when police stopped what appeared to be a drag race in a residential Miami Beach neighborhood. Driving a rented Lamborghini, officers thought that Bieber had a "smell of alcohol on his breath," and he failed a roadside sobriety test. Police chief Raymond Martinez said that after his arrest, "the pop star admitted to consuming alcohol and prescription medications and smoking marijuana."  After being charged with DUI, resisting arrest without violence and driving with an expired driver's license, Bieber was released on $2,500 bail.

What is Sizzurp?

Sizzurp, also known as “syrup,” "lean," or "purple drank," is a homemade party drink made up of sugary soda, such as Sprite or Mountain Dew, Jolly Ranchers (or other hard candy), and cough syrup containing codeine and the antihistamine promethazine. It is typically drunk in styrofoam cups.

The codeine in sizzurp causes a  mild euphoric effect. It is also a dissociative drug (like ketamine) and causes motor-skill impairment, lethargy, drowsiness. Occasionally users substitute codeine with the stronger opioid hydrocodone. Over-the-counter Robitussin has also been used as a replacement for codeine; however, the effect is described as hallucinatory rather than euphoric.

Promethazine is a phenothiazine derivative that acts primarily as a histamine (H1) antagonist, and is used to treat nausea, motion sickness, and allergy symptoms. It acts as a sedative.

Houston author points out that the super-sweet combination of soda, cough syrup, and Jolly Ranchers provides a flavor and mouth-feel that, due to the syrup, stays on the tongue -- causing users to obsess over the sweetness on their tongues all day.

What are the dangers of Sizzurp?

Because it is cheap and easy to make, Sizzurp has become popular with American teens. A 2012 found that more than 1 in 10 teens (12%) reported lifetime use of over-the-counter cough or cold medicines to get high.

Sizzurp can be highly addictive. It can also be deadly when mixed with alcohol or taken in large enough doses.

Symptoms of overdose include
:

Codeine:
  • CNS depression
  • miosis
  • decreased respiratory rate
  • hypoventilation
Promethazine:
  • tachycardia
  • altered mental status
  • delirium
  • seizures

Where did Sizzurp come from?

Sizzurp first gained popularity in the Houston hip-hop culture in the 1990's. It has been mentioned in a number of hip-hop songs, such as Kanye West's "Barry Bonds" and DJ Khaled's "We Takin' Over." One of it's biggest proponents is Lil Wayne, who has immortalized sizzurp on many song tracks, the most famous of which is in his 2008 single "Me and My Drank".

Of note is that Lil Wayne was hospitalized for seizures in 2013. Although he has a history of seizure disorder, Lil Wayne's most serious hospitalization (which had him in the ICU for 6 days) occurred after taking Sizzurp.

Have any of you seen Sizzurp use in your patients?