"[14] It has been suggested that the super-sweet combination of soda, cough syrup, and Jolly Ranchers provides a pleasing flavor and mouthfeel that lingers on the user's tongue for an extended duration.

"[17] Respiratory depression is a potentially serious or fatal adverse drug reaction associated with the use of codeine, but mainly the danger lies in the much more potent and CNS-depressing phenothiazine-related antihistamine promethazine.

[15] Codeine-based cough syrups were also turned to as an alternative to pentazocine/tripelennamine ("T's and blues") after the pharmaceutical industry added naloxone to its constitutent drugs, effectively blocking their potential for abuse.

"[15] DJ Screw's invoking lean in his lyrics and his use of slow tempos had caused his style to be characterized "[a]s if the song itself has taken too much codeine promethazine".

[19] Houston producer DJ Screw popularized the concoction, which is widely attributed as a source of inspiration for the chopped-and-screwed style of hip hop music.

[21] In June 2000, Three 6 Mafia's single "Sippin' on Some Syrup", featuring UGK, brought the term purple drank to a nationwide audience.

[26] DJ Screw, who popularized the codeine-based drink, died of a codeine–promethazine, Valium, and PCP overdose on November 16, 2000, several months after the video of Three 6 Mafia's single debuted.

[27] Big Moe, a DJ Screw protégé whose albums City of Syrup and Purple World were based on the drink and who has been described as having "rapped obsessively about the drug",[28] died at age 33 on October 14, 2007, after suffering a heart attack one week earlier that left him in a coma.

[30][31] Pimp C, a widely influential rapper from Port Arthur, Texas and member of the rap duo UGK, was found dead on December 4, 2007, at the Mondrian Hotel in West Hollywood, California.

The Los Angeles County Coroner's Office reported that the rapper's death was "due to promethazine-codeine effects and other unestablished factors."

A spokesman for the coroner's office said that the combination of sleep apnea and cough medication probably suppressed Pimp C's breathing long enough to bring on his death.

[33] In September 2006, Terrence Kiel, a San Diego Chargers player, was arrested during practice for the possession with intent to sell prescription cough syrup for use in making the drink.

[34] On July 8, 2008, Johnny Jolly, a Green Bay Packers player, was pulled over in his car by the police for playing excessively loud music in a nightclub parking lot.

[37] On July 5, 2010, former Oakland Raiders quarterback JaMarcus Russell was arrested at his home in Mobile, Alabama, for possession of codeine syrup without a prescription.

[38] On June 11, 2013, just days after being robbed at gunpoint in San Francisco, rapper 2 Chainz was arrested at Los Angeles International Airport on charges of possessing promethazine and codeine (the primary ingredients of lean) along with marijuana.

The commercial product contains no codeine or promethazine, but claims to "Slow Your Roll" with a combination of herbal ingredients such as valerian root and rose hips as well as the hormone melatonin.

[42][43] Similar "anti-energy" or relaxation drinks on the commercial market use the names "Purple Stuff", "Sippin Syrup", and "Lean".