A History of Hip-Hop’s Obsession With Lean
An in-depth look into the past and present of rap’s favorite drug.
In June, the estate of legendary Houston producer and turntablist DJ Screw announced that his full catalog—previously available exclusively through physical tapes and unofficial YouTube uploads—would be released on streaming services. A press release touted the rollout as “a celebration of DJ Screw’s enduring legacy and the culture he built.” That legacy is deeply complicated: Screw’s innovative approach to producing and remixing not only formed part of the bedrock of Southern hip-hop, but also pop culture’s deep fascination with codeine and promethazine, the two primary components of the syrupy narcotic drink best known as lean.
More than 25 years after Screw’s death, lean might be the central ingredient in hip-hop’s opioid crisis, which is part of the broader opioid crisis currently gripping America. The aesthetics of lean are still seemingly everywhere these days: the rage rap revival of Lil Uzi Vert’s latest EP Maverick “Almost Forever,” the sharp introspection of Nino Paid, and the wide-eyed street raps of indie experimentalists like Sideshow. Even after it took the lives of icons like Pimp C and Screw himself, lean is still a drug of choice for so many rappers. It’s worth asking how lean has maintained its hold on hip-hop’s imagination, and how it’s transformed from its first references on wax in the early and mid 1990s.
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The popular story of lean has become almost mythical. As a young DJ mixing at home with friends, Screw accidentally hit his turntable’s pitch button, making everything hypnotically slow. “Chopped and screwed” music became his trademark—and as it turned out, a perfect accompaniment to the sluggish effect codeine cough syrup has on the human body.
As Screw’s influence grew, lean’s popularity grew with it. The drug spread across regional rap scenes in Texas, then Tennessee, Louisiana, Georgia, Florida. It also sparked a moral panic in mainstream America and a commercial boom in products playing off the drug, like Cam’ron’s Sizzurp liqueur and “anti-energy” drinks made by a Houston-based beverage company.
Because of Screw’s massive influence, we generally take for granted how the recreational abuse of codeine cough syrup did, in fact, start in Houston. Writeups on the subject frequently quote Ronald Peters, a former professor at the University of Texas Health Science Center, who notes that Houston blues musicians mixed cough syrup with alcohol in the 1960s. But that’s not quite the whole story.
Although it’s common knowledge that codeine is an opiate—part of the same class of drugs as heroin and oxycodone—we don’t always acknowledge how common it actually is. Back in the ’60s and ’70s, heroin users were also known to take codeine cough syrup to ward off withdrawal symptoms. In cities like Baltimore, Chicago, and, yes, Houston, police raids on “syrup houses” influenced drug policies as the War on Drugs was taking shape. By the time lean reached the national spotlight in Houston, codeine cough syrup was available through seemingly endless avenues: trafficked through local doctors and pharmacists, smuggled from Mexico, or simply offered to patients who could persuade their doctors to prescribe it.
This accessibility is part of what made lean so attractive in the first place. Between 1986 and 1991, drug-related charges by the Houston Police Department increased 109 percent, largely due to the use of cocaine, marijuana, heroin, LSD, and methamphetamines. Wholesale amounts aside, being caught with a small amount of cough syrup was not necessarily an immediate cause for arrest; with the proper health insurance, you might not have to pay for it at all. Pharmaceutical companies began aggressively marketing prescription pain medicine to doctors in the late ’90s, helping flood the legal and illegal market with opioids.
At this point, changing drug policy and the ups-and-downs of the pharmaceutical industry have made prescription codeine and promethazine harder to obtain. In January, Minnesota-born rapper Lil Shine pled guilty to federal fraud charges: According to his indictment, Shine allegedly worked with two co-defendants as a 17-year-old to hack an online platform belonging to the DEA, “[stealing] physicians’ information to set up customer accounts in the physicians’ names with several online pharmaceutical wholesalers.” As a result, they were able to order 300 pints of promethazine with codeine (with a street value of around $750,000, according to the DEA).
As Atlanta rewired mainstream hip-hop in the 2010s, the city’s biggest stars brought lean with them, too. Where Houston’s “screwed music” was still fundamentally regional, Atlanta infiltrated pop like no other rap scene before it. No one embodies that shift better than Future, who, as Charles Holmes wrote for Rolling Stone, built much of his career treating lean as “a muse and preoccupation.” In a 2019 interview, Future famously grappled with his influence on artists like Juice Wrld, who claimed that Future’s music “first influenced him to experiment with lean.” “This shit really fucked me up for a minute,” Future told Holmes. “It’s all I could think about. Like, ‘Damn, what have I done? What have I done to other people? What I did to myself?’” Less than a year after that interview, Juice Wrld died from a codeine and oxycodone overdose after federal agents raided his private plane, adding his name to a wave of opioid overdose deaths that included Mac Miller and Lil Peep.
The defining hip-hop of the opioid crisis has often been marked by a shared sensibility, what essayist Jesse McCarthy has described as “a preoccupation with depression, mental health, a confused and terrible desire for dissociation.” In the 2010s, prescription drugs formed the cutting edge of drug culture in rap—not just lean, but other opioids like Percocet and Benzodiazepines including Xanax and Klonopin. As music journalist Thomas Hobbs wrote in 2019, the depressive and sedative qualities of these drugs were “mirrored by the sound of the music itself, which has inherited slow, spaced-out drums and subdued bass, as rappers channel the numbing effects of the Xan bars they’ve just ingested via sleepy vocals and mumbled, melancholic lyrics.” At the same time, fentanyl firmly entered our cultural lexicon—a more potent and deadly opioid that flooded the recreational market.
Now that we’re firmly behind that moment in Atlanta trap (and so-called “sad rap”), hip-hop has become both hyper-regional and post-regional. Lean has spread in a similar way: Where it used to be a marker of Southernness (or at least an homage to Southernness), you can now find it across small regional scenes in the DMV, Chicago, and New York. That being said, none of them have become ambassadors for lean quite like Detroit and Flint. From Rio Da Yung OG to RMC Mike and Veeze, Michigan’s regional rap stars often write about the lean market with the shrewd detail of an economist, in sleepy cadences that instantly recall ’90s Texas.
There’s a distinct local history behind those stylistic choices. Detroit’s Icewear Vezzo told No Jumper that he started selling lean in the late 2000s through connections to pharmacists, often relying on fake lean because it was still niche at the time: “I would sell a nigga some fake lean, and then give him a CD, and on the CD I’m talking about selling fake lean on the whole tape.” Vezzo, in turn, influenced Team Eastside—a Detroit rap collective that counts Babyface Ray and Peezy as its most prominent alumni. In a 2024 interview, Team Eastside’s Lil P argued that the group was “the originators of the syrup shit” in Detroit. Although they weren’t the first Detroit rappers to sip lean, Vezzo and Team Eastside were some of the first to make lean a central part of their aesthetic; as Lil P later recalled, “All we did was sip lean, all day… We wasn’t even heavy smokers like that, for real.” Tracks like “Money, Power, Lean” were local hits in the 2010s, and Vezzo has deeply intertwined lean references into his rap persona—much like Future did in Atlanta.
Lean references in contemporary hip-hop focus much more on its rarity, treating it like a luxury good. To a certain extent, you can track the lean market through rappers’ references to the pharmaceutical companies that produce it. Corporations like Akorn, Tris Pharma, and Amneal Pharmaceuticals have always been part of syrup’s slang. At the turn of the millennium in Texas, there was “barre”—which came from Barre-National, a subsidiary company that once produced cough syrup at plants in Maryland and North Carolina. During lean’s resurgence in the 2010s—the same time that references to other prescription meds began to increase—there was a rise in lyrics about brands like Actavis, Hi-Tech, Alpharma, and Qualitest. Now you’re more likely to hear brand names like Wockhardt and Quagen, although who uses which terms seems to largely depend on where and when you’re sourcing them. At the same time, rappers increasingly talk about promethazine-based syrups that are considerably cheaper than codeine-promethazine blends. They lack the euphoric high associated with codeine but retain its sedative effects. It’s fascinating to hear rappers show brand loyalties and hierarchies about multinational firms that could never publicly endorse such boosterism.
The black market for lean fluctuates: Brands go in and out of availability or style, for reasons that an average listener is unlikely to be aware of. Actavis famously discontinued its codeine-promethazine cough syrup in 2014 as the brand gained notoriety in the music world. In 2015, town officials in Morton Grove, a small Chicago suburb, became aware that the town’s name was trending on social media among lean users because a pharmaceutical company based nearby was a subsidiary of Wockhardt (which ended its U.S. operations just last year). In the midst of all this, it’s hard to tell how these companies relate to their products’ cultural cachet. Purdue Pharma, the original manufacturers of OxyContin, declared bankruptcy after massive lawsuits over their marketing tactics. But as Timothy Bella wrote for Bloomberg in 2017, “syrup companies have largely managed to avoid such controversy, leaving experts and users to speculate on whether they regard the illicit market as a problem or an opportunity.”
On top of that, the adverse effects of codeine addiction—including the stereotypical bloating known as “lean gut”—are common knowledge now. For artists heavily associated with the drug, these effects often slip into easy meme fodder. Take Chicago rapper Lucki. As the self-styled “alternative trap” artist’s brand has grown, so has the centrality of lean in his aesthetic: Clips have gone viral of Lucki debating pandemic-era lean prices on Lil Yachty’s podcast A Safe Place, while Lucki fans debate his health so much that Lucki’s referenced the chatter himself in recent tracks. A more extreme example is Dave Blunts, who gained notoriety for edgy, outlandish lyricism and viral stunts a couple of years ago. A lot of his virality stemmed from running jokes about his health, like performing with an oxygen tank during a tribute to Juice Wrld. It’s hard to separate that branding from singles like “The Cup” and “Purple Stuff”—which Blunts says reflected his actual lean addiction—and music videos featuring oceans and rainfalls of codeine.
That the adverse effects of codeine addiction have become so memeified is, quite honestly, bleak—a sign of how online fandoms are often so deeply detached from the realities of the artists they discuss. Codeine is still killing rappers today, most prominently Rich Homie Quan, who died from an overdose of lean, fentanyl, and Xanax in late 2024. Fentanyl was involved in the deaths of Gangsta Boo and Coolio in 2023, and Shock G in 2021. These aren’t just lifestyle choices, but part of a broader landscape in which Black folks frequently find it harder to access quality care—whether that’s chronic pain relief, mental health resources, or addiction treatment.
The broader context of codeine addiction also includes our country’s increasingly punitive stance toward drug trade and the intensifying fascism of the Trump era. Since Trump began his second term, the U.S. government has justified all kinds of questionable military interventions by invoking fears of drug traffickers—like capturing Venezuelan president Nicolás Maduro and conducting drone strikes on civilian boats in the Caribbean. The far right has often blamed the opioid crisis on undocumented immigrants, particularly when it comes to fentanyl, which has contributed to the ongoing occupation of U.S. cities by ICE agents and the National Guard.
If the failures of the War on Drugs are any indication, harsher policing and conservative moralizing won’t stop the flow of lean throughout contemporary hip-hop. Like any drug, people use lean for lots of reasons: to have fun, to fit in, to deal with physical and mental pain. But we’re also not dealing with the same crisis that we were when DJ Screw’s death put codeine’s dangers firmly on the map. Mainstream hip-hop has steadily moved away from drug sellers to drug users as a central archetype.
It’s hard to know where we go from here—but lean might be with us until our solutions to the opioid crisis fully account for the stories that hip-hop is so good at unveiling. Lean’s entrenchment in the genre’s vocabulary isn’t just defined by its current mystique as a luxury good, but by rappers’ constant struggles to let it go. Maxo Kream, one of the most compelling rappers in Houston hip-hop’s post-Screw landscape, begins his latest album O.Y.N by describing how he found his way back to codeine: “I was six months clean/Molly, no drank, no lean/But I relapsed, can’t help it.” Unsettled grief over his brother’s shooting death, estrangement from his daughter, and his parents’ health struggles loom over him like storm clouds. When his mother tries prescription antidepressants for her own grief, “they just brought up more problems.” Maxo suggests this shared reliance on drugs—over-the-counter and from the black market—isn’t a panacea, but a band-aid. The solution, then, must be something bigger. Something that can shift his relationship to his family, his community, and his body.
