STORY BYIt's called lean, barre, purple stuff, syrup and it is oozing everywhere.
Take a hip-hop song, slow it down to a distorted crawl, pour prescription cough syrup into a styrofoam cup and plop a couple of Jolly Rancher candies into the mix and you have the latest drug craze and cultural trend sweeping through our middle and high schools.
And Houston, Texas has the dubious distinction of being both the birthplace and the epicenter of this new drug subculture.
Though prior research is woefully thin on this drug trend, estimates indicate that 25 percent of at-risk Houston youth have reported recreational use of codeine syrup, with 10 percent reporting that they used it within 30 days of being asked about it, according to a study published by Peters and colleagues in the Journal of Psychoactive Drugs 35(2), 2003.
Findings show that of the admitted users interviewed, 81 percent were male, 54 percent were African American, 33 percent were Hispanic American and 13 percent were White American. Anecdotally, though, use among American college students is widespread and seems to have become a youth-culture craze, crossing all race and economic boundaries.
"Parents need to know that this is something that has become normal and is considered to be normal among children of all races," says Ron Peters, Dr.PH., lead author of the study and assistant professor of behavioral sciences at the UT School of Public Health.
"And we know that this phenomenon is seriously under-reported," Peters says.
But it isn't just the drug-it's the music known as "Screw" that drives this beat. "This drug and its use is heavily reinforced and induced by the Houston music that gave birth to it," Peters explains.
Peters and his fellow researchers have been exploring and documenting the illegal use of prescription cough syrups that contain codeine and promethazine and examining the entire culture that is built around Houston teens' use.
More importantly, he and his team have researched the perceived addiction rate of "lean" and the news is not good. Most kids believe that they are addicted to it from the first exposure. They also perceive the peer pressure to use it to be so strong that they have no chance of stopping.
"It's considered on the streets to be 'player potion,' " Peters says. "If you're not drinking syrup, then you're not a 'player.' "
Codeine is a naturally-occurring narcotic, derived from opium that is used for pain management and, in this case, cough suppression. Promethazine is a versatile drug that, in this case is used as a powerful antihistamine with sedative properties.
His research was published in last month's Journal of Drug Education, entitled "Beliefs and Social Norms about Codeine and Promethazine Hydrochloride Cough Syrup Onset and Perceived Addiction Among Urban Houstonian Adolescents: An Addiction Trend in the City of Lean."
The widespread abuse of codeine/promethazine cough syrup (CPHS) "has evolved as a result of lyrics in a popular and innovative form of hip-hop music in the Houston-based underground music scene called 'Screw,'" Peters explains.
DJ Screw, a hip-hop Houston rapper created an off-shoot of the inner-city rap music medium with the distinguishing feature of a markedly slowed beat, "like a 45 rpm record played at 33 and a third," Peters explains. "One of the first major songs written by [another Houston rapper] Big Mo was called 'Barre Baby' alluding to the pharmaceutical distributor, Barre."
Another song on the Billboard Top 10 was "Sippin' on Some Syrup" by 3-6 Mafia and Houston group UGK (Underground Kings).
Peters says that this subculture has proliferated through the rest of the United States and Canada. Codeine "purple stuff" use is growing and, Peters says is being recklessly encouraged by Screw--now a multi-platinum coup for the recording industry. "It's on radio, in video and on CD."
The combination of the distortedly slow music, the sedative effects of the drug and the anecdotal support of young users that it is indeed "cool" to do "lean" has the Texas Commission on Alcohol and Drug Abuse (TCADA) highly concerned, says Peters' report.
Kids purchase varying quantities of the syrup from street dealers, mix it with a soft drink-usually Sprite-add hard candy for flavor and consume it as a recreational drug.
The combination of these two drugs, when used recreationally prolongs the "high" and the sedative effects of both drugs.
The study showed both male and female students named "media modeling" as the foremost reason for the popularity of syrup usage, but males also acknowledged "euphoric effects," "peer pressure," and "accessibility" as additional reasons for the popularity of the drug.
Researchers also examined the perceived addiction rate of syrup and found that most kids believed they were addicted to it the first time they used the trend drug.
The illegal and recreational use of cough syrup is nothing new. Illegal prescription drug use and addiction in general is on the rise and is rampant. " What we have here is an underground culture that is now hitting mainstream rap, through radio, CD and video. It is infiltrating other states at an alarming rate and has now diffused to Canada," Peters says.
Kids procure the syrup in two-ounce bottles for about $30. A pint can cost $250 to $300 on the street.
Street dealers acquire the syrup in several ways, from unscrupulous pharmacists or doctors, through theft at the manufacturing or distributor level, or from well-meaning physicians who truly are trying to quell a cough.
"A cough is something that can easily be faked. Sometimes even the parents are obtaining prescriptions for their children and selling it to make a little money on the side. It is a huge problem," Peters says.
Dr. Ronald Peters is an assistant professor of behavioral sciences at the UT School of Public Health.
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Eating healthy
reverses metabolic syndrome
Dr. Tasnime Akbaraly of University College London and her colleagues were interested if healthy eating could actually turn-the-tide and reverse metabolic syndrome, which is having 3 or more of the following risk factors: excess abdominal fat; high triglycerides, hypertension, low levels of HDL the “good” cholesterol, or type 2 diabetes. Having metabolic syndrome doubles a persons’ risk of heart disease and greatly increases the odds of developing type 2 diabetes.
The researchers studied 339 British civil servants with metabolic syndrome, and how closely the adhered to the Alternative Healthy Eating Index (AHEI) to see if it could help reverse metabolic syndrome. The AHEI is a set of published nutritional guidelines by the Harvard School of Public Health in 2002 that emphasizes whole grains, fruits, vegetables and decreased red meat consumption.
Five years into the study, nearly 50% no longer had metabolic syndrome. People who followed the AHEI guidelines the closest were nearly twice as likely to have reversed their metabolic syndrome. The results of the study were published in Diabetes Care, online July 29, 2010.
Dr. Alice Lichtenstein, an expert on diet and heart health from Tufts University in Boston who was not involved in the study said, "It's not about focusing on individual components of the diet, it's really the whole package, and that becomes important because it means that if one of the components of a healthy diet is to eat more fruits and vegetables, just buying a pill saying that there's a concentrated extract of fruits and vegetables is probably not what's going to help you."
Call and make an appointment with Wellness Coach Sam Hester, CWC, CPT, LWMC, at 713-500-3327. It's confidential and free. For more information on the wellness services provided, visit UT Counseling and WorkLife Services.