Research Assistant Cohen Children's Medical Center West Babylon, New York, United States
Background: “Lean” is a concocted party drink composed of codeine and promethazine-based cough syrups, and soda. Lean, commonly referred to as “purple drank”, rose in popularity after rap/hip hop songs glamorized the drink. This mixture is prevalent in party scenes with 15% of e-dance party attendees having used Lean. TikTok is a video-sharing app with 1 billion users monthly, with the majority being youth. Objective: This study examines the prevalence of #Lean videos in order to assess dangers to youth. Design/Methods: The top TikTok videos under the hashtags “#lean”, “#purplelean,” “#purpledrank,” and “#sizzurp were collected using an online web scraper. The following data were collected: 1) creator age range; 2) perceived creator gender 3) demonstration of Lean use/how to make Lean; 4) cough syrup mentioned; 5) discussion of feeling; 6) health risks mentioned. Two trained coders reviewed initial data; a third coder adjudicated disagreements. Age was either self-reported by the creators or estimated by coders. Descriptive analysis was conducted in R. Results: A total of 113 videos (94,644,794 views) were analyzed. The age range of the video creators consisted of 15% (n=17) adults, 12% (n=13) young adults, 9% (n=10) college, 4% (n=4) child, and 61% (n=69) anonymous. A total of 81% (n=91) of videos included Lean usage/creation with high prevalence across age demographics (Figure 1). In these videos, showing the bottle or cup where Lean is held, commercialized Lean products, and adding cough syrup were most commonly shown (Figure 2). Cough syrup was mentioned in 14% of videos (n=16). Health risks were discussed in 2% (n=2) of videos.
Conclusion(s): A majority of popular TikTok videos contained information on Lean usage/mixing. These videos have the potential to pique the interest of young users who may be interested in trying Lean by providing a step-by-step road map. Only a small portion of these videos touch on associated health risks or mention cough syrup. Engaging with these videos has the potential to trigger algorithms and spread virally among youth, who may be susceptible to trends. This engagement becomes concerning when combined with the lack of awareness on the health risks or the composition of Lean. Our findings underscore the necessity for clinicians to engage in conversations with their patients about Lean and its dangers, while also calling for enhanced internet safety measures and relevant legislation to mitigate the dissemination of harmful content among impressionable viewers. Furthermore, parents should be vigilant about the accessibility and storage of cough syrup-related products.
