Lean & Mean

Those who drink codeine syrup call it lean because of its most obvious effect: a loss of coordination. Those who study the drug call it liquid crack. Those who abuse it can wind up dead.

There are plenty of reasons for Roscoe to sip tonight. It's a spring evening on the south side of Houston, pleasantly warm instead of oven-hot, and there's no place in particular Roscoe's got to be. No clock to punch, no girlfriend to see. No responsibilities except to the Styrofoam cup in his hand. There's music throbbing from a nearby open window, and Roscoe's drink will make the notes slow down and swell up until every nuance stands out in bold relief. There's money to be made, too, from the never-ending parade of fiends who approach him with crumpled bills and dirty change. The drink helps him deal with the crackheads, with their smell and contagious despair. There's also a lingering need, a feeling that almost pulls the cup to his lips of its own accord.

For guys like Roscoe (whose name has been changed), sipping codeine syrup mixed with soda is just a lifestyle accessory, like a pager or a pistol. Syrup is the drug of choice for most of the young hustlers that Roscoe runs with. If Rule No. 1 of drug dealing is never get high on your own supply, then Rule 1a. is stay high on something else. The use of drugs is inseparable from street life, which is inseparable from the drug-dealer aesthetic, which is inseparable from life itself on this South Park block.

Roscoe first started messing with syrup three years ago when he was 16. Back then, syrup was a new, exciting thing around the 'hood. It was like cocaine back in the late '70s and early '80s -- a status symbol. But it was still underground enough that $25 would get you an eight-ounce bottle, enough to keep you nice for about two days. Nowadays, though, everybody loves syrup, at least if all these rap songs are to be believed. And popularity means high prices. Today's eight ounces set Roscoe back $120. Maybe his tolerance has increased, or maybe his dealer is watering down the product, but Roscoe now needs half the bottle to achieve that delicious, delirious, on-the-edge-of-sleep feeling.

Demand and supply: Syrup's popularity has driven up the price, from $25 for eight ounces to $120 for the same amount.
Demand and supply: Syrup's popularity has driven up the price, from $25 for eight ounces to $120 for the same amount.

Truth is, Roscoe's a dope fiend, just like his faithful crackheads. Not that he's admitted it to himself. Syrup isn't really a drug drug -- it's pharmaceutical and regulated by the government. You can get it from the doctor or the drugstore, so it must be pretty safe. Plus you can drink it, and who ever heard of a hard drug you can drink? But Roscoe is an addict in the worst way -- the kind who feels physical pain without a fix. No one ever bothered to explain to him that codeine turns into morphine when it passes though the liver, and morphine ain't much different from heroin when it comes to getting you hooked.

It's too late for all that, though. Sipping from his cup, Roscoe absently scratches at himself. "That's how you know it's good," he says. "You get that itch."

"We call it liquid crack," Daphne Moore says. "That's really what it is."

As a primary investigator for a December 1999 study on codeine syrup, which was commissioned by the Texas Council on Alcohol and Drug Abuse (TCADA), Moore interviewed dozens of syrup users in Houston, the city that popularized the drug nationwide, about their addiction. Besides that, Moore is a social worker and a regular down-home girl, as comfortable on street corners as in any office.

The study, conducted by drug epidemiologist Dr. William N. Elwood, found that syrup is easily obtainable, both by manipulating the health care system and on the underground illegal drug market. "You can always find some doctor who will [prescribe] you some syrup, and when you do, folks'll pass the word. The doctors compete for customers and will lower their rates," said one study participant, outlining a common scenario of paying cash for office visits. And with codeine syrup available without a prescription in Mexico, the underground market is thriving. "It's everywhere," the study quoted another user as saying. "Just as easy to get as [crack] rocks. You just need to know who to go to." Said another person of his syrup dealer: "He has these big jugs he fills the bottles with, and the labels are all in Spanish. He's got to be getting his stuff" from Mexico.

That was a year and a half ago. "When we did the study, syrup was just beginning to get popular," says Moore. "Now it's the thing to do. You hear about it in songs, people talk about it in everyday conversation. People will ask you, 'Where can I get some lean at?' There's a lean house right down the street from me."

The term "lean" is used regarding syrup somewhat like "nod" is used with heroin -- literally. One of the main effects of drinking codeine syrup is a loss of coordination. Other effects include a drowsy, relaxed high; fatigue; and a sense of mellowness. Those are the good things. The downside includes constipation, dry mouth, urinary retention -- and physical addiction.

"Codeine is in the same category as heroin, morphine, Demerol and Percocet. They all work by the same mechanism," says anesthesiologist Dr. Jean-Max Hogarth. "Their greatest effects are lowering your heart rate and blood pressure, and respiratory depression. Depending on the level of carbon dioxide in your body, your body wants to breathe. Codeine changes the 'set point' so your body doesn't want to breathe until the carbon dioxide levels are really high. So you breathe less and less. When people overdose on codeine, they just stop breathing."

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