What Is Promethazine & How It Is Misused
Promethazine is a prescription medication used to treat allergies, nausea, and motion sickness—but when misused, it can be dangerous. Abusing promethazine can lead to serious health risks, including addiction, respiratory depression, and even overdose.
At Avenues Recovery Center, we’re committed to educating the public about lesser known but equally harmful substances. Understanding the dangers of promethazine misuse is the first step toward prevention, support, and healing.
Is Promethazine Addictive?
Promethazine itself isn’t considered physically addictive in the way that opioids or benzodiazepines are. However, it can be habit-forming—especially when misused for its sedative or euphoric effects. The real risk comes when promethazine is mixed with other substances, like codeine or alcohol. These combinations can enhance the high, making it more psychologically addictive. Over time, people may start relying on that high to relax, sleep, or cope with stress. This repeated use can lead to a pattern of abuse and dependency that’s hard to break.
So while promethazine may not cause intense withdrawal symptoms on its own, the behaviors and patterns around its misuse can absolutely point to an addiction that requires professional help.
How Promethazine Works
Promethazine is an antihistamine, which means it blocks the effects of histamine—a chemical in the body which causes allergy symptoms like sneezing, itching, and runny nose. But that’s not the end of the story. Promethazine also affects other receptors in the brain, including dopamine and acetylcholine receptors, which is why it can make you feel sleepy, relaxed, or even a bit “out of it.” That’s why it’s sometimes prescribed for nausea, motion sickness, or as a sedative before surgery. It works by slowing down signals in the central nervous system. When used correctly, Promethazine can be highly effective in calming anxiety or reducing nausea. But when misused or taken in high doses, those same calming effects can become dangerous —especially when combined with other depressants.
Side Effects and Health Risks
Short Term Side Effects:
Some common side effects of Promethazine include:
- Extreme drowsiness or sedation
- Dizziness and confusion
- Blurred vision
- Dry mouth
- Slowed breathing (especially dangerous when combined with opioids or alcohol)
- Hallucinations or disorientation
Long-term Side Effects:
- Memory problems
- Mood swings or depression
- Liver damage (particularly when used with codeine)
- Increased risk of overdose
- Physical dependence on mixtures like “lean”
Does Promethazine Get You High?
On its own, promethazine doesn’t usually produce a strong high. However, when taken in large amounts or combined with other substances like codeine or alcohol, it can create a sedative, euphoric effect that some people misuse to “feel high.” This combination—often called “lean” or “purple drank”—slows down the central nervous system, leading to a relaxed, almost dreamlike state. Some users describe feeling detached, drowsy, or pleasantly numb.
While the high may seem mild compared to other drugs, the dangers are very real—especially when promethazine is used frequently or in combination with other depressants.
Is Promethazine a Controlled Substance?
Promethazine itself is not classified as a controlled substance in the United States. It’s a prescription-only medication, but doesn’t fall under the DEA’s Controlled Substances Act unless it’s combined with certain other drugs. That being said, promethazine mixed with codeine—a common cough syrup combination - is a different story entirely. That combination is a Schedule V controlled substance because of the codeine component, which is an opioid. This version of cough syrup is tightly regulated due to its high potential for abuse and dependence.
So while plain promethazine isn’t controlled, it’s still a medication with real risks - especially when misused or taken without a prescription.
Risks and Dangers of Promethazine Abuse:
Abusing promethazine—whether alone or mixed with other substances—can lead to serious and even life-threatening consequences. These can include:
- Respiratory Depression
When promethazine is combined with depressants like codeine or alcohol, it can dangerously slow breathing. This is one of the biggest risks and a leading cause of overdose. - Sedation and Impaired Function
High doses can cause extreme drowsiness, confusion, poor coordination, and blackouts, increasing the risk of accidents, injuries, or impaired driving. - Heart and Liver Damage
Chronic misuse, especially with codeine, can strain the heart and liver, potentially leading to long-term health complications. - Overdose Risk
Combining promethazine with opioids, alcohol, or other sedatives greatly increases the risk of overdose, which can be fatal without immediate medical intervention. - Seizures and Hallucinations
High doses can trigger seizures or hallucinations, especially in people with underlying health conditions or when used recreationally.
Why Do People Abuse Promethazine?
People may turn to promethazine abuse for a number of reasons, but most often it's to experience the promethazine high—a sense of deep relaxation, drowsiness, or mild euphoria. While the high isn’t as intense as with stronger drugs, it can be appealing to those looking to escape stress, anxiety, or insomnia. Promethazine is also commonly abused in combination with other substances. When mixed, it enhances the sedative effects and creates a more pronounced high. This blend, often called “lean” or “purple drank,” has been glamorized in music and pop culture, making it particularly popular among teens and young adults.
Promethazine Overdose
While promethazine is generally safe when used as prescribed, promethazine drug abuse can lead to dangerous—even life-threatening—overdoses. This risk increases significantly when promethazine is mixed with other depressants like opioids, alcohol, or benzodiazepines.
Symptoms of a promethazine overdose may include:
- Extreme drowsiness or unresponsiveness
- Slowed or stopped breathing
- Severe confusion or hallucinations
- Seizures
- Irregular heartbeat
- Loss of consciousness
In some cases, overdose can result in coma or death—especially if emergency help isn’t received right away. Overdose often happens after repeated misuse or when someone struggling with promethazine addiction builds a tolerance and takes larger doses to chase the same sedative high. It can also occur when people underestimate how dangerous it is to mix promethazine with other substances.
If you or a loved one is struggling with promethazine addiction, it’s important to remember that you’re not alone—and recovery is possible. The path to healing begins with understanding the risks and taking the crucial first step toward treatment.
At Avenues Recovery Center, we offer personalized, compassionate care for individuals dealing with substance abuse, including those affected by promethazine misuse. Our team of experts is here to guide you through every stage of recovery, from detox to long-term support. We provide a safe, supportive environment where you can heal and regain control of your life.
Don’t wait for things to get worse. Reach out to Avenues Recovery Center today, and take the first step toward a healthier, substance-free future.