Promethazine is a prescription medication commonly used to treat allergies, motion sickness, nausea, vomiting, anxiety before surgery, and post-operative pain management. It’s a useful and effective drug when taken as directed under medical supervision. However, promethazine has become a target of misuse and abuse, especially among young people seeking to get high. Taking promethazine in high doses or mixing it with other substances to intensify its effects is extremely dangerous and can lead to serious health consequences, including overdose and death.
What is Promethazine and How Does it Work?
Promethazine belongs to a class of medications called phenothiazines. As an antihistamine, it blocks the effects of histamine, a chemical released by the immune system that causes allergy symptoms like sneezing, runny nose, and itchy eyes. Promethazine also acts as a sedative by depressing activity in the central nervous system (CNS), producing a calming and sleep-inducing effect.
Promethazine comes in tablet, syrup, and injectable forms. Common brand names include Phenergan, Promethegan, and Phenadoz. Doctors prescribe promethazine for a variety of indications:
- Allergic reactions like hay fever and hives
- Motion sickness and vertigo
- Nausea and vomiting from illness, pregnancy, or post-operative effects
- As a sedative before and after surgery
- To potentiate the effects of opioid painkillers and anesthesia
When used as directed, promethazine is generally safe and well-tolerated. However, it does have potential side effects including drowsiness, dizziness, blurred vision, dry mouth, and constipation. More rarely, it can cause abnormal muscle movements, confusion, and irregular heartbeat.
The Misuse and Abuse of Promethazine
Despite its medical benefits, some people misuse promethazine to experience an intense sedative effect and euphoric high, particularly when taken in higher than recommended doses. Promethazine misuse often involves mixing it with other substances that enhance its psychoactive effects. A common and notorious form of abuse called “purple drank,” “sizzurp,” or “lean” combines promethazine cough syrup with codeine (an opioid) and soda for a powerful, euphoric high. The concoction is glamorized in popular culture and music. Other substances like alcohol or even hard candies are also mixed with promethazine syrup to create a stronger high.
Misusing promethazine, either alone or in combination with other drugs, is very risky and dangerous. In high doses, promethazine’s CNS depressant effects can cause:
- Profound drowsiness and sedation, to the point of stupor
- Severely impaired coordination, motor skills, and judgment
- Slowed, shallow, or irregular breathing
- Increased risk of falls, accidents, and injuries
- Muscle twitches, tremors, and seizures
- Cardiac arrhythmia and heart failure
- Loss of consciousness, coma, and death (especially when mixed with alcohol or opioids)
Over time, promethazine misuse can also lead to tolerance, dependence, and addiction. Tolerance means that higher and more frequent doses are needed to feel the same effects. Physical dependence develops when the body adapts to the presence of the drug and goes into withdrawal if use is stopped abruptly. Promethazine withdrawal can involve very unpleasant symptoms like nausea, vomiting, restlessness, insomnia, and uncontrollable leg movements.
Addiction to promethazine is a serious substance use disorder with compulsive drug-seeking and using behaviors. People addicted to promethazine may experience strong cravings, unsuccessful attempts to cut down or quit, neglect of responsibilities, and continued use despite negative consequences to their health and lives.
The Path to Recovery Starts Here
Given the significant risks, promethazine should only be taken exactly as prescribed and directed by a doctor. Misusing this medication to get high is very dangerous and can quickly escalate to dependence and addiction. But if you or a loved one is struggling with promethazine abuse, know that compassionate, evidence-based help is available. At The Bluffs, our comprehensive addiction treatment programs address the root causes of substance abuse and empower clients with the tools and support to achieve lasting recovery. Don’t wait another day to break free from the cycle of prescription drug abuse. Call The Bluffs today at 850-374-5331 or reach out online to learn more about starting your healing journey at our scenic Ohio drug rehab center.
