Wayne's health scare brings the problem to light once again.

Written by Rob Kenner (@boomshots)

We haven’t heard much from Lil Wayne since he was hospitalized last week after suffering a series of seizures, reportedly during a video shoot for the Nicki Minaj song “High School.” He was released from Cedars-Sinai Hospital yesterday, and his mentor and label boss Birdman suggested that his issues were caused by "hard work," but this latest health scare has raised old fears that Wayne may be slipping back into drug dependency. This is not the first time he's suffered seizures. Late last October he was hospitalized following a medical emergency aboard his private jet. At the time his team attributed the incident to migraines and dehydration.

That hospitalization prevented Wayne from testifying in a court hearing related to his lawsuit against filmmaker Quincy Jones III, whose critically acclaimed 2009 documentary The Carter confirmed that one of the greatest artists of his generation had a problem with prescription cough syrup—which contains a highly addictive blend of codeine and promethazine. Although he initially cooperated with the movie, Wayne was not pleased with the final result. His lawyers did their best to prevent the “scandalous portrayal” from being distributed, but without success. The film, which has been compared to the classic Bob Dylan documentary Don’t Look Back, portrays a stone cold genius who has given his entire existence over to his art—and who is very much in the grip of addiction, although nobody around him can make him stop.

 

When Wayne was on tour he would hit his marks. He’d show up and do the show. He’d be in the studio and record all night. He was working hard the whole time. So I was trying to figure out when he had time to do all that stuff.
—Quincy Jones III

 

It is especially painful to watch Wayne’s childhood friend and manager Cortez Bryant struggling to convince Wayne he has a drug problem. “I was ready to walk away,” Bryant says during an interview. “I can’t look at him in that state.”

Jones says that he was inspired to make a film about Wayne because the rapper reminded him of Tupac. He maintains that portraying Weezy’s excessive syrup use was never the objective. “I was surprised at the fact that people were saying he was doing so much because his work ethic was so strong,” says QD3. “When Wayne was on tour he would hit his marks. He’d show up and do the show. He’d be in the studio and record all night. He was working hard the whole time. So I was trying to figure out when he had time to do all that stuff. He was getting on stage every night and killing it. That was more confusing to me than anything else.”

The filmmaker insists he was unaware of the extent of Wayne’s syrup use. “I’ve smoked weed before," he says. "I’ve tried other stuff when I was younger. But I’ve never tried syrup. That’s one of the few things I’m not familiar with. I’ve had family members who have done different things that I’m more familiar with but syrup is not something I’ve had experience with. Living in L.A. it’s not something that a lot of people do here. Every artist is kind of eccentric in their own way. So it was hard for me to decipher what was going on.”

Wayne has spoken about sizzurp through his music for many years. His 2007 mixtape classic “I Feel Like Dying” comes to mind: After Karma-Ann Swanepoel’s voice sings the haunting hook “Only once the drugs are gone, I feel like dying,” Wayne drops brutally frank bars about addiction: “Jumpin’ off a mountain into a sea of codeine/I’m at the top of the top but still I climb/And if I should ever fall the ground will then turn to wine/Pop-pop, pop-pop I feel like flyin’/Then I feel like fryin’ then I feel like dyin’.”

In a 2008 interview with Benjamin Meadows-Ingram, Wayne admitted that he was having a hard time kicking the syrup habit. “It pissed me off 'cause I couldn’t get off it,” Wayne explained while sitting on his tour bus. “That pissed me the fuck off. I can take pain good... but that wasn’t pain I could take. I was like, Lord—breathe! I saw a doctor—he gave me pills, told me, This is what you take to get off it. I never tried them. If them bitches work, then I probably gotta start. Other than that it’s gonna be hard. What a nigga told me to do is start lessening my amount. So what I do, I tell niggas to pour it for me instead of me pouring it... I be patient.”

In 2011, while still on probation following his year-long incarceration on gun charges, Wayne admitted that he still craved the sizzurp. “I drank syrup and I smoked a lotta weed,” he told a writer from GQ. “I wish I could be back on it. That’s how it fucking feels. How does it feel to be sober? I’ll be like, ‘It feels fucked up.’ What you want me to say? ‘It feels great?’ No. I was on something that the doctor prescribed. I was ill, and that was helping me… I cannot wait until I get off probation, sweetheart. No, not for syrup. I stopped syrup in May 9 of 2009. But nobody knew. Because I still rapped about it. Because I respect the culture of where it came from. I still rep that shit.”

 

Whether or not he actually did quit in 2009, the culture of which Wayne speaks traces its roots back to Houston and got started long before he was born. “For us it’s not new,” says Ray Andrews, the director of Houston Crackdown, an anti-drug task force run by the Mayor’s Office of Public Safety and Homeland Security. “When I was growing up in Houston, the whole cough syrup thing was happening back then. I don’t want to say my age but I’m talking about the early ’70s. And seemingly it’s had a resurgence of late.”

 

It goes by many names these days. They call it mud, Texas tea, lean, purple stuff. If you’re in the streets walking around and somebody says ‘Hey man, you need an oil change?’ they’re probably not talking about your car.
—Dr. Ronald Peters

 

Dr. Ronald Peters at the University of Texas School of Public Health specializes in “inner city kids and the ways that they self-medicate.” He has done extensive research into the cough syrup culture in the South. “Just like hip-hop music started in the Bronx and then diffused throughout the world, codeine-promethazine started here in Houston," he explains. "In the ’70s you had a lot of old-school cats that would use Robitussin with codeine and cut it with beer, and they started selling it. A lot of guys started seeing their uncles and fathers doing that and they looked up to them. Then something new came out, which was codeine-promethazine. That was desired more than the other cough syrups because it had three different substances in it. It had alcohol which is a depressant, it had promethazine which is an antihistamine. And then it had codeine, which is an opiate. So you’re getting three different substances at once. It goes by many names these days. They call it mud, Texas tea, lean, purple stuff. If you’re in the streets walking around and somebody says ‘Hey man, you need an oil change?’ they’re probably not talking about your car.”

Around the same time this new and improved form of cough syrup was hitting the street, an innovative new style of music was on the rise in Houston. Robert Davis, aka DJ Screw, came up with a woozy slowed-down sound that seemed tailor-made to match the cough-syrup buzz. His “chopped and screwed” mixtapes soon became the official soundtrack of H-Town and were inextricably linked with sizzurp. “If you study the phenomenon, DJ Screw promoted this lifestyle,” says Ray Andrews. “He’s no longer with us. I tend to attribute the height of this phenomenon to DJ Screw and chopped and screwed music.”

Dr. Peters is not so quick to blame the music: “Many of us consider Robert Davis to be the King of the South, one of the best DJs in the history of hip-hop. His music was simply telling people what was going on, telling stories of codeine-promethazine. Hip-hop music is an educational instrument that’s helpful to parents who want to know what their kids are being exposed in their particular communities.” 

Whether or not rap contributed to the problem, this much is certain: the untimely deaths of DJ Screw, Houston rapper Big Moe, and Pimp C of UGK have all been attributed to cough syrup abuseDr. Peters does concede that the rise of Houston rap helped spread the gospel of sizzurp. “Concurrently the focal point of hip-hop music shifted from the east and west coasts to the southern states, so our music and our culture was spread throughout the world. Then you had people in Amsterdam wanting to know what was purple stuff, what was oil, what was lean—and trying to experiment with this particular substance because of its diffusion through the music.”

 

Any syrup user will tell you, man, your bowels aren't right when you first get on that syrup. I'm almost forty right now. I don't sip at all. I haven't sipped in years.
—OG Ron C

 

Although Houston may forever be considered the sizzurp mecca, not everybody involved in Texas rap is a cough syrup abuser. OG Ron C, the co-founder of Swisha House Records and ChopNotSlop, an Internet site dedicated to the memory of DJ Screw, does not mess with the stuff. “That was the fastest fad I ever had,” he told David Drake in a 2012 interview. “It probably lasted, with me, a month and a half. You've got to develop an immune system to it. It don't have your bowels right at first. When you first get on that syrup, your bowels are not right. [Laughs.] Any syrup user will tell you, man, your bowels aren't right when you first get on that syrup. I'm almost forty right now. I don't sip at all. I haven't sipped in years. But will I? If somebody say, just have a little sip or something, if I go somewhere with Drake or A$AP Rocky and they want to pour up something, I might have a little sip with them or something like that. But I'm not the person that's gonna be like, Hey man, let's go! Naaah, that's been played out with me.”

On the other hand, New York rapper A$AP Ferg does not smoke marijuana but he enjoys drinking “lean,” a concoction that typically includes fruit punch, soda, hard candy, and prescription cough syrup. “I just fuck with lean because lean makes me feel good,” Ferg recently told Insanul Ahmed. “I’m not an advocate for it, but me personally, that’s what I prefer. People are scared of that shit like it’s like taking heroin or something. Motherfucker I sipped lean one time in Houston and Rocky, you know how he be wearing those Rick Owens, them shits that look like the Jordan 13s? It looked like triangles on his feet. That nigga was jumping on stage to the 'Trilla' beat, rapping, the whole shit what so tripped out I felt like he was a character in Mario or some shit. I was like, this motherfucker is like a very rare character from Mario. It was crazy.”

 

When the news broke that Lil Wayne had been hospitalized, one of the first hip-hop artists to express support was Pittsburgh-born rapper Mac Miller, who tweeted “Prayin for Wayne.” Mac knows better than most how hard it is to kick cough syrup addiction. “I was on lean very heavy starting the Blue Slide Park Tour,” Mac told Insanul Ahmed in his Complex Man of Next Year cover story, which explained how he kicked the habit just before he started taping his MTV2 reality show. “I love lean; it’s great. But it’s not good for you. Dude, I was so fucked up all the time that it was bad. My friends couldn’t even look at me the same. Because I’m always like 'I am the leader!' And I’m the one that’s supposed to have his shit together and knows what’s going on and I didn’t. You know I was very lost.”

 

I love lean; it’s great. But it’s not good for you. Dude, I was so messed up all the time that it was bad. 
—Mac Miller

 

Mac’s friend Jimmy concurs. “Lean’s a fucked up thing because you don’t see the negative effects,” he says. “It tastes delicious. It really fucks you up and you can do it every day because it’s not like drinking. It doesn’t give you a hangover or anything. You’ll be in a funk but it’s not a painful one. It’s a really easy thing to slip into. That was a time when Mac had his own tour bus. It was a studio bus, so all the homies were on the other bus and he was kind of in his own little world. I didn’t talk to him much that tour honestly… As a friend I don’t know what’s going on in his head, I wish I did. He was just getting fucked up.”

Yet somehow Mac summoned the willpower to kick the habit cold turkey. “It’s unbelievable that he stopped drinking,” says Jimmy. “For how much he was drinking, it was pretty crazy. It’s definitely one of the most impressive things he’s ever done.”

All opiates are powerfully addictive. Some studies have suggested that just two uses of sizzurp can be habit forming. According to clinical psychiatrist Dr. Gerald Busch, cough syrup addiction can effectively rewire an addict’s entire nervous system. “It’s like a software virus gets in that part of the brain that controls their priorities and starts a new top priority without them even knowing it,” he says. “That’s the essence of the disease. The new top priority is to obtain, use, or recover from the effects of these drugs. So they don’t even know it but they wind up spending their whole day every day seven days a week just rounding up the cough syrup and they’re not even aware of it. They still think they’re calling the shots.

"It gets to be really obvious when they say ‘I’m gonna quit doing it’ and then they find themselves still relapsing. That’s because they’re programmed differently. Their mental software has been subverted to turn their whole nervous system into kind of a drug-seeking missile. So the long-term effects are that the person’s entire nervous system is re-programmed to spend the predominance of their resources, time, labor, time management, financial, everything into making it a top priority.”

Dr. Busch says that codeine and promethazine effectively short-circuit the brain’s pleasure receptors. “There is something in your brain called the nucleus accumbens,” he explains. “When it’s stimulated the person will have feelings of well-being, pleasurable feelings like everything’s cool and they’re feeling great. When you have sex or eat a piece of chocolate or have some kind of success and you feel really good—that’s the part of your brain that’s stimulated. Syrup triggers that circuit in the brain and that’s what makes you feel high.”

Dr. Busch has seen patients who became so dependent on syrup they were unable to take care of their families or their business. “When they wake up in the morning, the first thing they think about is how much syrup do they have. Where are they gonna get it? Are they gonna try to get a prescription from a doctor or buy it on the street? It’s sort of like inventory control. It’s like they have to operate a small business in their brain every day. So it’s not a disease for a lazy person. They don’t get a day off from their disease. If they’re strung out on the syrup and they quit doing it then they get a withdrawal syndrome where they start getting sick to their stomach, nervous, sweaty, chills, vomiting, their bones and their muscles ache. It’s like they have the worst kind of flu in the world. So they don’t like to get into that state. But if you were to tell them that they had a problem and they need help for it, unless they’ve had a lot of bad stuff happen to them, they’ll be like ‘I don’t have a problem. Yeah I like syrup but it’s not a big deal. I can quit when I want.’ They’ll say all kinds of stuff.’”

Bruce Nixon works with recovering addicts in Houston. He has seen firsthand how difficult it is to overcome cough syrup addiction. “Opiates are pretty tough,” he says. “It really depends on the user and the length of use. Some people have to taper down with suboxone. But it’s very addictive and it can be very hard to come off. You’re going to need at least—I would say—a year of treatment. That’s going from residential treatment and then stepping down into an out-patient program, and then maybe some after-care. So you might do 60 or 90 days residential and then you still need some outpatient continued support for another six months. And if any person doesn’t go through that regimen they’re at high risk for relapse.”

Although he stresses that he’s not familiar with the details of Lil Wayne’s case, Nixon says that he has heard of seizures as a side effect of both using syrup and trying to get off syrup. “I’ve heard of seizures happening both ways—as a withdrawal and also while using in the case where they’ve had seizures previously in life.” Promethazine in particular has been known to "lower the seizure threshhold in users, making those prone to seizures more likely to have them," according to a recent piece in The Atlantic Monthly.

As difficult as it is to get clean, Nixon is baffled that prescription cough syrup is considered a recreational drug. “It’s pretty dangerous,” he says. “It’s an opiate, so you can overdose, especially if you’re not being careful. It will definitely slow your heart down and your respiratory system and you can stop breathing and you can die.” This alarming assessment runs counter to the portrayal of sizzurp as a good time drug in hip-hop culture. “You can be a functioning anything user but eventually something is going to happen—just like with Lil Wayne. It could be a health risk, a legal risk, a family issue, a parent issue. It’s going to be something.”

 

Despite the dangers, and the difficulty of obtaining the prescription drug, Dr. Peters says sizzurp is more sought after than ever. “Back in 2000, a quart of codeine-promethezine cost about $100. Now that same bottle costs about $900. And an ace, which is an ounce of codeine, costs you about $75 on the streets right now. This particular drug is considered to be cool with kids and young adults. Now it’s the champagne and caviar of drugs and a lot of people cannot afford codeine-promethezine. But if they can get it they would feel like they’re doing something that’s first class. They call it, ‘Playa Potion.’ Only the players can have access to this kind of drug today. That’s good because there’s not a lot of kids who have access to this stuff because of the price.”

 

Now it’s the champagne and caviar of drugs and a lot of people cannot afford codeine-promethazine. But if they can get it they would feel like they’re doing something that’s first class. They call it, ‘Playa Potion.’ Only the players can have access.
—Dr. Ronald Peters

 

Dr. Peters has nothing but contempt for companies seeking to cash in on the popularity of sizzurp by marketing over-the-counter “anti energy” drinks with names like “Purple Stuff” and “Sippin Syrup,” which he says are mostly marketed to inner-city communities. “When we were younger I can remember candy cigarettes, which was a very inappropriate form of candy. Now this stuff is in the stores, and it’s full of substances that have not been properly studied, and some of the bottles have candy on the label even though it says ‘not recommended for children.’ It's the worst thing since candy cigarettes. This could be used as a gateway… Sooner or later they’re gonna want the real thing."

Of course one of the best ways to discourage abuse of cough syrup would be for popular celebrities to come out against sizzurp. After the death of Pimp C, his UGK partner Bun B made a point of toning down his own lyrical references to the drug, and spoke out in interviews about a "syrup epidemic." But other rappers have been slower to step up.

QD3 says he was once inspired by Wayne’s potential as a leader. “I’ve worked with 'Pac and Ice Cube and LL before," he says. "Those guys were always down to change perceptions of the community and ride for politics and things like that. I saw Wayne’s work ethic and heard he wanted to go back to college. I started putting the pieces together and said 'Man, this is a guy who grew up in hip-hop and he’s already had gold records and stuff and now he wants to go back to college.' So that’s what captured my interest in Wayne. That’s where I thought he was headed and he still may be. We’ll see.”

Even after his court battles with Wayne over the movie, QD3 still holds out hope for a transformative change: “As confusing and difficult as that whole situation turned out to be, I still have compassion for him," says the film maker. "This generation has chosen Wayne as their spokesperson. So no matter what happens we want to see him at the top of his game. Cause he’s leading this generation—whether or not we put him in place to do that, the audience already spoke. They’ve chosen him. What's good for him is good for everybody because so many people are following him.”

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