Houston’s relationship with “lean,” or codeine-promethazine, goes back to at least the 1960s, when blues musicians would mix Robitussin with alcohol. These musicians lived in the same areas that would become hotbeds in the city for the new generation of musicians coming out of the Bayou City — rappers. The rise of Houston’s hip-hop culture also brought about the rise of “sizzurp,” which in turn would be the downfall of some of the city’s most well-respected figures, and, in the opinion of some, the culture of hip-hop itself.

In the early '90s, Robert Earl Davis Jr., better known as DJ Screw, came to prominence because of the new style of music he had created. The slowed-down beats, with altered pitches that emphasized the lyrical aspect of rap tracks, became Screw’s calling card. The effects of sizzurp, an opiate-based prescription-strength cough syrup, seemed to coincide perfectly with the seemingly time-altering aspects of Screw’s music. Yet despite the glorification of the concoction in his music and the fact that he himself was an avid syrup-sipper, Screw claimed that you didn’t need to be “leanin’” to truly enjoy his music.

Even among his peers, the music and the drug became synonymous; his friends insisted they had to get high to enjoy Screw’s music, in spite of Screw’s statements. Screw’s Screwed Up Click, or S.U.C., boasted a roster of other notorious drank-sippers like Big Moe, Z-Ro and H.A.W.K. who also glorified the use of lean in their music. Since the ’60s, sipping drank had been a largely localized epidemic, but that dynamic began to change as the popularity of the genre dubbed "chopped and screwed" increased. Screw began to remix music from artists outside of Houston, which opened up a new market for the Houston brand of hip-hop, as well as lean.

A huge turning point in the lean culture in hip-hop came in February 2000 with the release of Three Six Mafia’s “Sippin’ On Some Sizzurp,” which featured UGK, the Port Arthur, Texas, duo of Bun B and Pimp C. The song found nationwide airplay, alerting all corners of the country to the trend that had reached epidemic proportions in the South. Eight months later, in his studio bathroom, DJ Screw was found dead at 29 years old from a heart attack. His death left a huge hole in the hip-hop community; so many rappers felt he was a formative presence not only in their careers, but in their lives.

The same year DJ Screw passed, he and his peers sold more than 1 million albums. The city may have lost its leader, but it had finally achieved national recognition. Houston continued to remain in the mainstream spotlight with the emergence of Mike Jones in 2004 and Paul Wall in 2005, respectively. Tragedy struck once again in October 2007 when Big Moe, another Screw acolyte, passed, suffering a heart attack that put him into a coma at only age 33. Moe was a huge proponent of purple drank, naming his first two albums City of Syrup and Purple World, the latter of which reached as high as No. 3 on the U.S. R&B/Hip-Hop charts.

Although Moe's death was not attributed to a codeine overdose, one can speculate that his heart attack could have been due to long-term use of the concoction, whose side effects include bloating and constipation, which in turn can cause increased weight gain and stress on the cardiopulmonary system. Less than two months later, Houston lost another legend, Chad Butler, better known as Pimp C. He was found dead in his Los Angeles hotel room just a month before his 34th birthday; Pimp C’s death was attributed to a combination of codeine-promethazine use and sleep apnea, a condition that causes the sufferer to sometimes stop breathing while sleeping.

Pimp's death, like DJ Screw’s, was a huge tragedy to the hip-hop community nationwide. He had a binding role in the Houston rap culture. For example, Paul Wall claimed in a 2015 VladTV interview that Pimp C’s verse on “Knockin’ Doors Down” encouraged him to squash his beef with fellow Houstonian Chamillionaire, because “it put [our beef] in the public eye and we couldn’t run from it.” The verse called out the two, who were childhood friends and former members of the Color Changin’ Click. Bun B, who was the other half of UGK, spoke about the issues with syrup. “We all know that in Houston, Texas, we have a problem right now with the cough-syrup epidemic and while it wasn’t solely the cause of his death, we have to be real about the consequences to some of these things,” he told Fox 26 shortly after his friend’s death.

Even with the knowledge of what caused their deaths, many continued to sip lean, even pouring up in honor of the fallen. Drugs have always been an avenue to escape the harsh realities of life, and codeine-promethazine cough syrup is no different. However, pouring up to honor someone who died from that same lifestyle is counterproductive and tragically ironic. Sipping lean isn’t seen in the same light as smoking meth or shooting heroin, for example; it’s seen as largely recreational, a social drug. This is an issue in Houston more than anywhere else. Here it’s not stigmatized in the least, and in fact, it’s largely endorsed. If you aren’t sipping purple, you aren’t buying into the culture.

However, it's important to remember that lean is an opiate-based drug, like oxycotin, hydrocodone and heroin. All of these are highly addictive substances that have life-threatening consequences, and are nothing to glamorize. But Houston’s hip-hop culture and purple drank have been one and the same for the past 20-plus years. To stigmatize drank-sippers would be to stigmatize every rapper based in Houston, and that’s not desired. Instead of stigmatizing the drank-sippers, we should be honest about the dangers of the drug, just as Bun B said nearly ten years ago.

Some of the loudest voices opposing the use of lean have come from outside the H. Detroit rapper Danny Brown called lean “liquid heroin” — an apt description, to say the least — in an interview with Tim Westwood. In that same interview, Brown claimed his main reason for quitting was the weight gain he was experiencing owing to an increased intake of sugar from the soda and the Jolly Rancher candies that are commonly mixed with the codeine-promethazine syrup. He also addressed what he called “studio sipping,” or rappers who talk about sipping all this lean but show no signs of it. According to Brown, there’s no reason to glamorize something that gives you diarrhea when you’re trying to stop using it; he even went as far as to say that when you’re hooked on it, getting your fill is as serious as a crackhead's getting a fix.

Another notable former sipper is Gucci Mane, who was recently released from federal prison. Back in 2013, Gucci addressed his addiction to the substance on Twitter, saying he had been sipping for more than a decade and it had “destroyed” him, claiming he had lost memory of many of the things he did and said under the influence of the drug. Boosie Badazz, as he is now known, said in 2014 that he supported the discontinuation of Actavis, a popular brand of lean. He told TMZ that he had nearly died three or four times because of the drug, adding that it “fucked up a lot of rappers and the culture of hip-hop.” Badazz also spoke about the substance’s addictive qualities.

These artists have all gone against the grain in an industry that currently glamorizes hyperbolic drug use, which is a step in the right direction. However, the solution of the problem doesn’t start at the edges; the solution comes from the root.

Besides Bun B, Houston artists who have come out and said anything that can be construed as opposing drank usage have been few and far between. Like Bun said, we need to be honest about the dangers of lean, as difficult as that may be when so much of the city’s identity is tied up in it. We need to talk about issues like addiction, which are at the root of the epidemic. It’s one thing to be addicted to a substance and acknowledge you have a problem, but something else to deny that a problem exists. That’s where we currently sit; we won’t acknowledge the fact that lean has taken away some of our heroes, but we won’t deny it either.

The stigma carried by addiction is what makes us hold back from talking about the real problem. In our minds, an addict is some disheveled stranger panhandling for change at traffic lights, not a rapper who travels the globe performing, but that’s the plain truth. Just thinking of Pimp C as an “addict” makes my skin crawl. He is a cultural icon in this city, a larger-than-life presence even in death, but that doesn’t mean he didn’t have problems in life. Addiction is a disease, one that affects all of us. To pretend that we are immune is to assume ignorance.

The elevated status enjoyed by rappers like Paul Wall and Slim Thug should be used to talk about these issues the way that people from outside of Houston have spoken out. The city itself, and, more important, the hip-hop community have lost some of its most influential leaders. Yet we continue in our self-destructive ways, all to appear as those we are fully assimilated into the culture. We all have to remember that when we lay our head down at night, we are all human, all fundamentally the same.

Although our challenges and vices may be different, we are still just mortals. We have to accept this as an undeniable fact; from there we can be honest about what problems continue to plague the culture, one of which is drug abuse. We all know it, and yet we continue to buy into and perpetuate it, but it has to stop.

The end starts with the hip-hop community, which needs to acknowledge that lean has a parasitic relationship with our community. It takes the best of us, while continuing to take more and more from others. We have to acknowledge that sometimes we are weak, powerless and in need of a helping hand. No longer can we continue to glamorize something that has taken away our icons and is destroying our communities. We have to be honest about the things we promote — words can cause real damage.

Our city’s rappers should be honest about the evils that lurk in the darkness when it comes to addiction — how it has claimed the lives of their friends, not how it’s a great time and you should try this at home. I’m a huge fan of Houston’s hip-hop culture, but I also plainly see what codeine-promethazine cough syrup has done to that culture. Houston's hip-hop culture may have at one time been indebted to purple drank, but that debt has been paid in the lives of some our most cherished people.

Note: This article has been altered after publication to correct the cause of DJ Screw's death.