If you are hearing the word "sizzurp" for the first time, blame it on Justin Bieber.
The teen megastar is allegedly abusing sizzurp – a potent concoction made of soda pop, dissolved Jolly Rancher candy and prescription cough syrup containing promethazine (an antihistamine) and codeine (an opiate drug).
Bieber reportedly drinks between eight and 12 ounces of Actavis-brand prometh with codeine each day, according to gossip site TMZ.com.
Sizzurp is a drug of choice in the hip-hop world. Also known as "purple drank" or "lean," the beverage has been linked to seizures, notably in Lil Wayne. As well DJ Screw reportedly died of a codein-promethazine-alcohol overdose in 2000.
Canadian addiction specialists say they don't know whether Canadian youth have developed a taste for sizzurp, but recreational use of cough and cold medicines appears to be on the rise.
In 2013, nearly 10 per cent of Ontario students in grades 7 to 12 said they had used cough or cold medication at least once in the past year to "get high," according to the Ontario Student Drug Use and Health Survey.
That represents a significant increase since 2009, when just over seven per cent of students in the same age bracket said they had tried the drugs, noted Dr. Robert Mann, a scientist at the Toronto-based Centre for Addiction and Mental Health.
"It reflects an increasing trend," he said, adding that the data suggests "maybe this is something serious that we should be looking into."
Just two per cent of students said they had used cough and cold medication six or more times in the past year to get high, which indicates the majority of use was experimental.
Nevertheless, two per cent of that age group adds up to about 20,000 Ontario students, Mann said. "That's a sizable number of people who are using this in ways that suggest more than simple experimentation," he pointed out.
The survey did not distinguish between prescription cough syrups containing codeine and off-the-shelf drugs containing dextromethorphan (DXM), a cough-suppressant that is not in the opioid family.
Both carry the risk for abuse, however.
DXM is known as a dissociative drug, causing a feeling of detachment, impaired motor co-ordination and altered perceptions of sight and sound.
At high doses, DXM can cause impaired vision, increased heart rate and blood pressure, impaired judgment, gastrointestinal problems, hallucinations and coma. DXM is found in cough syrup brands including Robitussin and Buckley's.
In contrast, Bieber allegedly abuses the "champagne of sizzurp," made with prescription cough syrup containing codeine and promethazine.
Codeine gives a feeling of euphoria, and like all narcotics, it's highly addictive. When taken in large quantities or combined with alcohol, codeine may slow down the part of the brain that controls breathing, causing a coma or death.
Promethazine itself may cause drowsiness, dizziness, headache, blurred vision and gastrointestinal problems.
Cough syrup with promethazine and codeine is a prescription-only product – but that does not mean it is off-limits to kids.
Parents should be aware that in many homes, "these drugs are available in the medicine cabinet," Mann said.