480-447-4252

Promethazine Addiction: Risks, Signs & Treatment Options

Medical Providers:
Dr. Michael Vines, MD
Alex Spritzer, FNP, CARN-AP, PMHNP
Clinical Providers:
Natalie Foster, LPC-S, MS
Last Updated: December 4, 2025

Most people first encounter promethazine as an ordinary allergy or motion-sickness medication—nothing remarkable, just another item in the medicine cabinet. But in clinical practice, especially over the last decade, we’ve seen a shift. A drug that once seemed low-profile is now showing up in misuse cases, sometimes quietly and sometimes mixed into social trends like “lean.”

Promethazine isn’t an opioid, and is it a narcotic? No. Yet its sedating effects make it surprisingly appealing for people seeking an easy way to “take the edge off.” This mix of accessibility and calming effects is exactly why addiction is becoming a bigger concern in treatment centers across the country.

Our Promethazine Addiction Treatment Centers

Stunning View Of Our Pool, Jacuzzi And Rock Waterfall At The Hope House Scottsdale Rehab

Scottsdale Rehab

Luxury Personalized Rehab

The Hope House Vereda Solana Mansion backyard shot with resort style pool

HART Rehab

Luxury Personalized Rehab

An inside look at the medical detox facility for drug and alcohol addiction at Scottsdale Detox

Scottsdale Detox

Luxury Medical Detox

Take control of your narrative. Rewrite your story today with The Hope House.

Promethazine Overview

Promethazine belongs to the older class of antihistamines—strong, sedating, and multipurpose. Clinicians use it in everything from nausea management to pre-operative sedation. Because it dulls the central nervous system, even small changes in dose can drastically shift how someone feels, especially in people younger than 2 years or vulnerable age group populations.

This unpredictability is part of what makes it risky. A person may start taking it to sleep better or treat allergies, but misuse often sneaks in when they realize, “Hey, this makes me feel really relaxed,” sometimes after noticing effects like dry mouth or changes in blood pressure.

What is Promethazine Used For?

Doctors prescribe promethazine for a surprising number of reasons. It can help with:

  • Allergy symptoms
    Nausea and vomiting
    Motion sickness
    Sedation before procedures

In short: it calms the body, quiets the stomach, and slows everything down. That “slowing down” sensation is exactly what some individuals end up chasing—especially those who already struggle with anxiety, insomnia, or substance cravings. Those combining doses or using a household spoon may unintentionally take too much.

Mechanism of Action

Promethazine blocks histamine, but that’s only the beginning. It also influences parts of the brain that regulate alertness, which is why people get drowsy so quickly. When too much is taken—or it’s combined with alcohol, opioids, or benzos—the sedative effect can ramp up into something dangerous, like slowed breathing, respiratory depression, or confusion.

This is also where drug interactions, CNS depression, and drinking alcohol become major risk factors. This is one reason people end up asking whether it is a controlled substance—its side effects can feel intense even though the drug itself isn’t scheduled.

Does Promethazine DM have Codeine in it?

A common misconception: Promethazine DM does not contain codeine.

It includes:

DM is a cough suppressant—not an opioid—and it works differently from codeine. Still, when people misuse promethazine DM, they often do it for the “floaty,” sedative feeling rather than the cough relief, sometimes even when the original issue was only a sore throat.

Is Promethazine DM the Same as Robitussin DM?

No. They share DM as an ingredient, but promethazine DM has a strong sedative component. Robitussin DM focuses more on mucus and cough relief. They feel different in the body and are not interchangeable from a medical standpoint.

Take control of your narrative. Rewrite your story today with The Hope House.

Promethazine Addiction

Rise of Promethazine Abuse

Promethazine misuse didn’t explode overnight. It’s been building slowly through a mix of underground trends and easy access. While the old promethazine-with-codeine cough syrup has been restricted or discontinued in many places, illegal markets still circulate versions of it.

What complicates things is that many people experimenting with it are not trying to get “high” in the traditional sense. Some mix it with alcohol at parties. Others add it to opioid use to intensify sedation. Teens may try it simply because they saw someone online talk about “purple drank.”

And although people often ask, does promethazine DM have codeine in it? Nope. But the association with codeine-containing syrups still drives a lot of curiosity and misuse—sometimes leading to panic calls to a poison control center when symptoms escalate.

Reasons for Promethazine Abuse

People misuse promethazine for several very human reasons—not just “to get high.”

Sedative Calm

For some, the attraction is simple: “It helps me relax.” Unfortunately, that calm can cross the line into slowed breathing or dangerously deep sedation.

It Feels ‘Safe’

Since promethazine isn’t an opioid and isn’t a controlled substance, many assume it’s harmless. That assumption is one of the biggest drivers of misuse among young adults.

Cultural Influence

Music, social media, and certain subcultures have made syrup mixtures look fun or harmless. It creates a false sense of confidence that leads people to experiment.

Easy to Get

Promethazine exists in tablets, syrups, and combination products. That variety makes it appealing because people can find it almost anywhere.

Mixing With Other Substances

Some individuals use it to “smooth out” stimulants or intensify opioids and alcohol. This is extremely dangerous, but it’s more common than people realize.

Is Promethazine A Controlled Substance?

On its own? No. It isn’t scheduled under U.S. controlled substance laws.

When it includes codeine, however, that’s a different story. Promethazine-with-codeine syrup falls under Schedule V due to the opioid content—not the promethazine. Some misuse happens among certain years of age groups who assume it’s harmless.

Is Promethazine a Narcotic?

Promethazine itself is not a narcotic. If it’s paired with codeine, that combination becomes a narcotic medication—but it alone doesn’t fall into that category.

You deserve a life free from addiction. Reach out for help and reclaim your future.

Promethazine Addiction Treatment

Treatment for Promethazine addiction typically involves a combination of medical detoxification, behavioral therapy, and ongoing support.

During treatment, doctors may advise patients that if they skip the missed dose, they should not double up later—especially given the risk of sedation.

Patients are often encouraged to talk to their doctor before restarting or adjusting their medication routine.

icon for medical prescription and dosage

Medical Detoxification

Detox can look different for each person. Some experience mild symptoms; others—especially those mixing it with alcohol or opioids—may need close monitoring to stabilize breathing and prevent complications.

mixing alcohol and medications can be harmful

Medication-Assisted Treatment (MAT)

When opioid dependence is part of the picture, clinicians may bring in treatments like buprenorphine or methadone to prevent severe withdrawal.

Icon Representing Behavioral Therapy

Behavioral Therapy

CBT, motivational interviewing, and reward-based approaches help people understand the emotional or environmental triggers driving their misuse.

A small group therapy sessions for addiction treatment

Support Groups

Groups like NA or SMART Recovery offer accountability and connection—sometimes the exact things someone needs to stay on track.

healthy lifestyle icon engaging in exercise

Lifestyle Changes

Better sleep routines, improved diet, structured daily habits, and stress-reduction techniques all play a role in long-term recovery.

evaluation icon to access the appropriate detox plan

Aftercare Planning

Recovery doesn’t end when someone leaves treatment. A solid plan—including therapy, relapse-prevention strategies, and follow-up appointments—helps keep progress steady.

Break the silence of addiction. Embrace a path of recovery today.

Find Help at The Hope House

Promethazine addiction often hides behind the misconception that the drug is “safe.” But misuse can spiral quickly, especially when it’s part of a larger substance-use pattern.

At The Hope House in Scottsdale, we provide individualized treatment grounded in medical expertise and long-term recovery support. If you or someone close to you is struggling with promethazine addiction, reach out. The sooner treatment begins, the better the outcome.