J. DRUG EDUCATION, Vol. 33(4) 415-425, 2003 BELIEFS AND SOCIAL NORMS ABOUT CODEINE AND PROMETHAZINE HYDROCHLORIDE COUGH SYRUP (CPHCS) ONSET AND PERCEIVED ADDICTION AMONG URBAN HOUSTONIAN ADOLESCENTS: AN ADDICTION TREND IN THE CITY OF LEAN RONALD J. PETERS, JR., DRPH, MS STEVEN H. KELDER, MPH, PH.D. CHRISTINE M. MARKHAM, PH.D., MA University of Texas Health Science Center at Houston GEORGE S. YACOUBIAN, JR., PH.D., MS The McFarland Institute LECRESHA A. PETERS, MD Family Practice Resident ARTIST ELLIS, MS Gulf Shores Outpatient Center ABSTRACT In the current study, we used a qualitative approach to investigate relevant beliefs and norms associated with codeine and promethazine hydrochloride cough syrup (CPHCS) consumption, initiation, and perceived addiction among 48 alternative school students who identified themselves as current CPHCS users. In general, both boys and girls believed that CPHCS addiction started during an individual’s initial consumption. A majority of both groups reported that their second CPHCS event was initiated during the same or next day after their first event. Our findings suggest that friends and an innovative form of hip-hop music called “screw” are strong reinforcers of CPHCS use. INTRODUCTION Cough syrup containing codeine and promethazine hydrochloride, known on the streets as “lean,” “barre,” “purple stuff,” and “drank,” has become a drug of choice 415 Ó 2003, Baywood Publishing Co., Inc.