This is one of the ways in which lean made its way to the streets of Atlanta from 2008-2013:
Last year, according to the Atlanta Journal-Constitution, investigators in Georgia found that technicians at Emory University Hospital Midtown in Atlanta had diverted 110 gallons of promethazine codeine to the street from 2008 to 2013, leading to a $200,000 fine. (The hospital told the newspaper it had systems in place to prevent such thefts, which it had strengthened in the wake of the revelations.)
Promethazine was reported as a substance abuse trend over two decades ago:
In the two decades since promethazine codeine was first reported as a substance abuse trend, pharmaceutical companies have rarely acknowledged, let alone taken steps to combat, the illegal market. By contrast the companies most closely associated with the broader opioid epidemic have occasionally been called to account for their practices and have defended themselves publicly. For example, the maker of OxyContin, Purdue Pharma LP, in 2007 pleaded guilty to charges of misleading regulators, doctors, and the public about the addiction risks of its product; Purdue has since said that it reformulated the drug to give it “abuse-deterrent properties” and that it’s funding programs to help prevent pharmacy robberies.
In August 2015, Wockhardt became the second company to publicly address the issue of recreational use of promethazine codeine syrup, following a controversy related to a syrup put out by its subsidiary Morton Grove. Three days after the Chicago Tribune published an article highlighting how the local suburb of Morton Grove, where the subsidiary is based, had become synonymous on social media with purple drank, Wockhardt issued a statement about what it called the “disturbing practice” of unapproved use of its syrup. “While some may attempt to glamorize it, prescription drug abuse is a public health problem,” the company said. “We will continue to work with law enforcement and others to deter the unauthorized use of prescription cough medicine.”