Much Ado About Sizzurp

Rapper Lil Wayne's seizures and hospitalization highlight a double standard in hustler culture. Crack cocaine and heroin users are considered junkies. Meanwhile codeine "sizzurp" and pills are less stigmatized, but not necessarily any more benign.

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Details about Lil Wayne's medical condition are scant. And while he tweeted, "I'm good everybody. Thx for the prayers and love," after TMZ depicted him practically on his deathbed over the weekend, he reportedly remained hospitalized on Monday after suffering yet another debilitating seizure. Doctors may have found codeine in his system, prompting TMZ to report that his seizure was the result of a drug binge. That "Weezy" would have codeine in him shouldn't come as a surprise. The rapper has professed his love for the drug in multiple public venues -- in the form of "sizzurp," which usually involves prescription cough syrup (codeine is an opiate that requires a prescription) mixed with soda and sometimes hard candy, like Jolly Ranchers.

RTR324GJthumb.jpgAndrew Innerarity/Reuters

Opiate withdrawal doesn't typically result in seizures, but codeine cough syrup frequently comes paired with promethazine, a sedative-type drug that can lower the seizure threshold in users, making those prone to seizures more likely to have them. Even more so when it's paired with narcotics. Syrup drinkers also frequently combine the drug with Xanax or other benzodiazepines (Lil Wayne has rapped about his struggles with Xanax as well) whose withdrawal syndrome can cause seizures. When syrup is taken with benzo pills the combo is called "pancakes and syrup" on the streets. Both promethazine and Xanax when taken with codeine syrup boost the otherwise mild narcotic's effects into the heroin-range of intoxication. Lil Wayne hasn't confirmed that his most recent seizure had any connection to his drug use; he's reportedly been prescribed seizure medication in the past, but whether he's actually diagnosed with epilepsy is unconfirmed.

Sizzurp, or "purple drank," or "water," depending on the part of the country in which one cops it, has for years been a drug of choice for inner city dealers of drugs like crack and heroin. In the hustling culture that produced Lil Wayne, with which he self-identifies, one's street reputation as being reliable with money is paramount to conducting business. Lower level dealers often get packages of drugs fronted to them on credit, and coming up short on money to repay upper level traffickers for their fronted drugs can result in grievous physical injury and death. Nothing does more damage to a hustler's business prospects than word spreading on the street that they're a crackhead or dopefiend, as it's taken as gospel that addicts can't be trusted with money, and worse, might snitch their whole crew to the narc squad. So hustlers tend to avoid stigmatized "hard" drugs like cocaine and heroin that are strictly commodities for sale.

However, this doesn't mean that hustlers don't party. Urine drug test results in probation departments around the country substantiate claims to the contrary. An analysis of Philadelphia's probation department drug test results for 2012 show that 31 percent of the nearly 70,000 total tests taken were positive for some illicit substance. Marijuana was the drug of choice, accounting for 55 percent of positive results. Opiates like codeine syrup and benzodiazepine pills accounted for 20 and 19 percent of the total positive results, respectively. So hustlers, in this case the lower level drug sellers comprising the bulk of Philladelphia's county probation population, are getting high with some regularity.

The arbitrary distinctions drawn between certain classes of drugs or means of consuming them by inner city hustlers in the absence of any real education on pharmacology obviously doesn't reflect the realities of abusing those drugs that have been deemed less addictive or harmful on the street. Just because you don't use a needle to shoot heroin doesn't mean you can't get addicted to codeine syrup just as badly, especially if you're drinking it all day and night to escape the reality of sitting on a corner selling crack. Not smoking crack doesn't mean you don't suffer its consequences.

Benzodiazepines, seen on the streets as almost totally harmless, in actuality have the worst withdrawal of any class of drugs other than alcohol; these are the only two commonly abused substances whose sudden discontinuation can result in death. Rates of prescription drug overdose deaths, called "epidemic" by the CDC, are a more accurate reflection of the potential destructive power of drugs with less addictive potential than heroin or crack cocaine.

Many hustlers do eventually get treatment, though most are sent there by courts and probation officers. Their experience in treatment settings is different from those self-identified addicts who voluntarily enroll themselves. Very few hustlers who get stipulated to drug treatment are willing to admit that they are drug addicts, as the term carries baggage among their street associates. Drug addicts are seen by hustlers as lower forms of life; addicts are to be profited from, not for associating with socially, and certainly not for sharing intimate details about one's life struggles with. On the streets, being either a hustler or an addict is seen as a mutually exclusive statement of one's identity.

When hustlers find themselves in treatment sitting next to the heroin users and crack smokers they sold to, faced with admitting they have the same problems (just with a different set of substances), many will stubbornly refuse to admit it. Yet the admission of having a drug problem is the starting point for most drug treatment programs; without admitting that you have a problem, there's not much work that done towards treating it. For Lil Wayne to get clean, he would have to set aside street conventions surrounding the hierarchies of abuse.