Sleep apnea causes people to stop breathing for up to 30 seconds at a time while sleeping.
Besides the cough syrup, the rapper, born Chad Butler, had two labeled prescriptions in his room at the time of his death, coroner's spokesman Craig Harvey told The Associated Press. The first prescription, clorazepate, is most commonly used to relieve anxiety. It can also be used to control agitation caused by alcohol withdrawal and seizures. The second, acyclovir, is most often used to treat herpes.
The abuse of codeine-laced cough syrup is so prevalent in Houston that the city has been nicknamed "The City of Syrup" and Pimp C often rapped about using the drug recreationally.
"I got the wet promethazine, thick orange and yellow tuss," Pimp C raps on Three 6 Mafia's 2000 hit, "Sippin' on some Syrup."
In another song he boasts that he "got kids in the 'burbs, sipping on syrup."
A sleep disorder specialist said people with sleep apnea should not take codeine-laced cough syrup because the sedatives in it inhibit respiration.
"We caution the person against sedative hypnotics and drugs that suppress respiration," said Max Hirshkowitz, the director of the Sleep Disorders Research Center of the Veteran Affairs Medical Center in Houston. "That they (have) sleep apnea is automatically put in every single report and every patient that we see is warned that sedative hypnotics, cough medicines, sleeping pills, all of this kind of stuff you have to be very careful with and they shouldn't take them without first checking with a doctor."
Hirshkowitz said the risk of taking these medications when one has sleep apnea is so great that people who are prescribed them are made to sleep with a breathing machine in order to keep their airway open during sleep.
He also said that people who are obese are at increased risk for sleep apnea. Pimp C was 5-foot-11 and 261 pounds.
Pimp C, one-half of the trailblazing rap duo Underground Kingz, was found dead in the Mondrian Hotel in Los Angeles on Dec. 4 at the age of 33.
It is unclear how Pimp C obtained the drug.
But Houston has dealt with an epidemic of the illegal use of cough syrup for several years. In 2006, four local pharmacists were found guilty of drug conspiracy for selling more than 2,500 gallons of it to people without prescriptions.
DJ Screw, who popularized Houston's slowed-down hypnotic style of rap, died of a heart attack in 2000 after a reported overdose of codeine-laced cough syrup. Rapper Big Moe, who rapped obsessively about the drug, died in October of a heart attack.
Though the glamorization of the drug has been a staple in rap throughout the South for years, some in the area were growing tired of its influence.
"I know I'm running the risk of sounding "preachy"... but I'm starting to hate everything that "syrup" stands for," Houston rapper Chamillionaire said in a blog attributed to him in October. "We been promotin' it in our freestyles for a while and it's an imbedded part of Texas culture but I don't like the thought of it anymore. Not because I been up since 5:30 a.m. talkin' about it, not because I'm Hollywood and don't appreciate it. Not because I don't like the color purple. It's because I got two homies in jail behind "drank" cases and I'm aware of the fact that it has been attached to the untimely deaths of some people."
