Hip-hop highs: Long on lyrics, short on rehab

"Sizzurp" has even found its way into Lil Wayne's song lyrics, and his issues with substance abuse have been well documented. Promethazine has several uses, including treating allergy symptoms, easing nausea and as a sedative. According to Drugs.com, dangerous side effects can include "twitching or uncontrollable movements" of limbs, face, eyes and the tongue.

Of course, rappers talking about drug use is nothing new. As is often the case with hip-hop -- which began as a vehicle to document the lives of inner-city youth -- art, more often than not, imitates life.

But Lil Wayne's recent hospitalization has cast a spotlight on hip-hop and drug use because of fans' concerns over his past behavior. Scant information has been released about what may have caused the award-winning artist, who was born Dwayne Michael Carter Jr., to have a seizure that landed him in a Los Angeles hospital. His label's publicist confirmed to CNN at the time that the rapper had suffered a seizure.

And what will happen now that he's out? Talking drug use is one thing. But rehab seldom comes up in the conversation.

"Where hip-hop falls short is in addressing the rehabilitation aspect," said writer JasFly, who has reported on the industry. "Wayne is one of our hip-hop rock stars, but where is the help for him?"

With his monumental success on the charts and devil-may-care attitude, Lil Wayne has in some ways transcended the male dominated hip-hop genre and occupies the rarefied air of one of music's biggest stars.

Lil Wayne is not only a platinum-selling artist in his own right, but he's also the man responsible for stars like "American Idol" judge Nicki Minaj and rapper Drake. He often appears on songs of other artists as diverse as Kelly Rowland and teen heartthrob Joe Jonas.

He also is one of a number of rappers who have openly discussed drug use. In 2011, he and fellow rap superstar Eminem discussed their substance abuse issues with GQ magazine.

The New Orleans native, who fans also lovingly call "Weezy," said he quit narcotics, not necessarily by choice, but partly because it was a requirement of his probation after a 2008 arrest in Arizona where authorities allegedly found ecstasy in his backpack. The rapper secured a plea deal and was given probation.

"I wish I could be back on it," he told the publication. "That's how it f**king feels. [cracking himself up] 'How does it feel to be sober?' I'll be like, 'It feels f***ed up.' What do you want me to say? 'It feels great'? No."

The list of those who, like Lil Wayne, have been accused of drug charges is long -- including the recent arrest of rapper Too Short who was charged with a felony count of drug possession after police allegedly found suspected meth on him, according to a Los Angeles Police Department spokesman.

There has been no information released about how the rapper has pleaded to the charge. The rapper's manager, David Weintraub, denied in a statement to CNN that Too Short had drugs on him at the time of his arrest. "Any assertion that Short was carrying powder is ridiculous! Every rap fan knows Short's into weed!," the statement said.

Rapper Snoop Dogg (now known as Snoop Lion in homage to the Rastafarian culture) has been a well-known marijuana user. VH1's reality show "Love and Hip Hop" highlighted rapper Joe Budden's addiction and relapse after years of sobriety.

"My two demons are real simple, drugs and depression," Budden told the Combat Jack radio show in December. "They go hand in hand with one another."

Such openness about mental health issues -- and the self-medication that illegal drugs can provide -- has historically not always been the case in the African-American culture.

"The African American community generally has a certain amount of circumspection as it pertains to psychiatry and mental health, and reasonably so," said Dr. Drew Pinsky, host of HLN's "Dr. Drew on Call."

"(Those medical disciplines) have ill-served that community historically, and there's a certain amount of distrust, and you can't do this work without absolute trust," he said. "There's also a lack of embrace of things like 12-step (programs) and the idea that these are long-term propositions to get better from."

That historical reticence -- coupled with a life of fame that often finds celebs of all races surrounded by entourages who may not be willing to offer tough love -- can contribute to the issue.

"There's also a cultural insulation," Pinsky said "They don't want to change, like many addicts and musicians."

Rap artist DMX appeared on Pinsky's show "Dr. Drew's Lifechangers" in 2011 and said he began using drugs at the age of 14, and the wealth he acquired accelerated his drug use. According to Billboard, the rapper has had dozens of arrests, and as of 2010 they tallied 26 convictions -- 11 felonies and 15 misdemeanors. Some of those have included drug charges.

Jermaine Hall, editor-in-chief of Vibe magazine, told CNN that some rappers have now moved well beyond drinking and smoking marijuana. Hall said he believes "the casual drugs are different now."

"Now we have pills, now we also have Molly (the crystal or powder form of the drug MDMA), and I would say to the late 2000s, we also had the ecstasy rush," Hall said. "So we're dealing with different levels of drugs that are now being considered recreational, which is a very dangerous situation."

But journalist and San Francisco State adjunct professor Davey D said drugs have long been a problem in the music industry as a whole, not just hip-hop. Artists referencing drugs goes back as far as jazz star Cab Calloway's "Reefer Man" in 1932, and use has been well-known on down through rockers like Kurt Cobain and others who suffered overdoses.

"The whole adage behind 'sex drugs and rock 'n' roll' is something that people kind of conveniently forget about," he said. "Not to say that it's right, but in terms of suddenly saying 'Well these guys are [rapping] about purple syrup' and overlook the LSD and psychedelic stage in music ... is just ridiculous."

Davey D said the issue of drugs in hip hop is "systemic with an economic incentive to keep it going."

"When these artists are on drugs and they are able to do their music or it gives them a certain notoriety, then everybody's cool with it because it kind of adds to the allure and mystique," he said. "The artists themselves, sure they should take some responsibility, but if they actually have a substance abuse problem, whether they are a drinker or whether they are someone using mind altering substances...then they actually have a disease that needs to be cured, and I don't know if you suddenly do that on your own.

"So then we have to ask questions of the multimillion-dollar record label that they are on: 'Why are you putting this out and why are you allowing this to exist?'"

Harold Owens, the senior director for MusiCares Musicians Assistance Program -- which is funded by the Grammy Foundation -- has witnessed the addiction struggles of musicians across various genres. He's staged interventions for some.

There is a stigma in the hip-hop community, Owens said, about coming clean and discussing it in a genre that many feel has helped promote drug use.

"There could be many sober hip-hop artists -- in the community that have gotten sober, or at least more than a few that just don't talk about it." Owens said.

JasFly, who is also a cast member of the soon-to-debut VH1 reality show "The Gossip Game," which explores the lives of female journalists and bloggers who cover hip-hop, said she worries there may be more of a focus on preserving Lil Wayne's image. Helping him, if that's what he needs, doesn't seem to be a priority, she said.

"There seems to be a lot of concern about Lil Wayne the business," she said. "But what about Dwayne Carter the person?"