Tianeptine was developed decades ago to treat depression and anxiety, but today, this drug is earning a far more nefarious reputation as “gas station heroin.”
The Rise of Tianeptine Abuse
Tianeptine is an antidepressant sold under brands like Stablon and Coaxil. Though not approved for any medical use by the U.S. Food and Drug Administration (FDA), the drug is approved to treat depression and anxiety in other countries. Still, its use is limited due to inconsistent results and high abuse potential.In the United States, tianeptine is often sold over the counter as a supplement. Its widespread availability at gas stations and convenience stores—where it is often sold in capsule form and used as an ingredient in energy drinks—has fueled misuse. Tianeptine provides euphoria and relieves opioid withdrawal.
In January, the FDA warned about Neptune’s Fix drinks containing tianeptine, which is linked to seizures, unconsciousness, and death.
Similar to what’s happening with other “gas station drugs,” the increasing incidence of people experiencing harmful effects has brought attention to the use of tianeptine within the medical community, Dr. Nima Majlesi, director of medical toxicology at Staten Island University Hospital in New York, told The Epoch Times.
Deceptive Marketing and Legal Loopholes
Deceptive marketing exacerbates issues, touting improved mood, energy, and sexual performance as well as cognitive benefits, Dr. Majlesi said. Worse, companies making the drug exploit the opioid crisis, he added.“The manufacturers have even gone so far as to claim that they can reduce the symptoms of opioid withdrawal,” Dr. Majlesi noted.
Manufacturers evade bans by tweaking chemical structures or mislabeling. Lack of oversight also allows erratic dosing, heightening toxicity risks.
Health Dangers of Tianeptine Abuse
Despite its reputation as a “legal high,” tianeptine abuse poses the following serious health risks:- Addiction: With prolonged, high-dose use, tianeptine can cause physical dependence and addiction. Users build tolerance, requiring more for desired effects, thus increasing overdose and withdrawal risks. Its opioid-like potential for abuse is how it earned the nickname “gas station heroin,” Dr. Majlesi said.
- Heart problems: Tianeptine abuse has been tied to hypertension, rapid heart rate, and heart attacks. All of these are especially dangerous for those with preexisting conditions.
- Psychiatric symptoms: Chronic abuse may trigger or worsen psychiatric disorders like anxiety, depression, and psychosis. Stopping suddenly can also cause withdrawal symptoms, including agitation, insomnia, and dysphoria.
- Death: Tianeptine overdose can lead to respiratory depression, seizures, coma, and even death. Risk heightens when combined with other depressants like alcohol or opioids.
Tianeptine and the Opioid Crisis
Tianeptine is contributing to the opioid crisis, which impacts nearly 3 million people aged 12 and above in the United States.“Exposure to these types of substances increases the risk of opioid use disorder developing,” Dr. Majlesi said. “People who need treatment should seek out a provider who can prescribe buprenorphine.” Additionally, supervised methadone use is a safer alternative.
In support of the FDA’s efforts to restrict tianeptine distribution, the U.S. Department of Justice, in collaboration with the FDA’s Office of Criminal Investigations and the U.S. Postal Inspection Service, is taking enforcement actions against individuals and entities distributing tianeptine-containing products.
Although tianeptine is banned in only 12 states, according to the FDA, it remains readily accessible by traveling to states where it is legally available.