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Gas Station Heroin: Dangers & Public Health Concerns 

Gas station heroin is a slang term for tianeptine, an antidepressant medication used in other countries. Tianeptine attaches to the same receptors used by illegal drugs like heroin. It’s been linked to serious health problems, including overdose and addiction. 

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While tianeptine is dangerous, it’s not regulated under the Controlled Substances Act. Some states have banned the substance, but others haven’t. That means gas station heroin remains widely available. Consumers may not realize how deadly this drug really is. 

What Is Gas Station Heroin?

Tianeptine is a medication approved in other countries as a treatment for anxiety and depression.[1] When it’s bundled into products sold over the counter, it’s typically called by its slang name: gas station heroin. 

Many companies market and sell products with tianeptine. The following items contain the drug:[1]

  • Neptune’s Fix
  • ZaZa Red
  • Tianna Red 

It’s usually sold in a brightly colored bottle decorated with cartoon characters. Consumers can open the bottles and drink the liquid in a few swallows. They may not be aware that the substance they’re drinking contains tianeptine. 

Other names for the active ingredient include tianeptine sulfate, tianeptine sodium powder, and tianaa.[2] These elements might be listed in product ingredients, but consumers may not be aware of what the terms mean.

How Does Tianeptine Work?

In the early 2000s, researchers thought tianeptine was safer than other antidepressant medications. They said the drug increased serotonin and didn’t cause problems with sleep or thought patterns. They also said it had a low potential for abuse.[3] A lot has changed since then. 

Current research suggests tianeptine latches to opioid receptors in the brain, triggering euphoria.[4] Just as substances like heroin latch to opioid receptors and cause a profound shift in the way people think and feel, so does tianeptine. 

Researchers say most tianeptine doses leave the body within about 12 hours.[1] This short period can be dangerous. People who take the drug experience a big rush that fades away fast. Drugs that work this way are typically considered more addictive than long-lasting versions. 

Researchers also say that tianeptine carries a significant risk of overdose.[5] All opioid drugs are central nervous system depressants, capable of slowing breathing and heart rates. If people take too much and these critical systems aren’t functioning properly, people can die. 

Is Gas Station Heroin Legal?

Authorities like the U.S. Food and Drug Administration (FDA) use the Controlled Substances Act to rank drugs and create penalties for abuse. Tianeptine is not currently controlled under this law.[4] It’s not technically illegal to use the drug in many parts of the United States.

Tianeptine abuse is a growing problem. Poison control cases involving the drug rose from 11 between 2000 and 2013 to 151 in 2020 alone.[6] As more people use the drug and become sick, more people push their elected officials to act. 

States like Alabama, Michigan, Mississippi, and Florida have responded. At least 12 states have banned tianeptine, says the FDA.[7] However, the federal government hasn’t done the same. 

Is Tianeptine Harmful? 

Researchers say tianeptine is a harmful drug that can cause a variety of very serious health problems. 

In calls to poison control centers, people described neurological, cardiovascular, and gastrointestinal symptoms after using tianeptine. Of those who went to the hospital for help, 44% were treated and released, but 24% required help in a critical care unit.[8]

Poison control centers also got calls about tianeptine withdrawal symptoms. In those calls, people reported symptoms like the following:[8]

  • Agitation
  • Nausea
  • Vomiting
  • Fast heartbeat
  • High blood pressure 
  • Tremor 

These symptoms are similar to those seen in people who quit other opioid drugs like heroin. Without treatment, severe diarrhea and vomiting can lead to life-threatening dehydration. Withdrawal symptoms can also keep people from quitting drugs, as they relapse to make the discomfort stop. 

The FDA also says people have experienced harmful side effects like agitation, drowsiness, and sedation when combining tianeptine with drugs like antidepressants and anti-anxiety therapies. Some people have died from these interactions.[6]

How to Help Someone Experiencing an Overdose 

Opioid drugs are central nervous system depressants, and they can cause overdoses at high levels. If someone has used tianeptine and you can’t wake them up, even after shaking them, you must act. 

The National Capital Poison Center recommends using naloxone to help people overdosing on tianeptine.[1] Since tianeptine latches to opioid receptors, naloxone could reduce that connection and restore normal breathing. 

In March 2023, the FDA approved an over-the-counter version of naloxone.[9] You can buy this drug without a prescription at any pharmacy. These products are typically sold as nasal sprays. Put the tip of the nozzle in the person’s nose and depress it. 

Once you’ve given naloxone, call 911 and tell the operator what has happened and what you’ve done to help. Stay with the person until trained medical staff arrive. 

How to Quit Tianeptine 

Withdrawal symptoms can make quitting gas station heroin difficult. There is hope. A qualified treatment program can use medications like buprenorphine and methadone to help you withdraw from the drug safely. Then, you can enroll in treatment and rebuild your life for the better. 

If you’re using tianeptine, talk to your doctor about getting the help you need. You can also reach out to us here at Boca Recovery Center for assistance.

Updated March 19, 2024
Resources
  1.  Amirshahi M. Tianeptine: Gas station heroin. National Capital Poison Center. Accessed February 23, 2024.
  2. Tianeptine in dietary supplements. U.S. Food and Drug Administration. Published February 22, 2023. Accessed February 23, 2024.
  3. Wagstaff A, Ormrod D, Spencer C. Tianeptine: A review of its use in depressive disorders. CNS Drugs. 2001;15(3):231-59.
  4. Tianeptine. Drug Enforcement Administration. Published February 2024. Accessed February 23, 2024.
  5. Edinoff AN, Sall S, Beckman SP, et al. Tianeptine, an antidepressant with opioid agonist effects: Pharmacology and abuse potential, a narrative review. Pain and Therapy. 2023;12(5):1121-1134.
  6. Tianeptine products linked to serious harm, overdoses, death. U.S. Food and Drug Administration. Published February 10, 2022. Accessed February 23, 2024.
  7. Letter. U.S. Food and Drug Administration. Published January 11, 2024. Accessed February 23, 2024.
  8. Zahran T, Schier J, Glidden E, et al. Characteristics of tianeptine exposures reported to the National Poison Data System, United States, 2000-2017. Morbidity and Mortality Weekly Report. 2018;67(30):815-818.
  9. FDA approves first over-the-counter naloxone nasal spray. U.S. Food and Drug Administration. Published March 29, 2023. Accessed February 23, 2024.
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