Tianeptine, Often Referred to as “Gas Station Heroin,” Is Addictive and Has Serious Side Effects

WASHINGTON (AP) — Health authorities are urging consumers to proceed with caution before buying those small, vibrant bottles often found in gas stations, convenience stores, and smoke shops.

Commonly referred to as “gas station heroin,” these products are marketed as energy shots or cognitive enhancers but actually contain tianeptine, an unapproved and addictive substance that carries significant risk of severe side effects.

The U.S. Toxicology Control Center has noted a consistent rise in reports associated with this drug over the past decade. Last month, the Food and Drug Administration issued a warning to healthcare professionals regarding “the inherent dangers posed by the size of these products.”

Here’s what you should know about gas station heroin:

How are these products sold in the US?

Tianeptine is generally recognized as an antidepressant, typically administered in low-dose tablets taken three times daily. However, it has never received FDA approval for any medical indication in the U.S.

Moreover, this drug cannot legally be incorporated into foods or beverages, nor can it be marketed as a dietary supplement—a warning the FDA has repeatedly emphasized to U.S. companies.

Yet, companies operating in the shadows frequently sell tianeptine in various formulations under brand names like Zaza, Teana, Pegasus, and TD Red. Although it is technically illegal, the FDA does not pre-screen ingredients added to supplements or drinks.

“This exists in a grey area of consumer products or supplements, where the contents aren’t regulated or tested like drug therapies,” explains Dr. Diane Carrero from the New Jersey Poison Information and Education System.

Last year, Callello and her team published a study highlighting a cluster of emergency calls in New Jersey linked to a flavored elixir known as Neptune’s Fix. Individuals experienced symptoms like pain, rapid heartbeat, hypotension, and seizures after consumption. Of the 20 patients, over 12 required hospitalization for intensive care.

Why use these products?

Many tianeptine products tout their potential to treat conditions such as addiction, pain, and depression—without solid evidence or FDA endorsement.

In 2018, the FDA sent a warning letter to the manufacturer of a product called Tianna, which claimed to provide an “unparalleled solution to cravings for opiates.”

While tianeptine is not an opioid, it can bind to certain brain receptors and produce temporary effects resembling those of oxycodone and other opioids. It also poses similar physiological risks, including the potential for fatal respiratory depression.

“We’ve seen numerous cases of distress concerning this substance,” remarked Hannah Hayes, PhD, from National Children’s Hospital in Columbus, Ohio. “People are using it for opioid-like effects and self-managing opioid withdrawal, which can lead to respiratory issues.”

Individuals grappling with opioid addiction, pain, depression, anxiety, or other conditions should consult healthcare professionals to secure FDA-approved treatments, Hayes urged.

Is tianeptine use rising?

Experts are uncertain, but national statistics indicate a marked surge in emergency calls involving this drug.

According to data published earlier this year, calls to poison control centers escalated by 525% between 2018 and 2023, with approximately 40% of cases necessitating medical attention.

One theory behind the rising call volume is simply increased use of the product by Americans.

However, experts also suggest that as the substance becomes more potent and perilous, it leads to a greater number of emergencies. Research from New Jersey investigating Neptune’s changes found that some liquids also contained synthetic cannabis and other drugs.

“You have no idea what’s in that bottle,” Carrero emphasized. “It’s crucial for people to understand that even if they’ve used similar products before, they could end up with a bottle containing something entirely different from what they expect.”

Are there any policies that can reduce the use of tianeptine?

Tianeptine is not classified under federal controlled substances laws that outlaw or restrict drugs lacking medical utility, such as heroin, LSD, or PCP, or those likely to be abused. However, about 12 states have enacted regulations banning or limiting tianeptine, including Alabama, Georgia, Michigan, Minnesota, Ohio, and Tennessee.

In some instances, these regulations have led to an increase in withdrawal symptoms among tianeptine users, as the substance is chemically addictive. Nevertheless, state data indicates some success in mitigating drug-related harm.

Until recently, Alabama reported the highest rate of tianeptine-related calls in the Southern United States, with an increase of over 1,400% between 2018 and 2021.

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The Associated Press School of Health Sciences is supported by the Howard Hughes Medical Institution’s Science and Education Media Group and the Robert Wood Johnson Foundation. AP is solely responsible for all content.