An antidepressant is a tianeptine. Although it works like an opioid, it is marketed as a dietary supplement in the United States, particularly at gas stations.
Several states have outlawed tianeptine, also referred to as "gas station heroin." Although it is advertised as a dietary supplement, some users describe it as a highly addictive opioid.
A tricyclic antidepressant called tianeptine is used to treat depression in some European, Latin American, and Asian nations, but the FDA has not given the drug U.S. approval for medical use. It is not a controlled substance and is frequently offered for sale in the United States as a dietary supplement, nootropic (a substance that enhances cognitive function), or research chemical under the brand names ZaZa Red, TD Red, and Tianna. It is readily available online or in gas stations.
According to medical professionals, tianeptine acts as an opioid because it binds to opioid receptors in the brain. This accounts for why users who try to stop using it experience severe withdrawal.
According to Dr. Patrick Marshalek, an associate professor at West Virginia University's School of Medicine, "people are using it either to manage or withdraw from harder, harsher stuff, or they're kind of starting their journey and developing an unhealthy relationship with it based on its effects—and its effects are opioid-like effects."
There is very little information available about tianeptine, including how many people use it, but reports from the DEA and FDA have shown an increase in calls to poison control centers about the drug through at least 2020. In addition to Mississippi, it has been outlawed in Michigan, Alabama, Minnesota, Tennessee, Georgia, and Indiana; earlier this year, health officials in Mississippi issued a warning about it.
According to experts interviewed by VICE News, despite being marketed benignly, unregulated substances that mimic the effects of illicit drugs are a larger issue than the problems associated with their use.
Hunter Barnett, 26, who has a painful esophageal condition and a history of opioid addiction, was dubious about the tianeptine's potential for success. However, when he relocated from Alabama to Pensacola, Florida, in January, he observed that every time he went to the gas station, customers were purchasing ZaZa Reds.
He told VICE News, "I'm sitting there thinking it's a gas station, this shit ain't going to be any good."
Even so, he continued to purchase some and eventually switched to TD Red, which he said had a Percocet and cocaine-like effect.
"They were incredible. Wow, it eliminated all the pain," said Barnett. But after five days, he claimed he started increasing his dosage. He used to take three pills at a time, every few hours, but can now swallow the entire bottle—15 pills—in one sitting.
"It was without a doubt one of my biggest mistakes. He said, "I wish I had never touched them.
According to Barnett, tianeptine's effects subside quickly. To avoid going into withdrawal, he would occasionally take them before going to sleep and then have to get up in the middle of the night to take more. He claimed that he started using three to six $30 bottles per day.
He claimed that despite starting his job as a daily Instacart grocery delivery driver, he was still broke because of how much money he was spending on the pills.
"I've spent about $50,000 on these since January," he claimed.
Barnett told VICE News that his 10-day detox had been more challenging than his previous withdrawals from opioids like oxycodone, fentanyl, and buprenorphine. He claimed to have felt sick, sweated, vomited, feverish, in pain all over, and had constant chills.
He admitted, "The withdrawal, I can honestly say, is the worst experience of my life.
The extremely high doses that some users are taking and the fact that many of these products contain proprietary blends, so nobody knows what's inside, according to researcher Kirsten Smith from the National Institute on Drug Abuse, both have an impact on the severe withdrawal.
Smith stated that "tianeptine is part of a larger story of people taking a bunch of crap and not knowing what they're taking," adding that she hasn't heard of any researchers purchasing tianeptine products and testing what's in them, probably because it's not on anyone's radar.
A paper on tianeptine posts from 2012 to 2020 that was published in the American Journal of Drug and Alcohol Abuse last year had Smith as its lead author. She claimed that over 70% of posts discussed withdrawal and over 80% of posts compared tianeptine to an opioid. More than 3,800 people are active on the Reddit subreddit r/QuittingTianeptine, where they share harrowing tales of their withdrawal and offer one another tips on how to stop using the drug.
While claiming to be "great for pain relief" and to "provide a euphoric and energizing mood lift," a ZaZa Red online advertisement cautioned, "Be Mindful! ZaZa RED works on the same receptors as traditional opiates."
Another advocated using tianeptine instead of marijuana and alcohol, saying, "In just one capsule, your stress and anxiety all melt away almost instantly."
Inquiries about tianeptine's potential side effects were sent to a number of the drug's producers and sellers by VICE News, but no responses were received.
The FDA issued a warning in February stating that tianeptine has been linked to serious harm, overdoses, and fatalities. Retailers of tianeptine, according to the warning, are "making risky and unsupported claims that tianeptine can enhance brain function and treat anxiety, depression, pain, opioid use disorder, and other conditions." It was stated that using tianeptine carries a higher risk of side effects for those who have opioid addictions, some of which include agitation, drowsiness, confusion, sweating, rapid heartbeat, high blood pressure, nausea, vomiting, slowed or stopped breathing coma, and death.
Although he hasn't heard of tianeptine being used extensively, Marshalek said he thinks the substance will end up in the same category as synthetic cannabinoids and bath salts. And like those substances, he believes that the target users are either those who are unable to access more conventional drugs or those who undergo drug testing regularly.
You might think that what you're doing is safe because it's not illegal drugs, but it's somewhat similar. He added that this scenario repeatedly occurs as a result of prohibition, where people turn to stronger drugs or legal highs when something is made illegal.
Companies can profit from the fact that these substances are not heavily regulated, according to Marshalek.
"Can you trust these people who are only interested in making money?" Do they receive the same level of FDA oversight or follow the same safety procedures as pharmaceutical companies?
Barnett claimed he believes the marketing for tianeptine has seriously misled consumers and that he would support a ban or, at the very least, stronger warnings.
You know what I mean: "Be honest on the damn bottle and say things like, 'This is super fucking addictive. Because they are not nutritional supplements, don't call them that, he advised.
He said he plans to move back to Alabama, where tianeptine is banned. Despite the difficulty of his withdrawal, he said he celebrated his 10-day detox by taking 12 pills. But he doesn’t believe it will override the detox.
“I just wanted to celebrate a little bit,” he said. Asked how it felt to take them again, he said, “Amazing. But it doesn't last very long.”
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