A dangerous substance known as gas station heroin is alarming medical professionals across the country. More states are now making moves to restrict or completely ban tianeptine to protect their communities. Fourteen states have officially classified the tricyclic antidepressant as a Schedule I controlled substance.
Connecticut is the latest state to crack down on the dangerous drug. The state officially banned the sale and use of the substance starting on Wednesday.
The U.S. Food and Drug Administration warns that tianeptine can produce euphoria in higher doses. The agency notes it can be more potent than morphine and other addictive opioids. Misuse can cause severe adverse health effects, including respiratory depression, severe sedation, and death, according to the Drug Enforcement Administration.
Some companies market the drug as an aid for pain, anxiety, and depression. It is often sold to improve mental alertness in pill, powder, salt, or liquid forms. The products are typically found at convenience stores, gas stations, and vape shops under names like Tianaa, ZaZa, and Neptune’s Fix.
Connecticut Lieutenant Governor Susan Bysiewicz stated that the schedule change is a necessary step to combat addiction. "With false marketing that led consumers to believe these are safe products, and with candy-like flavor options, these substances posed a clear threat to those battling substance-use disorder and our youngest residents," she added.
The Nutmeg State also added kratom and several other similar substances to the schedule classification. FDA Commissioner Martin Makary recently penned a letter sounding the alarm on the drug. He called the widespread availability of tianeptine a "dangerous and growing health trend."
"I am very concerned," Makary wrote regarding the accessibility of the substance. "I want the public to be especially aware of this dangerous product and the serious and continuing risk it poses to America’s youth."
Dr. Robert Schwaner of Stony Brook Emergency Medicine noted that the FDA has never approved tianeptine as a dietary supplement. "The euphoria at low doses is primarily due to increased serotonergic activity from its serotonin reuptake effects," Schwaner said. "With increasing doses, the mu-opioid receptor stimulation may become lethal."
He warned that the drug carries the exact same lethal risks as traditional street narcotics. "As with heroin and other opioids, significant mu-opioid receptor stimulation ultimately results in a loss of respiratory drive and subsequent cardiac arrest," Schwaner explained.
Schwaner believes the substance requires national regulation due to its highly addictive qualities. "Acting at the same receptor as opioids, tianeptine has the potential for an individual to develop tolerance, subsequent dependence and withdrawal from its use," he cautioned.