A drug called tianeptine, known colloquially as “gas station heroin,” has been banned by several states. It’s being marketed as a dietary supplement, but some users are describing it as a highly addictive opioid.
Tianeptine is a tricyclic antidepressant used to treat depression in some European, Latin American, and Asian countries, but it’s not approved by the FDA for medical use in the U.S. It’s not a controlled substance and is typically sold in the U.S. as a dietary supplement, nootropic (a chemical that improves cognitive function), or a research chemical under brand names like ZaZa Red, TD Red, and Tianna. It can be found in gas stations or easily bought online.
Medical experts say tianeptine functions as an opioid because it hits opioid receptors in the brain, which explains why people have reported severe withdrawal when they try to stop using it.
“People are using it either to manage or withdrawal 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,” said Dr. Patrick Marshalek, an associate professor at West Virginia University’s School of Medicine.
There’s very little known about tianeptine, including how many people are using it, though reports from both the FDA and the DEA have noted upticks in poison control calls about the drug up until at least 2020. It’s been banned in Michigan, Alabama, Minnesota, Tennessee, Georgia, and Indiana; officials in Mississippi issued a health alert about it earlier this year.
Experts told VICE News the issues surrounding its use are part of a larger problem where unregulated substances mimic the effects of illicit drugs, despite being marketed in a benign way.
If you've had adverse reactions or gotten addicted to tianeptine or other drugs marketed as supplements, we'd like to hear from you. Email firstname.lastname@example.org.
Hunter Barnett, 26, who has a painful esophagus condition and has been addicted to opioids in the past, was skeptical that the tianeptine could be effective. But when he moved to Penscacola, Florida, from Alabama in January, he noticed that every time he went to the gas station, people were buying ZaZa Reds.
“I'm sitting there thinking it's a gas station, this shit ain’t gonna be any good,” he told VICE News.
Still, he bought some and eventually switched over to a brand called TD Red, which he described as feeling like a mix of Percocets and cocaine.
“They were amazing. Like wow it took away all the pain,” Barnett said. But within five days, he said he began upping his dose. While he started taking three at a time, every few hours, he can now take an entire bottle of 15 pills in one go.
“It was definitely one of the biggest mistakes in my life. I wish I would have never touched them,” he said.
“It was definitely one of the biggest mistakes in my life. I wish I would have never touched them.”
Barnett said tianeptine’s effects wear off quickly. He would sometimes take them before bed and have to wake up in the middle of the night to take more to avoid going into withdrawal. He said he began going through three to six bottles a day, each costing $30.
He said he started working his job delivering groceries via Instacart every day but was still broke due to how much he was spending on the pills.
“I’ve spent about $50,000 since January on these,” he said.
When Barnett spoke to VICE News, he said he’d just come off a 10-day detox that was more difficult than when he came off opioids like oxycodone, fentanyl, and buprenorphine. He said he experienced nausea, sweats, vomiting, fever, body pain, and relentless chills.
“The withdrawal, I can honestly say, is the absolute worst experience of my life,” he said.
Kirsten Smith, a researcher with the National Institute on Drug Abuse, said a couple factors impact the severe withdrawal: the incredibly high doses that some people are taking and the fact that many of these products include proprietary blends, so nobody really knows what’s inside them.
“Tianeptine is part of a broader story of people taking a bunch of crap and not knowing what they’re taking,” Smith said, adding that she hasn’t heard of any researchers buying tianeptine products and testing what’s in them, likely because it’s not on anyone’s radar.
Smith was lead author of a paper on Reddit posts about tianeptine from 2012-2020 that was published in the American Journal of Drug and Alcohol Abuse last year. She said 81 percent of posts likened tianeptine to an opioid, 83 percent mentioned addiction, and over 70 percent mentioned withdrawal. A subreddit called r/QuittingTianeptine has more than 3,800 members, with people sharing horror stories of their withdrawal and giving each other advice on how to get off the drug.
One online ad for ZaZa Red boasted that it’s “great for pain relief” and “provides a euphoric and energizing mood lift,” but noted, “ZaZa RED works on the same receptors as traditional opiates so Be Mindful!”
Another positioned tianeptine as an alternative to alcohol and weed, stating, “In just one capsule, your stress, your anxiety all melt away almost instantly.”
VICE News reached out to several manufacturers and retailers that sell tianeptine to ask for comment on the health concerns surrounding the drug but did not receive a response.
In February, the FDA issued a warning stating that tianeptine has been associated with serious harm, overdoses, and death. The warning said tianeptine retailers are “making dangerous and unproven claims that tianeptine can improve brain function and treat anxiety, depression, pain, opioid use disorder, and other conditions.” It said people with opioid addictions are particularly at risk when using tianeptine and that some of the adverse effects are agitation, drowsiness, confusion, sweating, rapid heartbeat, high blood pressure, nausea, vomiting, slowed or stopped breathing, coma, and death.
Although he hasn’t heard of widespread tianeptine use, Marshalek said he sees the drug falling into a similar landscape as synthetic cannabinoids and bath salts. And like those substances, he sees the target users as being people who can’t access more traditional drugs or people who regularly get drug tested.
“You think you're doing safe stuff because it's not street drugs, but it's kind of maybe a little bit closer to it than you would think,” he said. It’s a scenario that plays out time and time again with prohibition, he added, where people turn to legal highs or more potent drugs when something becomes illegal.
Marshalek said companies can take advantage of the fact that there’s very little oversight of these substances.
“Can you trust these folks that are really looking to make money and only do that? Do they have the same safety practices that pharmaceutical companies would or the same degree of oversight from the FDA?”
Barnett said he feels very misled by the marketing around tianeptine and would support a ban, or at the very least, more warnings.
“Be honest on the damn bottle and be like this is super fucking addictive, you know what I mean? Don't call them dietary supplements because they’re not,” he said.
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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