Tianeptine, which is often called “gas station heroin,” is an antidepressant medication used in Europe but not the United States. Its pharmacology is somewhat complicated, as it shares the properties of both tricyclic antidepressant and opioid medications. These opioid properties are why many people misuse them or use them to self-medicate other opioid withdrawal symptoms.
Whether you’re in recovery from an opioid use disorder (OUD) or you’ve never taken opioids before, these pills are dangerous. They can trigger many of the same reactions opioids do and are extremely addictive.
Tianeptine is not regulated here in the U.S., so each pill also could be dangerous due to contamination. You may not know what’s inside the doses you take. Despite its dangers, tianeptine is not a federally scheduled drug.
However, certain states, such as Florida, Alabama, Tennessee, Ohio and beyond, have banned tianeptine, making it a Schedule I controlled substance. This means it has no medical use, is illegal to possess and use, and is extremely addictive.
The tianeptine ban in Florida and other states may result in countless people going through abrupt tianeptine withdrawal, which can be very severe and painful. Since tianeptine has opioid properties, MAT options like Suboxone can relieve symptoms and cravings and help you on the road to recovery.
What Is Tianeptine?
Tianeptine is an atypical antidepressant that also has some opioid properties. It has a half-life of one to two hours.[2] It’s not prescribed in the U.S. Instead, it’s considered a dietary supplement and is sold under brand names, such as:
- Tianaa
- Pegasus
- Zaza
Tianeptine products are regulated via the 1994 Dietary Supplement Health and Education Act (DSHEA). Under DSHEA, pre-market testing is not required to assess the purity, efficacy or safety of substances marketed as supplements. Manufacturers also don’t have to tell their customers about the harm their products can cause.
Tianeptine works on opioid receptors, and it’s inherently dangerous. But manufacturers aren’t required to disclose this fact on their labels.
How Is Tianeptine Used?
The United States Food and Drug Administration (FDA) hasn’t approved tianeptine for any medical or commercial use, but it’s moved into the United States anyway.
Officials have encountered tianeptine products in stamp bags typically used to distribute heroin.[3] This packaging suggests some people buy the drug from dealers, or they buy bags they think contain heroin but that contain something else instead.
Experts say tianeptine is also sold in the United States via online merchants, and in some states, it’s sold in convenience stores in packages that suggest it could make you smarter or more focused.[1] People who buy these packages may think they’re using a safe herbal supplement to make them perform better at work or school.
In Europe, some people may use tianeptine with a prescription to ease depression. But in the United States, people may use the drug for various reasons, such as:
- To get high
- To relieve other opioid withdrawal symptoms
- To self-medicate depression or anxiety
Dangers of Tianeptine Misuse
Any supplement you buy could be dangerous because the FDA doesn’t regulate supplements like medications. Tianeptine could be particularly risky for people with opioid use disorder (OUD) and those without OUD alike.
Contamination
Substances that claim to contain tianeptine can often contain other substances or other opioids instead. If you purchase tianeptine illegally, you don’t really know what substance you are getting or how much.[3]
Risk of Opioid Misuse
You might buy tianeptine products to treat cravings or withdrawal symptoms from opioids. However, tianeptine has misuse potential for people in recovery from OUDs.[4]
Additionally, tianeptine is sometimes the first opioid drug people encounter, especially since it is readily available in convenience stores and gas stations. This drug is highly addictive and can cause compulsive misuse and tianeptine withdrawal symptoms.
Risk of Overdose
Tianeptine is an opioid medication and thus carries the same risks as other opioids, including respiratory depression, overdose and death.[5]
What the Tianeptine Bans Mean for People Who Use This Drug
The states that have banned tianeptine include:
- Mississippi
- Ohio
- Kentucky
- Indiana
- Michigan
- Oklahoma
- Georgia
- Minnesota
- Tennessee
- Alabama
- Florida
Florida is the most recent state to ban tianeptine, which means people in Florida who misuse it and are dependent on it may soon go into tianeptine withdrawal as their supplies run out. Tianeptine withdrawal symptoms resemble opioid withdrawal and are extremely distressing and painful.
Typical withdrawal symptoms for this drug include:[6]
- Nausea and vomiting
- Stomach cramping
- Diarrhea
- Chills and sweating
- Goosebumps
- Insomnia
- Extreme anxiety
- Agitation
- Restless legs
- Runny nose and tearing eyes
- Muscle aches and joint pain
These withdrawal symptoms can be so severe that people may seek out other opioids, such as prescription painkillers or heroin, in order to relieve these symptoms and feel better. This can be extremely dangerous and lead to opioid overdose or a continued cycle of opioid misuse.
Other people may start buying tianeptine online or will drive across state lines to obtain this addictive drug.
Suboxone Treatment for Tianeptine Withdrawal and Addiction
Because tianeptine withdrawal is the same as opioid withdrawal, there are thankfully evidence-based medications out there that can save your life and help you achieve sobriety.
Suboxone is a Medication for Addiction Treatment (MAT) consisting of buprenorphine, a partial opioid agonist, and naloxone, an opioid antagonist. Suboxone can help treat tianeptine addiction or opioid use disorder by:[7]
- Reducing tianeptine cravings
- Alleviating tianeptine withdrawal symptoms
- Reducing the risk of relapse to tianeptine or other opioids
- Increasing retention in rehab
If you are affected by the recent tianeptine ban and need immediate treatment, you can get emergency or same-day Suboxone through one of our online providers at Bicycle Health.
Reviewed By Peter Manza, PhD
Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More
- Tianeptine Use: Another Dangerous Substance Emerges During Opioid Crisis. Healio. https://www.healio.com/news/primary-care/20201201/tianeptine-use-another-dangerous-substance-emerges-during-opioid-crisis. December 2020. Accessed October 2023.
- Pharmacokinetic Study of Tianeptine and Its Active Metabolite MC5 in Rats Following Different Routes of Administration Using a Novel Liquid Chromatography Tandem Mass Spectrometry Analytical Method. Naunyn-Schmiedeberg’s Archives of Pharmacology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5778159/. December 2017. Accessed October 2023.
- Tianeptine. Drug Enforcement Administration. https://www.deadiversion.usdoj.gov/drug_chem_info/tianeptine.pdf. January 2023. Accessed October 2023.
- Characteristics of Tianeptine Exposures Reported to the National Poison Data System, United States, 2000 to 2017. Centers for Disease Control and Prevention. https://www.cdc.gov/mmwr/volumes/67/wr/mm6730a2.htm. August 2018. Accessed October 2023.
- Tianeptine Products Linked to Serious Harm, Overdoses, Death. Food and Drug Administration. https://www.fda.gov/consumers/consumer-updates/tianeptine-products-linked-serious-harm-overdoses-death. February 2022. Accessed October 2023.
- Opiate and opioid withdrawal. U.S. National Library of Medicine. https://medlineplus.gov/ency/article/000949.htm. April 2022. Accessed October 2023.
- Medications for Substance Use Disorders. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medications-substance-use-disorders. July 2023. Accessed October 2023.
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