More States Ban ‘Gas Station Heroin’ as Health Concerns Intensify

A dangerous substance nicknamed “gas station heroin” is drawing increased scrutiny from state governments across the nation, with Connecticut becoming the latest state to officially ban the sale and use of tianeptine. The prohibition, which took effect Wednesday, brings the total number of states classifying the tricyclic antidepressant as a Schedule I controlled substance to fourteen.

Health officials have raised serious concerns about tianeptine, which can produce euphoria in higher doses and has been found to be more potent than morphine and other addictive opioids, according to the U.S. Food and Drug Administration.

“I am very concerned,” FDA Commissioner Martin Makary wrote in a recent letter about 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.”

The drug, which has never been FDA-approved as a medication or dietary supplement in the United States, is commonly sold at convenience stores, gas stations, vape shops, and through online retailers. Products containing tianeptine go by brand names such as Tianaa, ZaZa, Neptune’s Fix, Pegasus, and TD Red, often marketed as remedies for pain, anxiety, depression, or cognitive enhancement.

Companies typically sell tianeptine in pill, powder, salt, or liquid forms, with some products featuring candy-like flavoring that critics say could appeal to younger consumers.

“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,” said Connecticut Lieutenant Governor Susan Bysiewicz in announcing the state’s ban.

Connecticut’s action goes beyond tianeptine to include several other substances of concern, including Mitragyna speciosa (kratom), 7 hydroxymitragynine, Bromazolam, Flubromazolam, Nitazenes, and Phenibut under the Schedule I classification.

Health experts point to tianeptine’s pharmacological properties as the source of its danger. At lower doses, the drug produces mood-enhancing effects by affecting serotonin reuptake. However, at higher doses, it activates opioid receptors in the brain, creating euphoric effects similar to those of traditional opioids.

Dr. Robert Schwaner, vice chair of system clinical affairs at Stony Brook Emergency Medicine in New York, explained the escalating risk pattern: “The euphoria at low doses is primarily due to increased serotonergic activity from its serotonin reuptake effects. With increasing doses, the mu-opioid receptor stimulation may become lethal.”

The consequences of misuse can be severe. According to the Drug Enforcement Administration, tianeptine can cause respiratory depression, severe sedation, and death. Users can develop tolerance and dependence, leading to withdrawal symptoms similar to those experienced with opioid addiction.

“Acting at the same receptor as opioids, tianeptine has the potential for an individual to develop tolerance, subsequent dependence and withdrawal from its use,” Dr. Schwaner cautioned. He advocates for national regulation of the substance due to its addictive properties.

Some countries outside the United States where tianeptine is prescribed medically have already taken steps to restrict how it’s dispensed and have updated product labels to warn about addiction potential.

The growing trend of state-level bans reflects mounting evidence of tianeptine’s dangers and an increasing number of emergency room visits and poison control center calls related to the substance. Public health officials are particularly concerned about the easy accessibility of these products and marketing that often suggests they’re safe alternatives to prescription medications.

As more states consider similar restrictions, health officials continue to warn consumers about the risks associated with unregulated substances sold as supplements or remedies, particularly those with opioid-like effects that can lead to serious health consequences.