Substance guides
Tianeptine (gas station heroin): The dangerous supplement
Tianeptine is sold as a supplement (ZaZa, Tianna, Neptune Fix) at gas stations and convenience stores but acts as an opioid agonist at high doses, producing effects similar to heroin and causing severe opioid-like withdrawal.
What it is
Tianeptine is a prescription antidepressant in other countries that at therapeutic doses (12.5mg) affects the serotonin system. At the doses used recreationally (100-1000+mg), it acts primarily on mu-opioid receptors, producing opioid-like euphoria.
The danger
Opioid-like overdose at high doses including respiratory depression. Severe opioid withdrawal upon cessation of heavy use. No quality control or dosing standardization. Frequently taken in massive doses (20-80x the therapeutic dose).
Withdrawal
Tianeptine withdrawal closely resembles opioid withdrawal: muscle aches, nausea, diarrhea, anxiety, insomnia, and severe cravings. Buprenorphine (Suboxone) has been used successfully to manage tianeptine withdrawal.
Regulatory response
Several states have banned tianeptine. FDA has issued warnings. Poison control center calls related to tianeptine have increased dramatically.
Frequently asked questions
What is gas station heroin?
Is tianeptine dangerous?
Is tianeptine legal?
Disclaimer: Informational only. Not medical advice. SAMHSA: 1-800-662-4357.