‘Gas Station Heroin’: Lawmakers Question FDA on Proliferation of Addictive Opioid-Like Drug

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‘You have to keep using it to keep from withdrawing. And when you do withdraw off it, it’s like you are withdrawing off two to three drugs at one time’

A bipartisan group of lawmakers sent a letter to the Food and Drug Administration (FDA) last week over the use of an “extremely addictive” drug called tianeptine, questioning how the agency intends to deal with it.

“We write to request information about the FDA’s actions to address tianeptine use. Tianeptine, which is commonly known as ‘gas station heroin’ and sold under brand names like Zaza and Tianna, has opioid-like qualities and is extremely addictive,” the lawmakers wrote in a Jan. 18 letter to the FDA commissioner. “We urge the FDA to take immediate action to research and provide guidance on tianeptine use.”

“Recent reporting indicates that … tianeptine withdrawal symptoms are strikingly similar to opioid withdrawal symptoms, including nausea, chills, and insomnia. Recent medical research indicates that tianeptine can cause fatal overdoses.”

Tianeptine is classified as a tricyclic antidepressant and was in use before Prozac became available in the 80s. Prozac falls under the category of serotonin reuptake inhibitors (SSRIs). The difference between the two is that while SSRIs take several weeks to take effect, tricyclic antidepressants have immediate effects.

“You don’t have to take it for very long before you get physically dependent on it,” Dr. Melissa Thompson of the Ivy Creek Detox Program at Elmore Community Hospital in Wetumpka, Alabama, told The Epoch Times last year.

“Before you know it, you have to keep using it to keep from withdrawing. And when you do withdraw off it, it’s like you are withdrawing off two to three drugs at one time.” A person detoxing from tianeptine could take up to a month to become mentally stable once again, she said. “It’s very powerful, and it gets a hold of your mind.”

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The Jan. 18 letter pointed out that while tianeptine has been approved in certain European, Asian, and Latin American nations, the FDA has never sanctioned it for medical use in the United States.

The antidepressant is not listed under the Controlled Substances Act (CSA) nor is it regulated by the Drug Enforcement Agency (DEA). However, the drug is “widely available for purchase.”

Multiple states have already banned or strictly controlled tianeptine sales, including Alabama, Michigan, Mississippi, Tennessee, Georgia, Indiana, Ohio, Florida, and Kentucky. The letter noted that the FDA had issued three warnings on tianeptine use over the past five years.

In 2018, the agency said that tianeptine users may “inadvertently find themselves addicted to tianeptine and should avoid all products containing this ingredient,” the letter noted. In 2022, the FDA said it received reports suggesting that tianeptine “has a potential for abuse.”

The agency warned people in November 2023 “not to purchase or use Neptune’s Fix or any tianeptine product due to serious risks.” The FDA received “severe adverse event reports after use of Neptune‘s Fix products, including seizures and loss of consciousness leading to hospitalization.”

The lawmakers wrote that while they appreciate FDA warnings, “more action on tianeptine use is needed to ensure the health and well-being of the American people.”

As such, it asked the FDA to answer certain questions regarding tianeptine, including oversight actions, research into the antidepressant, detailing its effects on human health, and whether the drug should be scheduled under the CSA.

“The urgent need for FDA action on tianeptine cannot be overstated. It is vital to support legislative or administrative initiatives that strengthen FDA oversight and provide states greater ability to protect our communities from the dangers posed by substances like tianeptine.”

Addiction Dangers

The FDA said in its 2022 warning that some people began using tianeptine as an alternative to opioids or to self-treat depression and anxiety.

“In the United States, reports of bad reactions and unwanted effects involving tianeptine are increasing. Poison control center cases involving tianeptine exposure have increased nationwide, from 11 total cases between 2000 and 2013 to 151 cases in 2020 alone,” the agency said.

The agency revealed it sent warning letters to companies who were illegally marketing products with tianeptine as dietary supplements and unapproved drugs. It has also issued import alerts to prevent the shipment of the drugs into America.

The Jan. 18 letter by lawmakers followed a recent article by The New York Times detailing the dangers of tianeptine.

In countries where the drug is approved, it is taken in low doses as an antidepressant. However, tianeptine can give a short-lived euphoria when taken in high doses, which prompts some people to see it as a safe alternative to opioids like fentanyl.

“People develop a tolerance very quickly, and so they rapidly start advancing the dosing,” Dawn Sollee, a clinical toxicologist and director of the Poison Control Center in Jacksonville, Florida, told the outlet.

“They will set alarms to wake themselves every two hours to take tianeptine pills so they do not go into withdrawal. And then they have to keep taking more and more just to stay functional.”

In its November 2023 warning, the FDA highlighted that tianeptine is being illegally sold under claims that the drug can “improve brain function and treat anxiety, depression, pain, opioid use disorder, and other conditions.”
Ms. Thompson told The Epoch Times that people who get hooked on tianeptine may not be perceived as addicts.

“Certainly, we are seeing a lot of college students. We are also seeing average people—children and next-door neighbors—who were looking to manage their anxiety and depression … They aren’t who you would think of when you think of addicts,” she said.

People usually come to her to get treated within five days. However, “I’ll give them medicine to taper off for the next 30 days because you can’t really come off of it completely in five days.”

Matt McGregor contributed to the report.

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