Tianeptine “Gas Station Heroin”: A Dangerous Rise

What is Tianeptine?

Tianeptine is a pharmaceutical originally developed and used in parts of Europe, Asia and Latin America for major depressive disorder and related conditions. In those approved markets, it was marketed under trade names such as Coaxil, Stablon, Tatinol. Tianeptine was once thought to act via serotonin reuptake enhancement (rather than the classic SSRI route) but also has documented activity as a µ-opioid receptor (MOR) agonist in higher doses. In the U.S., however, tianeptine is not approved by the Food and Drug Administration (FDA) for any medical condition. That being said, because of its availability via non-traditional retail (gas stations, convenience stores, online), and its opioid-like effects at high doses, it has gained the street name “gas station heroin” and is being seen more regularly in treatment centers as a drug of abuse.

History of Tianeptine – From Antidepressant to Misuse

Tianeptine was first developed in the 1960s in France and introduced in Europe in the early 1980s for depression. Over time it was used in several countries for depression, sometimes anxiety or IBS-related mood issues. In approved countries, tianeptine was taken under medical supervision, typically in therapeutic dose ranges. The U.S. never approved it, so its only legal context in the U.S. has been as unapproved use, often marketed as a “supplement” or “nootropic”. Over the last decade, tianeptine products labeled as dietary supplements, cognitive enhancers or mood boosters began appearing in gas stations, convenience stores, online smoke-shops. It became part of a broader category of what some call “gas-station drugs” — easily obtainable, minimally regulated substances with psycho-active effects. The U.S. poison control and regulatory agencies began sounding alarms. More recently, clusters of severe illness tied to tianeptine-containing elixirs were documented. So, the history moves from a psychiatry drug in regulated settings to an unregulated substance with abuse potential — and now to a public-health threat.

The Increase in Usage in the United States

Several indicators point to a rising trend of misuse of tianeptine in the U.S.:

• The FDA issued warnings in 2024–2025, stating the number of adverse events and deaths involving tianeptine-containing products is increasing.

• Calls to poison control centers involving tianeptine rose 525% between 2018 and 2023.

• In 2025, media outlets and academia noted the rise of use especially among youth, convenience-store purchases, and the ease of online access.

These trends show not only increasing use but increasing harms, which suggests the uptick is meaningful and concerning.

How People Are Becoming Addicted

Mechanism of addiction

Because tianeptine at higher doses acts on the µ-opioid receptor (MOR), it produces effects similar to traditional opioids: euphoria, analgesia, sedation (in some cases), and with repeated use, tolerance and withdrawal. Withdrawal symptoms have been documented that mimic opioid withdrawal: agitation, nausea, vomiting, tremor, sweating, tachycardia, hypertension, diarrhea. Users may begin taking tianeptine to self-treat mood issues, pain, or even opioid withdrawal, but then escalate doses to chase euphoria. Because the drug is marketed as a supplement, some users believe it is safe and “just a mood enhancer,” underestimating its potency. This contributes to misuse. Once high-dose use begins, dependence often follows: users find they need increasing doses to achieve the same effect, and then they experience withdrawal when stopping.

Medical Field Use & Approved Indications

As stated prior, in some countries tianeptine is or has been used to treat major depressive disorder (MDD) and anxiety disorders. However, there are a few key caveats:

• The U.S. FDA has not approved tianeptine for any medical use.

• In approved countries, therapeutic doses are tightly controlled; the abuse risk at high doses is recognized.

• Some recent trials exploring tianeptine’s use in treatment-resistant depression were discontinued due to disappointing results.

So while it has legitimate medical origins, in the U.S. the medical use is essentially non-existent, making the current use almost entirely non-medical and unregulated.

Addictive Properties & Danger to the Community

As discussed: MOR agonist-like effects → euphoria → tolerance → dependence → withdrawal. The supplement-style packaging creates a false sense of safety, which delays recognition of misuse. Case reports show serious overdose risk, respiratory depression, and death. For instance, naloxone reversed tianeptine overdoses in multiple cases. Withdrawal from tianeptine has been described as severe and difficult. Because tianeptine is sold easily (gas stations, online), its availability can lead to new populations initiating use, including adolescents and people not previously using opioids. The product forms vary (elixirs, pills, powders) and some shipments intercepted by U.S. authorities have been bulk powders destined for retail distribution. Some tianeptine-containing products have been found to include synthetic cannabinoid receptor agonists (SCRAs) or other adulterants, compounding risk. Retail-level availability without medical supervision means people may use high doses, combine with alcohol or other depressants, increasing risk of respiratory arrest, seizures, cardiac events. The term “gas station heroin” reflects both the simplicity of access and the seriousness of the risk (i.e., a “cheap” easy supply of opioid-like drug). The societal risk: increased overdose, dependence, burden on emergency services, regulatory challenge.

Regulatory & law-enforcement issues

Because tianeptine is not federally scheduled (in many places) and was marketed as a “supplement,” it has flown under standard regulatory radars. States have begun to act, however, with Alabama, Ohio, Kentucky, Florida all having banned or scheduled it. In more good news, legislators introduced bills to schedule tianeptine under U.S. federal law along with the FDA having issued warning letters, recall announcements, and import alerts regarding the drug.

How Individuals Are Getting Their Hands on It

• Convenience stores and gas stations: Tianeptine products are sold as mood boosters, cognitive enhancers, or nootropics.

• Online sources: Web-vendors ship tianeptine powders, capsules, elixirs across state lines or even internationally.

• Smuggling/importation: The U.S. Customs and Border Protection reported interception of ~22 pounds of tianeptine destined for the U.S. in late 2024.

• Misleading labeling: Some products are marketed as dietary supplements or food/beverage enhancements, though the FDA has stated tianeptine does not meet the legal definition of a dietary ingredient.

Because the products can be purchased over-the-counter at smoke shops, gas stations, or online without prescription, the barrier to access is very low compared to traditional opioids.

What to Do: Awareness, Regulation & Prevention

For individuals & families

• Recognize that tianeptine is not a safe “supplement”, especially high-dose or heavy use.

• Be aware of the signs of misuse: euphoria, increasing doses, withdrawal symptoms (nausea, tremor, sweating, diarrhea), mixing with alcohol or opioids.

• If someone is using tianeptine to self-treat depression, anxiety or pain, encourage seeking professional medical care rather than self-medicating.

• In case of suspected overdose or severe reaction (slow breathing, unconsciousness, seizures) call emergency services and contact poison control.

For healthcare professionals

• Screen for non-traditional “supplement” use in patients with signs of opioid-type withdrawal or toxicity.

• Report adverse events to FDA MedWatch or local poison control centers.

• Be aware of tianeptine’s presence and risk-profile, especially in adolescents, smokers, convenience-store-purchased “enhancers”.

For regulators & policymakers

• Consider scheduling or regulating tianeptine as a controlled substance (as many states are doing) to limit retail access.

• Enforce import controls and labeling rules (tianeptine cannot be legally marketed as a dietary supplement).

• Public education campaigns to make consumers aware of risks.

• Collaborate with enforcement agencies to monitor retail and online distribution (for example, the 22 pounds seizure by U.S. Customs).

Frequently Asked Questions (FAQs)

Q1: Is tianeptine legal in the United States?
A1: No, tianeptine is not approved by the FDA for any medical use in the U.S. While it is sold in some states as a “supplement” or nootropic, these sales are not legal in the sense of proper drug approval, and many states have moved to restrict or outlaw it.

Q2: Why do people call it “gas station heroin”?
A2: The nickname arises because (1) it is often sold in gas stations or convenience stores, (2) its effects at high doses mimic those of heroin or other opioids (euphoria, sedation, addiction), and (3) it’s part of a trend of easily available, minimally regulated psychoactive substances.

Q3: How does tianeptine cause addiction or withdrawal?
A3: At higher than therapeutic doses, tianeptine acts as a µ-opioid receptor agonist, producing opioid-like effects. Repeated high-dose use leads to tolerance (needing more to get the effect), dependence, and when the person stops, withdrawal symptoms similar to opioids (tremor, sweating, nausea, diarrhea, tachycardia).

Q4: What are the health risks of misusing tianeptine?
A4: Misuse can lead to serious adverse effects: respiratory depression, seizures, cardiac problems, overdose deaths, and severe withdrawal. Some cases have needed ICU care. Adulterated products increase the risk further.

Q5: How are people obtaining tianeptine?
A5: Typically via retail purchase at gas stations, convenience stores, smoke shops (often labelled as mood enhancers, nootropics, or supplements) or online from domestic or international vendors. Some shipments are hidden/mis-labelled in importation.

Q6: What should I do if I suspect someone is using tianeptine or in withdrawal?
A6: Encourage the person to seek professional medical help. For overdose or severe symptoms (slow breathing, unresponsiveness, seizures) call 911 immediately. Health providers should report the event via FDA MedWatch or contact poison control. Preventive education and proper substance-use treatment are critical.

Tianeptine, commonly dubbed “gas station heroin,” represents a troubling intersection of unregulated supplements and opioid-like pharmacology. What began as a legitimate antidepressant in other countries has morphed into a widely available product in U.S. retail settings — with increasing misuse, addiction, and safety risks. The ease of access, coupled with its potent opioid-like effects and minimal regulatory oversight, makes it a public-health challenge. Awareness by individuals, vigilance by healthcare providers, and decisive regulatory action are essential to curbing this emerging trend.