Several states have banned a pill that can cause withdrawal symptoms similar to opioids — and can be readily available at gas stations and online.
Mississippi became the latest state to pass a ban on tianeptine on March 1, TV station WCBI reported on Thursday. Under the proposal, it will be illegal to sell or possess the drug in the state as of July 1. If approved by Mississippi's governor, the state will join Alabama, Michigan, Tennessee, Georgia, Indiana, and Ohio in passing bans on tianeptine.
But the pills are still for sale in many states and through supplement websites. Medical experts and local officials say their continued sale is putting people at risk similar to opioid use. The drug is so potent that it has even earned the nickname "gas station heroin."
Tianeptine is sold as a supplement, meaning it isn't regulated like a prescription drug or a controlled substance
Tianeptine targets the same receptors in the brain as opioids, Vice reported. That means it can become addictive and cause the same kind of withdrawal symptoms as opioids, including paranoia and hallucinations.
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Users often buy tianeptine, sold under brand names including Za Za Red, Tianna, and TD Red, hoping for a boost of energy and better focus. Others incorrectly believe that the drug can treat anxiety or depression, according to the Food and Drug Administration. The pills are sold as dietary supplements, meaning they aren't subject to the same regulations as drugs and can be freely bought at stores or online.
One brand, Tianaa, says on its website that its pills have "relaxing and energizing properties" and "strong soothing abilities."
But tianeptine is addictive and has multiple risks, from drowsiness and confusion to coma and death, according to the FDA.
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Despite the claims made by some companies that make it, tianeptine is not approved by the FDA for any medical use.
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"Consumers should avoid all products containing tianeptine, including those claiming to treat an ailment or disorder," according to FDA guidance updated in 2022.
Tianeptine's withdrawal symptoms mirror those of opioids
Quitting the drug requires an approach similar to quitting opioids, according to the FDA.
In Wetumpka, Alabama, the local hospital's detox unit has attracted attention for helping people get off the drug, local television station WSFA reported in February.
One former tianeptine user in Florida, Hunter Barnett, told Vice in December that he started taking just a few pills at a time to manage the pain from an esophagus condition. But he ended up taking between three and six bottles of pills each day as his tolerance grew, he said.
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When he quit, the withdrawal was "the absolute worst experience of my life," surpassing detoxes he had gone through after taking opioids such as oxycodone and fentanyl, he told Vice.
Tianeptine is a common choice for people who have struggled with addiction to opioids in the past, according to the FDA.
In Mississippi, one 64-year-old man overdosed on the drug in January, sending him to the hospital. The man lived, but local officials told television station WTVA that he had previously taken hydrocodone, also known by the brand name Vicodin, before switching to tianeptine because it was easier to buy.
"People with a history of opioid use disorder or dependence may be at particular risk of abusing tianeptine," according to the FDA's guidance.
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