In recent months, a wave of concern has rippled through the U.S. public health community over a so-called “cognitive supplement” that’s been quietly—and dangerously slipping into the hands of consumers. Marketed with appealing names and colorful packaging, often sold at gas stations, smoke shops, and corner stores, these energy-boosting elixirs and mood enhancers are anything but benign. They contain tianeptine, an unapproved drug in the United States that’s quickly earning notoriety under the alarming nickname “gas station heroin.”With a growing number of emergency calls, FDA warnings, and unregulated formulations circulating under the radar, tianeptine has become a chemical wildcard posing significant risks to public health while masquerading as an over-the-counter supplement.What Is Tianeptine?Tianeptine is a tricyclic antidepressant originally developed and approved for use in several European, Asian, and Latin American countries to treat conditions like major depressive disorder, anxiety, and even irritable bowel syndrome. Despite these approved medical uses abroad, tianeptine has never received approval from the U.S. Food and Drug Administration (FDA) for any therapeutic purpose.What’s particularly alarming is the way this compound is being sold in the U.S.—not as a regulated pharmaceutical, but as an unregulated cognitive enhancer or energy booster, available under brand names such as Zaza, Tianna, Pegasus, TD Red, and Neptune’s Fix. These products are packaged to resemble energy drinks or wellness shots, creating a false sense of safety for unsuspecting buyers.How Tianeptine Is Slipping Through the Regulatory CracksTianeptine’s entry into the U.S. market exploits a regulatory loophole. The FDA doesn’t preapprove ingredients used in supplements before they hit store shelves. As a result, many companies are selling tianeptine-based products under the guise of dietary supplements, despite explicit warnings from the FDA stating that tianeptine cannot legally be added to food, beverages, or supplements.“It’s kind of this grey area of consumer products,” explains Dr. Diane Calello, medical director of the New Jersey Poison Information and Education System. “These products are not tested or regulated in the same way that medications are.”This grey area is not without consequences. A recent study led by Calello documented a cluster of emergency cases in New Jersey, where individuals experienced symptoms such as rapid heartbeat, seizures, and low blood pressure after consuming a tianeptine-laced beverage called Neptune’s Fix. Of the 20 patients, more than half were admitted to intensive care units.Why Are People Using Gas Station Heroin?Tianeptine’s appeal lies in its opioid-like effects, even though it is not classified as an opioid. The drug interacts with mu-opioid receptors in the brain, producing short-term euphoria, pain relief, and mood elevation. These effects are similar to those of controlled narcotics like oxycodone—but without the same legal restrictions.Some products claim, without clinical backing, that tianeptine can treat addiction, anxiety, depression, and even sexual dysfunction. In 2018, the FDA issued a warning letter to the makers of Tianna, a supplement that claimed to offer a solution to opioid cravings—another red flag in a market already marred by misinformation.But the pursuit of relief comes at a price. Many users increase their dosage over time, either to self-treat withdrawal symptoms or to chase a high. High doses can cause severe respiratory depression, the same life-threatening condition caused by opioid overdoses. And unlike regulated medications, there’s no standardization in these products, making them even more dangerous.What are The Risks And Side Effects of Using Tianeptine?Even in small doses, tianeptine is not without risk. Reported side effects include:Nausea and vomitingDizziness and drowsinessConstipationAbdominal discomfortBad dreamsHeadachesDry mouthHowever, when misused or taken in large amounts—especially in combination with substances like alcohol, opioids, or stimulants—tianeptine can lead to cardiac arrest, seizures, or even death.Moreover, regular users may find themselves battling withdrawal symptoms similar to those experienced during opioid withdrawal. These can include:Agitation and anxietyMuscle pain and sweatingDepressionChills and tremblingWithdrawal begins quickly and can be intense, reinforcing the cycle of dependence.The FDA and U.S. poison control centers have issued repeated alerts, cautioning the public and health professionals about the growing number of adverse events linked to tianeptine.Last month, the FDA took a firmer stance, warning healthcare providers about “the magnitude of the underlying danger of these products.” Poison control centers across the country have seen a steady uptick in calls involving tianeptine-related overdoses, particularly among individuals with a history of substance use or mental health issues.Despite these warnings, tianeptine remains accessible in many gas stations and smoke shops, often labeled misleadingly as a natural mood enhancer or energy booster. This underscores the need for stronger regulations and consumer awareness campaigns.If you or someone you know is experiencing depression, anxiety, addiction, or chronic pain, consult a licensed medical professional for FDA-approved treatments. There are safe and effective therapies available—including medications and cognitive behavioral therapy—that have been rigorously tested and regulated.Avoid purchasing any so-called “cognitive supplements” or energy drinks from gas stations or smoke shops, especially those that are vaguely labeled or make unverified medical claims.If you suspect someone is experiencing an overdose or withdrawal from tianeptine, contact emergency medical services immediately.What’s marketed as a quick fix in a flashy bottle may actually be a dangerous and addictive drug. As the story of gas station heroin unfolds, it’s clear that consumers need to be vigilant, and regulators must act faster to protect public health.