US health officials are raising serious concerns about 'Gas Station Heroin', a substance called tianeptine. This has opioid-like-effects and the availability and accessibility is only increasing. It is also sold as over-the-counter supplements at gas stations, smoke shops, and convenience store. The drug is also marketed as Zaza, Tianaa, Pegasus, and TD Red.Though used as an antidepressant in some other countries, tianeptine is not approved for medical use in the United States. Experts warn that its effects can mimic those of opioids, including addiction and withdrawal symptoms, even though it is not officially classified as one.What Is Tianeptine?A 2023 study published in journal Pain and Therapy, notes: "Tianeptine is an antidepressant drug approved for the treatment of major depressive disorder in countries other than the US. It is classified as an atypical tricyclic antidepressant and has shown potential benefits in addressing anxiety and irritable bowel disease. However, it is important to note that tianeptine is not approved for any use by the United States Federal Drug Administration (FDA). Despite its lack of approval by the FDA, tianeptine has been distributed online and at small retail locations."The term “gas station drugs” refers to a wide range of substances typically available for purchase from gas stations, corner stores, bodegas, mini marts, smoke shops, and the Internet. These substances may be produced commercially by drug manufacturers or in clandestine laboratories to mimic the effects of more well-known illicit/controlled substances such as marijuana, cocaine, opioids, etc.The study also notes that misuse of tianeptine can lead to euphoric, opioid-like highs with the potential for chronic users to develop dependence and tolerance. Overdose and use in suicide attempts have also been documented. Its popularity stems from its ability to bind to the same brain receptors as opioids, which can create feelings of euphoria, calmness, and even pain relief. “It’s kind of this grey area of consumer products, or supplements, where the contents are not regulated or tested the way they would be with a medication,” explained Dr. Diane Calello of the New Jersey Poison Information and Education System. “You never quite know what’s in that bottle.”FDA Warns Against Its Easy Accessibility In response to rising reports of adverse effects, the FDA issued a formal warning last month, calling tianeptine "a dangerous and growing health trend." The agency urged retailers to stop selling these products and asked consumers to avoid purchasing or using them altogether.Poison control centers have seen a sharp rise in tianeptine-related incidents. The FDA noted that many of these cases involve young people, and the symptoms often require emergency medical attention. Reported side effects include seizures, low blood pressure, rapid heartbeat, and mental distress. In a review of 20 recent cases, more than half of the patients had to be admitted to intensive care units.The Alabama Case StudyThe state of Alabama serves as a stark example of the risks associated with tianeptine. Between 2018 and 2021, poison control calls related to the drug spiked by over 1,400%. However, after the state imposed strict regulations and bans, the number of such incidents saw a notable decline. This indicates that legal restrictions can play a significant role in curbing misuse.Health professionals are urging federal and state authorities to take faster and stronger action before tianeptine use becomes a full-blown public health crisis. Some compare the current trajectory of the drug to the early days of the opioid epidemic, which caught the country off guard and led to long-term consequences.