Gas Station Heroin, also known as Tianeptine, can mimic the effects of opioids. Found at convenience stores, smoke shops, and online, Tianeptine’s popularity is all-time high.
However, Tianeptine falls into a category of substances that are increasingly difficult to control. Despite not being classified as a federally-scheduled drug, it is illegally marketed as a treatment for depression, anxiety, and a cognitive booster.
What is Tianeptine?
Tianeptine is a tricyclic antidepressant that interacts with opioid receptors. It’s marketed under names like Coaxil and Stablon in many countries for depression and anxiety. However, it is not approved for medical use in the U.S. due to significant risks.
Despite this, Tianeptine often sold in the U.S. as “health supplements,” “nootropics,” or “dietary supplements,” misleading consumers about its safety. This lack of regulation has led to multiple FDA warnings and several deaths.
Tianeptine is commonly sold under various brand names:
- Zaza Red, Zaza Silver, Zaza White
- Pegasus
- Tiana
- Tianna Red, Tianna White, Tianna Green
- TD Red
- Neptune’s Fix or Neptune’s Elixir
It is also known by slang names such as “Tia,” “gas station heroin” and “gas-station dope”. The forms in which Tianeptine is sold include:
- Tablets
- Capsules
- Powder
- Liquid shots
According to National Institutes of Health Research, tianeptine is typically sold online as either a Tianeptine Sodium or Tianeptine Sulfate. Vendors often claim that the Tianeptine Sulfate salt is slower-acting, longer-lasting, and produces less intense effects. However, these products frequently contain tianeptine mixed with other substances, making accurate dosing difficult and increasing the risk of adverse effects.
States Where Tianeptine is Banned
To reduce the risks associated with Tianeptine, many states have implemented bans, including Florida, Arkansas, Kentucky, Michigan, Alabama, and more. These bans highlight the growing recognition of Tianeptine’s dangers within the U.S., as calls to poison control centers have surged in states with legal access.
Tianeptine’s Effects and Dangers
Tianeptine interacts with opioid receptors in the brain, producing euphoria and pain relief similar to prescription opioids. However, these effects are quickly replaced by severe withdrawal symptoms such as insomnia, shakes, nausea, and anxiety. Tianeptine use has also been linked to seizures and hospitalizations.
A Safe Alternative to Opioids?
Many individuals mistakenly believe that Tianeptine is a safe alternative to street opioids like fentanyl or heroin, or even a method to taper off using them. Some users think Zaza Red or Tianne can alleviate chronic pain without the risks associated with opioids. However, Tianeptine is far from safe.
Reports indicate that Tianeptine products can cause a range of serious complications, including low blood pressure, seizures, and heart rhythm irregularities such as tachycardia. In some cases, individuals have experienced cardiac arrest.
Dangers of Neptune’s Fix and Similar Tianeptine Products
Neptune’s Fix and Seizures
Recent reports highlight the severe risks associated with drinking shots of “Gas Station Heroin,” specifically Neptune’s Fix, a liquid form of Tianeptine. FDA issued a warning in November indicating that people were experiencing seizures and hospitalizations after consuming this gas station drug.
The FDA has documented severe adverse events following the use of Neptune’s Fix products, including seizures and loss of consciousness leading to hospitalization. They advise consumers who experience adverse reactions to seek immediate medical help.
User Reports and Online Support
Due to limited awareness about Tianeptine in the medical community, many users turn to online forums like the “quittingtianeptine” subreddit for advice and support. There has been a noticeable increase in posts about individuals passing out and being hospitalized after consuming Neptune’s Fix in recent months.
One alarming post titled “Neptune’s Fix almost killed me,” described a man who became disoriented after drinking a bottle, drove home, and woke up 11 hours later in the hospital, hooked up to a ventilator.
Users have compared the effects of Neptune’s Fix to those of synthetic weed.
Undeclared synthetic cannabinoids in Neptune’s Fix likely contributed to the severe clinical effects seen in patients, including altered mental status and cardiac issues.
CDC Warning on Neptune’s Fix
The CDC issued a warning about Neptune’s Fix, noting that it may be tainted with synthetic cannabinoids and other chemicals, posing life-threatening risks such as seizures, brain swelling, and hallucinations. Analysis of samples from patients revealed the presence of synthetic cannabinoid receptor agonists (SCRAs) MDMB-4en-PINACA and ADB-4en-PINACA, in addition to Tianeptine and kavain.
How Long Does It Take to Get Addicted to Tianeptine?
The physical dependence on Tianeptine can set in almost overnight.
After initially experiencing opioid-like euphoria, users quickly become addicted, needing more and more of the drug to fend off Tianeptine withdrawal symptoms, including extreme anxiety, nausea, chills, restless legs, and a sense of doom.
People rapidly advance their dosing, taking Tianeptine pills every two hours to avoid withdrawal. They then have to keep taking more and more to stay functional.
Many report that Tianeptine also know as Zaza withdrawal is more severe than that experienced with Oxycodone or Hydrocodone.
Withdrawal can involve vivid hallucinations similar to those caused by LSD and mushrooms, lasting for a week or more.
Some users on r/QuittingTianeptine have mentioned that changing Tianeptine brands (such as Zaza Red, Zaza Silver, Pegasus, and Neptune’s Fix) can cause unexpected withdrawal symptoms.
In a compelling video produced by Vice, a user candidly recounts her battle with Zaza pills addiction and the challenges she faced during withdrawal.
@vicenewsdocs While it’s regulated in parts of Europe and Latin America, it isn’t in the U.S. That means you can buy it as an unregulated supplement from some smoke shops and even gas stations. #gasstation #jacksonville #florida ♬ original sound – VICE News Docs
Tianeptine Overdose
The Morbidity and Mortality Weekly Report from the Centers for Disease Control and Prevention specifies that lethal overdoses of Tianeptine pills are often tied to serum concentrations ranging from 4,000 to 18,000 ng/ml.
Similarly to many illicit drugs, Tianeptine is often sloppily mixed with unlabeled ingredients, such as potent synthetic cannabinoids. That is one reason Tianeptine overdose symptoms appear to range widely, including clamminess, nausea, low blood pressure, unconsciousness, seizures, and severe stomach cramps.
Sometimes naloxone, a drug that reverses opioid overdoses, can be effective in reviving patients, but not always.
At least four deaths have been associated with Tianeptine, according to Journal of Analytical Toxicology report.
How Long Does Tianeptine Stay in Your System?
Tianeptine breaks down quickly in the bloodstream, making its half-life short, around 2.5 hours. This rapid breakdown can cause withdrawal symptoms to appear almost immediately, and users start to feel the craving after the intake. To prevent withdrawal, some individuals resort to setting alarm clocks as reminders to take their Zaza pills every two hours.
Tianeptine Detox
For those who want to stop using Tianeptine aka Tia, or are forced to by state bans, the detox route isn’t clear-cut.
Because tianeptine isn’t an approved drug, there’s a shortage of research on it and many doctors have never heard of it, leaving people who are addicted to fend for themselves a lot of the time.
While medications like methadone and buprenorphine are the gold standard for treating opioid addiction, tianeptine doesn’t function exactly like an opioid so it’s not clear that these drugs would have the same impact.
Many users struggling with Tianeptine addiction find themselves reverting to street drugs like fentanyl and crack cocaine when they are unable to manage the severe withdrawal symptoms.
Death and Abuse Statistics of Tianeptine
Determining the exact number of Tianeptine abuse cases is challenging due to the lack of routine hospital testing. Reports to poison-control centers are typically voluntary and made by concerned relatives, resulting in a significant undercount.
Increase in Tianeptine Exposure Cases:
- The use of Tianeptine-containing drugs, like “Zaza Red” or “TD Red” increased 24-fold from 2014 to 2019.
- In 2013, there were only four reported cases of Tianeptine exposure nationwide.
- By 2023, this number had risen dramatically to 391 cases, according to America’s Poison Centers.
- In New Jersey alone, which typically sees one report a year, 27 cases were reported in 2023, with patients ranging in age from 20 to 69.
FDA Reports and Gas Station Heroin Deaths:
- The FDA has received two Tianeptine-related death reports between 2015-2022.
- Poison control center cases of Tianeptine exposure spiked from 11 total cases between 2000 and 2013 to 151 cases in 2020 alone.
- A 2018 study on Tianeptine deaths worldwide found that fatalities not involving other drugs were primarily linked to respiratory depression or cardiac arrhythmias.
State-Specific Spike in Exposure Calls:
- According to the CDC’s Morbidity and Mortality Weekly Report, over six months, a state’s poison control center received 20 exposure calls from healthcare facilities regarding Tianeptine use in 17 unique patients. This marked an “uncharacteristic spike” compared to their typical average of two or fewer cases per year.
- Of these 17 cases, 13 were admitted to intensive care units and seven required intubation. All patients were reported to have altered mental status upon evaluation.
Notable Case: Ryan M. Stabile
Ryan M. Stabile, 37, of Pasadena, sold “gas station heroin” through his companies, including the websites “Supplements for Work” and “Ultra Vulgar Festival Drip,” and made $250,000 a month, according to court documents. The illegal sales earned him at least $2.2 million, a conservative estimate.
With the help of a Chinese supplier, Stabile smuggled large quantities of Tianeptine into the U.S. from China and repackaged the drug to sell to customers. A judge sentenced Stabile to two years in prison on charges of conspiracy and two counts of introduction of misbranded drugs with intent to defraud and mislead, the U.S. Attorney’s Office for the District of Massachusetts announced in a Feb. 15 news release.
