Products containing tianeptine can cause severe opioid-like effects, putting kids and teens at risk
Doctors warn about easily obtainable 'gas station heroin'
Dr. Patrick Marshalek on the gas station drug that is marketed as a dietary supplement and antidepressant.
A dangerous drug is causing a spike of illnesses in New Jersey, health officials warn — and in many cases, the drug is being sold on the shelves of corner convenience stores.
Neptune’s Elixir and ZaZa Red — also referred to as "gas station heroin" — are just two of the products that are being marketed as dietary supplements. They're sold in gas stations and on the internet, according to a health alert from the New Jersey Department of Health.
Between June and Nov. 2023, there were 20 reported cases of tianeptine causing "severe clinical effects" in New Jersey, as noted in a Feb. 1 alert from the U.S. Centers for Disease Control and Prevention (CDC).
This is a significant spike from the two or fewer calls the poison center typically receives each year.
What is tianeptine?
Tianeptine is a tricyclic antidepressant that has not been approved by the U.S. Food and Drug Administration.
Some companies market the drug as an aid for pain, anxiety and depression, or as a means of improving mental alertness.
Neptune’s Fix Elixir is one of the products being marketed as dietary supplements and sold in gas stations and online, according to a health alert from the New Jersey Department of Health. Fox News Digital reached out to Neptune Resources and others for comment. (FDA's Office of Regulatory Affairs, Health Fraud Branch)
It is also sometimes billed as a "safer" alternative to opioids — but experts are warning that it has highly addictive and dangerous properties.
"Tianeptine interacts with opioid receptors in the brain, and in larger doses, can mimic the effects of traditional heroin such as euphoria, but also the consequences frequently associated with tolerance, withdrawal and toxicity," Dr. David Campbell, clinical and program director of Recover Together Bend in Oregon, told Fox News Digital.
"With such ease of access, even kids are getting caught in the crossfire."
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Tianeptine can be sold as a pill, powder, salt or in liquid form as a supplement — or as an active ingredient in a supplement — and is widely available in many states, noted Dr. Adam Scioli, corporate medical director and head of psychiatry at Caron Treatment Centers in Philadelphia.
"We have seen patients come in having gotten tianeptine over the internet or at gas stations," Scioli told Fox News Digital. "They often suffer from withdrawal symptoms similar to those of an opioid withdrawal and often need medication-assisted treatment such as buprenorphine."
"With such ease of access, even kids are getting caught in the crossfire," an addiction specialist warned. (iStock)
"Why it is being sold commercially as an active ingredient in a supplement in everyday settings is beyond me."
The widespread availability and ease of accessibility at gas stations, minimarts and smoke shops is one of the main reasons people seek it out, Scioli said.
"These are dangerous, addictive substances with potentially fatal outcomes."
"There is also this ongoing misconception that if something is easily accessible, legal in some states and available, it is safe — which isn’t true of several substances, not just products that contain tianeptine," Scioli warned.
"These are dangerous, addictive substances with potentially fatal outcomes."
Dangers of tianeptine
Scioli called tianeptine a "substance of abuse" that can be addictive and fatal.
"Tricyclic antidepressants have what we call a narrow, therapeutic index, meaning that it is fairly easy to tip into the non-therapeutics/toxic range," he said.
Among tianeptine’s significant and severe withdrawal symptoms, according to Campbell, are nausea, vomiting, confusion, flu-like symptoms, depression, anxiety, coma and even respiratory failure and overdose. (iStock)
"Tricyclic antidepressants in and of themselves can also cause seizures, electrolyte abnormality and death in overdose. Symptoms will be similar to an opioid withdrawal or overdose."
Among tianeptine’s significant and severe withdrawal symptoms, according to Campbell, are nausea, vomiting, confusion, flu-like symptoms, depression, anxiety, coma and even respiratory failure and overdose.
Calls for regulation and awareness
In 2023, the FDA posted an alert warning of the dangers of Neptune’s Fix or any other product containing tianeptine.
"FDA has received severe adverse event reports after use of Neptune’s Fix products, including seizures and loss of consciousness leading to hospitalization," the agency stated.
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"FDA considers tianeptine to be a substance that does not meet the statutory definition of a dietary ingredient and is an unsafe food additive. The FDA is aware of several serious adverse event reports associated with tianeptine."
Scioli pointed out that several states — including Florida, Kentucky, Michigan and Ohio — have made tianeptine illegal to sell.
"Despite that, companies are marketing and selling products containing tianeptine to consumers," he warned.
In 2023, the FDA posted an alert warning of the dangers of Neptune’s Fix or any other product containing tianeptine. (REUTERS/Andrew Kelly/File Photo)
Campbell of Recover Together Bend in Oregon echoed the need for greater regulation of tianeptine.
"The FDA ought to be called upon to act now before the increasing use of this substance and other ‘gas station drugs’ leads to yet another drug epidemic in this country," he said.
"Until the time comes when tianeptine is more strictly regulated or preferably banned, prevention and education must take center stage for parents, schools and other institutions to curtail the scope of underage use," he added.
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Mark Stovall, regional executive director for American Addiction Centers in Mississippi, noted that the FDA has urged convenience stores, gas stations and other organizations to stop selling tianeptine products, but said there needs to be increased awareness of non-approved FDA drugs and supplements to prevent severe health risks and addictions.
"With such ease of access, even kids are getting caught in the crossfire."
"If you have an inkling of gas station drugs being sold in the future, be empowered to apply community pressure," Stovall advised in an interview with Fox News Digital.
"Take initiative by visiting your local gas station and ask them why they’re selling these addictive drugs. Explain the dangers and ask them to stop selling before more individuals are negatively impacted. Talk with your local law enforcement. Some local officials have already started to control these dangerous substances even without federal involvement."
Anyone who is using tianeptine or a product containing tianeptine and is experiencing withdrawal symptoms should seek emergency medical assistance, experts say. (iStock)
The experts also urged parents and caregivers to be aware of the risk to kids and teens.
"With so many supplements and substances easily available to children through the internet and stores, it is imperative that parents, guardians and schools become educated — not just about the substances and their effects, but also about how to talk to children and teens about them," said Scioli.
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"An open dialogue is imperative, especially with the proliferation of adulterated drugs sold online. With the overdose risk, there is no safe experimentation."
On Jan. 28, 2024, Neptune Resources, LLC, the maker of Neptune’s Fix, issued a voluntary recall of its products due to the presence of tianeptine — but experts are warning that other products may also contain the drug.
Fox News Digital reached out to Neptune Resources, LLC — based in Kansas City, Missouri, according to the FDA's announcement of the recall — as well as to MRSS Inc. (maker of ZaZa Red) and Super Chill Products, a New York-based distributor of Neptune's products that has since issued a recall.
Comments were also requested from the FDA and the New Jersey Department of Health.
Experts urged parents and caregivers to be aware of the risk to kids and teens and to maintain an open dialogue. (iStock)
Anyone who is using tianeptine or a product containing tianeptine and is experiencing withdrawal symptoms can call the National Poison Control Center at 1-800-222-1222 or seek emergency medical assistance, experts advised.
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Melissa Rudy is health editor and a member of the lifestyle team at Fox News Digital. Story tips can be sent to
