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The New Jersey Poison Center is sounding an alarm about a worrying rise in poisoning cases involving tianeptine, a substance with opioid-like effects that is being falsely sold as a dietary supplement in gas stations and online. This dangerous substance is commonly referred to as “gas station heroin,” “ZaZa Red,” or “Neptune’s Elixir.”
Over a period of 60 days last summer, the poison control center has received 9 calls about patients poisoned by tianeptine, some of whom have become critically ill. As a result of this alarming increase, the New Jersey Department of Health has heightened surveillance efforts surrounding this substance and is urging consumers to exercise caution.
Despite its use as an antidepressant in some Latin American, Asian, and European countries, tianeptine is not approved or regulated by the Food and Drug Administration for use in the United States. It is often inaccurately marketed as a safer alternative to opioids, potentially making it more attractive to individuals with an opioid use disorder.
The FDA has issued warnings about the false and unproven claims made by manufacturers of tianeptine, such as its alleged ability to improve brain function, treat anxiety, depression, pain, opioid use disorder, and other health ailments. Over the past two decades, U.S. poison control centers have reported a concerning increase in adverse reactions to tianeptine exposure.
Tianeptine can cause opioid-like effects by binding to and acting as an agonist at the mu opioid receptors. Repeated use can lead to dependence and withdrawal symptoms similar to those of opioids, including agitation, nausea, anxiety, diarrhea, and chills. In severe cases, withdrawal symptoms have required patients to be intubated.
Exposure to tianeptine can cause a range of symptoms, including agitation, drowsiness, confusion, sweating, rapid heartbeat, increased blood pressure, nausea, vomiting, slowed or stopped breathing, coma, and even death.