"Gas Station Heroin"—an FDA official's warning

Martin A. Makary, M.D., is a commissioner of food and drugs with the FDA, and he’s worried about “gas station heroin.” In a letter written to his colleagues, he sounds the alarm against products containing a drug called tianeptine, an opioid that’s similar to heroin. Prescribed in some countries as an antidepressant, tianeptine’s nickname comes from its availability at gas stations and convenience stores.

Improved cognition and elevated mood are among the benefits touted by manufacturers. However, as Dr. Makary writes, reported adverse effects include vomiting, elevated blood pressure and heart rate, coma, and death. Because it targets a particular opioid receptor in the brain, tianeptine can become addictive.

First approved as an antidepressant in France in the ‘80s, tianeptine eventually spread to at least 66 other countries. NPR reports that millions of people in Europe, Asia, and South America have used the drug, but the FDA has never cleared it for medical use. This hasn’t stopped it from being sold in the US with product names like Neptune’s Fix, Pegasus, and Tiann.

The marketing and packaging of these products are geared toward young people. In particular, Neptune’s Fix is sold as a liquid in colorful, shot-style bottles, and in 2023, the New Jersey Poison Control Center received multiple calls traced to its consumption. It has since been banned in 13 states.

Dr. Makary’s letter acknowledges that the FDA has failed to recognize past threats to the public's health and well-being and urges his counterparts to wake up to the dangers of tianeptine. It also puts parents on notice that "gas station heroin" may be readily available to their kids.

You can read Dr. Makary’s warning and learn more about tianeptine here:
https://www.fda.gov/consumers/health-fraud-scams/new-gas-station-heroin-...