U.S. Food and Drug Administration (FDA) Commissioner Martin A. Makary has raised concerns about tianeptine, a substance colloquially referred to as ‘gas station heroin,’ due to its increasing prevalence and associated health dangers, particularly among young people. Makary’s recent letter to colleagues underscores an alarming trend of rising adverse events tied to tianeptine, which is often sold in unexpected places like gas stations, convenience stores, and online retailers under various names such as Tianaa, ZaZa, Neptune’s Fix, Pegasus, and TD Red.
The FDA has confirmed that tianeptine is not approved for use in the U.S. and is not listed under the Controlled Substances Act. Despite its unapproved status, it is commonly consumed recreationally, and abrupt cessation can lead to withdrawal symptoms mirroring those of opioid withdrawal, including cravings, sweating, and diarrhea. Makary warns that excessive doses can induce euphoria and lead to severe health complications like agitation, coma, confusion, and even death. The drug has been linked to multiple hospitalizations and reports of severe adverse effects, with the FDA issuing warnings about products such as Neptune’s Fix and others containing tianeptine.
Recent incidents in New Jersey highlight the growing public health crisis, where the FDA and CDC have noted significant cases of tianeptine-related health issues in 2023. Neptune Resources, LLC, the manufacturer of Neptune’s Fix, initiated a voluntary recall in January 2024 due to tianeptine contamination, though experts caution that other products may also contain the substance. Health officials stress the importance of public awareness and swift action to mitigate the risks posed by this increasingly available and dangerous drug.