In recent years, a new substance has quietly infiltrated gas stations, smoke shops, and convenience stores across the United States, contributing to the growing problem of “gas station dope.” Known by names like Zaza (Zaza Red, Zaza White) and Tianaa (Tianaa White, Green, Red), this substance, Tianeptine, has evolved from a little-known antidepressant into a drug of concern, responsible for an increasing number of poisonings, addiction cases, and even deaths. Originally developed in the 1960s by the French Society for Medical Research, Tianeptine has slipped through the cracks of federal regulation in the U.S. Its opioid-like effects, especially at high doses, have made it a popular but dangerous drug for recreational use, leading to a troubling spike in poisonings and other serious health consequences. We touched briefly on Tianeptine in our Gas Station Dope webinar, but as we are hearing more and more about its misuse from our clients, we felt it needed its own spotlight. This blog will dive into the history, pharmacology, dangers, and public health concerns of Tianeptine misuse, as well as the ongoing legislative responses to control its spread.
What is Tianeptine?
Tianeptine is classified as an atypical tricyclic antidepressant. While it shares some molecular similarities with traditional tricyclic antidepressants (its three-ring structure gives it the name “tricyclic”), it has an atypical mechanism of action. One of the most significant factors that makes Tianeptine stand out is its mild μ-opioid agonist properties, meaning it binds to opioid receptors in the brain, leading to mood-elevating and pain-relieving effects, not unlike opioids.
In therapeutic doses, Tianeptine’s antidepressant properties have been used in various countries to treat depression and anxiety disorders. However, at high doses, it acts more like an opioid, which significantly increases the risk of addiction, overdose, and death. Because of this, recreational use of Tianeptine has become a growing public health threat, particularly in regions where it is easily accessible and largely unregulated.
Historical Context
The earliest recorded instances of Tianeptine misuse date back to 1989 in Europe, particularly in France. Since then, its misuse has slowly increased, with its effects becoming more widely recognized and documented. Despite early warnings, the drug’s reputation as a relatively safe antidepressant in other parts of the world shielded it from regulatory scrutiny in the U.S. until more recently.
The Opioid Crisis Connection
The opioid crisis has made Americans more aware of the dangers of opioid addiction. Yet, many are unaware that substances like Tianeptine, legally sold under names like Zaza and Tianaa, are part of the problem. The CDC reported an alarming increase in Tianeptine-related poisonings, from 11 cases between 2000 and 2013 to 151 cases in 2020 alone *figure 1. The fact that it can be purchased in gas stations, often without any age restrictions or warnings, makes it a hidden danger.
Health Risks of Tianeptine Misuse
While Tianeptine is marketed as a dietary supplement in the U.S., consumers are often unaware of the potential dangers of misuse. At higher-than-recommended doses, it exhibits opioid-like effects—leading to euphoria, sedation, and a reduction in pain. This has made it attractive to those seeking an opioid-like experience without the perceived stigma or legality issues associated with traditional opioids.
Signs of Tianeptine Overdose
Some of the most serious consequences of Tianeptine misuse include:
- Agitation and confusion
- Severe drowsiness and lethargy
- Sweating and rapid heartbeat
- High blood pressure
- Nausea and vomiting
- Slowed or stopped breathing (respiratory depression)
- Coma or death
Due to its opioid properties, Tianeptine overdose can look similar to opioid overdose, with the risk of respiratory failure being especially high. Unfortunately, public awareness about these risks is low, partly because the drug is often marketed as a “supplement” or “natural remedy.”
*figure 1
Legal and Regulatory Status
Despite the dangers, Tianeptine is not classified as a controlled substance at the federal level in the U.S. This means that in most states, it can still be legally sold in gas stations and other retail outlets. However, the FDA has ruled that it is unlawful for use in dietary supplements or food products, though enforcement of this ruling remains inconsistent.
Several states have taken their own steps to ban or restrict the sale of Tianeptine. These include:
- Michigan (2018)
- Alabama (2021)
- Tennessee (2022)
- Ohio (2022)
- Kentucky (2023)
- Florida (2023)
- Georgia (2024)
Some states, such as Indiana, are considering similar legislation, though no official law has been passed as of this writing. In states where Tianeptine has been banned, the black market has stepped in to fill the demand, with the drug now being trafficked illicitly. This mirrors patterns seen in the opioid crisis, where restrictions on legal access have led to a surge in illicit drug markets.
The Way Forward: Public Health Implications and Solutions
The rise of Tianeptine misuse is a clear example of the dangers posed by unregulated substances sold in seemingly harmless locations like gas stations. To address this issue, education and awareness are crucial. Both the general public and healthcare professionals need to be better informed about the risks associated with Tianeptine and other so-called “gas station drugs.” Additionally, policy measures at both the state and federal levels are needed to regulate the sale and distribution of Tianeptine. This could involve tighter controls on the sale of products containing the substance, as well as increased enforcement of existing FDA rules prohibiting its use in dietary supplements. Finally, international cooperation may be necessary to combat the global nature of Tianeptine misuse. As the drug continues to be prescribed in some countries, efforts to prevent its diversion into the U.S. market will require collaboration across borders.
Detection and Testing
One of the challenges in combatting Tianeptine misuse has been the difficulty in detecting the drug in standard drug tests. Until recently, most drug testing panels did not include Tianeptine. However, recent advances have led to the development of instant urine drug tests specifically designed to detect Tianeptine.
These tests are currently available as single-panel strip tests, but they have not yet been incorporated into more comprehensive multi-panel tests. This means that individuals who misuse Tianeptine can still pass many standard drug tests, complicating efforts to monitor its use in populations at risk.