The Growing Health Risk of Tianeptine: A Dangerous Synthetic Drug

The Growing Health Risk of Tianeptine: A Dangerous Synthetic Drug

The Food and Drug Administration (FDA) has issued urgent warnings to consumers regarding the dangers of purchasing and consuming tianeptine, commonly known as “gas station heroin.” This synthetic drug, available in tablet or powder form, can be found online, as well as in convenience stores, gas stations, and smoke shops. Despite being approved in some countries as a prescription drug for depression, tianeptine mimics the actions of opioids such as fentanyl, posing similar risks of addiction, withdrawal, and overdose. Furthermore, its use can lead to psychosis, seizures, kidney damage, and even death.

Despite the FDA’s active efforts since 2022 to warn US consumers about the dangers of tianeptine, vendors continue to promote the drug as a dietary supplement. This marketing tactic is misleading, as the FDA has explicitly stated that tianeptine “does not meet the statutory definition of a dietary ingredient and is an unsafe food additive.” The deceptive labeling of tianeptine-containing products under names like Neptune’s Fix, Za Za Red, and Tianaa further exacerbates the potential health risks to unsuspecting individuals.

Tianeptine stimulates the same receptors as well-known opioids like fentanyl, heroin, and morphine. When these drugs enter the brain through the bloodstream, they bind to the “mu” type opioid receptor, resulting in pain relief, euphoria, but also dangerously slowed or halted breathing. High doses of tianeptine can produce euphoric effects similar to heroin and induce dissociation, which is the perception of detachment from one’s surroundings and body, reminiscent of the anesthetic ketamine. The problem is exacerbated by the fact that products containing tianeptine are often categorized as “legal high drugs” or “gas station drugs,” referring to non-FDA-approved synthetic drugs casually sold in gas stations, online, and elsewhere.

Clinical trials, case reports, and poison control centers have revealed that tianeptine commonly induces agitation, accompanied by a rapid heart rate, high blood pressure, confusion, nightmares, drowsiness, dry mouth, and nausea, among other conditions. However, the most severe adverse events include slowed or stopped breathing, coma, heart arrhythmia, and death. Moreover, products containing tianeptine often fail to adhere to good manufacturing practices, raising concerns about possible lead contamination, heavy metal contamination, microorganism contamination (e.g., salmonella or mold), or undisclosed ingredients. The inconsistency in the amount of active ingredient in tianeptine products, even within the same manufacturer, also poses a significant risk, as past use does not guarantee similar effects.

To control market access, the Drug Enforcement Agency (DEA) is responsible for regulating drug products that are not FDA-approved for prescription or over-the-counter use. However, manufacturers are not required to inform the DEA before selling their products to US citizens, creating a potential gap in regulation. Schedule I designation, which indicates that a drug has no legitimate medical purpose and a high abuse potential, must be assigned before the DEA can ban an active ingredient in a drug product. Tianeptine evaded scrutiny by falsely claiming to be a dietary supplement and is sold online under the guise of research purposes. The failure to clearly label tianeptine products or restrict their purchase to researchers further adds to the risks imposed on consumers.

Non-FDA-approved products containing synthetic drugs, such as tianeptine, pose a significant risk to users and should be avoided. FDA-approved drugs are available through prescriptions or over-the-counter purchases with approved active ingredients. It is crucial to exercise caution when encountering claims about non-FDA-approved drug products that promise pain relief or anxiety reduction, increased energy, or a feeling of euphoria. These claims can be dangerous, as the associated risks may not be apparent during initial use. Furthermore, continued use may lead to addiction. Products sold as “not for human consumption” or “for research purposes only” carry a high risk when consumed. Before taking any dietary supplement, it is essential to verify that the active ingredient is a natural product rather than a synthetic chemical.

Certain signs can indicate a potentially dangerous situation involving tianeptine, such as unmarked bags of powder, products labeled for research use or not for human consumption, and tablets or capsules not in standard drug bottles. Standard drug tests available over the counter may not effectively detect tianeptine. This synthetic drug’s ability to evade detection is why some individuals opt for it instead of regular opioids, cannabis, or amphetamines. If the DEA fails to respond promptly to emerging threats, individual states can also take action to ban the sale of dangerous active ingredients. Currently, at least 12 states have banned the sale of tianeptine as of January 2024, according to the FDA, although illegal online procurement remains a concern. Contacting state legislators can be an effective way for individuals to exert their power and contribute to preventing the harms associated with tianeptine and similar products.

The growing health risk of tianeptine, a dangerous synthetic drug, necessitates increased awareness and regulation. Its mimicry of opioids, potential for addiction and overdose, and various adverse effects underscore the need for consumers to exercise caution. Purchasing FDA-approved drugs from reputable sources is crucial for ensuring safety. By recognizing signs of potentially dangerous situations and advocating for stricter regulations, individuals can play an active role in protecting themselves and others from the harms associated with tianeptine and similar synthetic drugs.

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