Kentucky Latest State To Ban Tianeptine—Opioid-Like Drug Sold In Groceries

Topline

Kentucky Gov. Andy Beshear (D) signed an emergency regulation Thursday banning all products containing tianeptine, citing a warning by the U.S. Food and Drug Administration that the opioid-like drug—referred to as “gas station heroin”—has been linked to overdoses, addiction and death over the last two decades.

Tianeptine, or “gas station heroin,” was recently banned in Kentucky.

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Key Facts

Tianeptine, an antidepressant typically used to treat depression, anxiety or asthma, is now a Schedule I controlled substance in Kentucky, according to an announcement Thursday by Beshear, who said the drug was previously available in dietary supplements online, over the counter in convenience stores and in gas stations throughout the state.

The drug—banned in Alabama, Michigan, Mississippi, Tennessee, Georgia, Indiana and Ohio—is unapproved and unregulated by the FDA, the agency noted, though other countries in Europe, Asia and Latin America have approved tianeptine to treat depression and anxiety.

Some studies have indicated the drug can be used to treat depression and symptoms of anxiety if prescribed properly—though its effects mimic other antidepressants and anti-anxiety medicines if used in excess, including agitation, high blood pressure, coma or death.

The clinical effects of tianeptine abuse and withdrawal can also mimic opioid toxicity and withdrawal, according to the Centers for Disease Control and Prevention, which added the drug has the potential to be abused by former opiate drug users.

Both the CDC and FDA do not indicate when the drug first became publicly available in the U.S., though the CDC said there were at least 218 calls to poison control centers between 2000 and 2017, while other reports suggest at least four people have died after using the drug during the same period.

The Drug Enforcement Administration reported in January that tianeptine—consumed in pills in a “salt” form—has been discovered by law enforcement in packages mimicking hydrocodone and oxycodone.

Surprising Fact

A 64-year-old man overdosed on tianeptine in Lowndes County, Mississippi, in January, after he was previously addicted to hydrocodone. Police said the man switched to tianeptine because of its accessibility at gas stations and convenience stores. Sheriff Eddie Hawkins emphasized his concern for the drug’s availability, adding “not only are we worried about some dealer selling our kids drugs, we are worried that our 15-year-old kid will get hooked on something he purchased in a convenience store.”

Crucial Quote

Mississippi State Rep. Lee Yancey (R) said tianeptine “was causing so many problems,” adding that state legislators “have letters from family members begging for us to get it off the shelves.”

Big Number

80,411. That’s the number of overdose deaths involving any opioid in 2021, according to the National Institute on Drug Abuse. West Virginia has the highest death rate per 100,000 people in the U.S. at 81.4, followed by Kentucky (49.2) and Delaware (47.3).

Key Background

The FDA first issued a warning on tianeptine in November 2018, noting the drug—sold by brands like Tianaa and ZaZa in gas stations across the U.S.—was improperly included in dietary supplements. The FDA said it was “aware of serious adverse events” associated with tianeptine, though because the drug was not labeled by a Schedule I substance—like heroin or marijuana—law enforcement cannot enforce a nationwide ban, though the FDA noted it was taking regulatory action to prevent its marketing. Some companies have been issued warning letters for selling the drug, the agency said, while it has also issued alerts to help stop shipments of the drug into the U.S. The most commonly reported health effects from using the drug include damaged neurological, cardiovascular and gastrointestinal systems.