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

March 24, 2023 Abraham Smith

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

Important 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 from Beshear, which said the drug was previously available in supplements online and over the counter been available in convenience stores and at gas stations across the country.

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

Some studies have shown that the drug can be used to treat depression and anxiety symptoms when properly prescribed – although its effects mimic other antidepressant and anti-anxiety drugs when 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 that the drug has the potential to be abused by former opiate drug users.

Both the CDC and FDA don’t say when the drug first became publicly available in the United States, although 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 died after using the drug in the same period.

The Drug Enforcement Administration reported in January that tianeptine — taken in pill form in “salt” form — was discovered by law enforcement in packaging that mimics hydrocodone and oxycodone.

Surprising fact

A 64-year-old man overdosed on tianeptine in Lowndes County, Mississippi, in January after becoming addicted to hydrocodone. Police said the man switched to tianeptine at gas stations and convenience stores because of its accessibility. Sheriff Eddie Hawkins stressed his concerns about the availability of the drug, adding: “Not only are we concerned that a distributor is selling our children’s medicines, we are concerned that our 15-year-old child will become addicted to something bought it in a supermarket.”

Crucial quote

Mississippi State Assemblyman Lee Yancey (R) said tianeptine has “caused so many problems,” adding that state lawmakers “have letters from family members asking us to take it off the shelves.”

Big number

80.411. That’s the number of opioid overdose deaths in 2021, according to the National Institute on Drug Abuse. West Virginia has the highest death rate per 100,000 population in the US 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, finding that the drug — sold by brands like Tianaa and ZaZa at gas stations across the US — was improperly included in dietary supplements. The FDA said it was aware of “serious adverse events” associated with tianeptine, though law enforcement can’t enforce a statewide ban because the drug wasn’t labeled with a Schedule I substance — like heroin or marijuana — although the FDA found that it was officially prescribed measures to prevent their marketing. Warning letters have been issued to some companies for selling the drug, the agency said, while it has also issued warnings to stop shipping the drug to the United States.

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