US Issues Warning Over "Gas Station Heroin" Drug Risk

US health officials have issued a public warning about a surge in the use of a dangerous and unregulated drug commonly referred to as "gas station heroin". Marketed misleadingly as an energy booster or cognitive enhancer, the drug, containing the illegal substance tianeptine, is being sold in gas stations, smoke shops, and convenience stores under names like Zaza, Tianaa, Pegasus and TD Red.

Although tianeptine is used as an anti-depressant in some countries, it is banned in the United States. The Food and Drug Administration (FDA) emphasised that despite not being classified as an opioid, tianeptine produces opioid-like effects by interacting with similar brain receptors. Its exact mechanism, however, remains unclear.

Often packaged in brightly coloured, shot-sized bottles, these illicit products vary in drug concentration and have also been found to contain harmful synthetic cannabinoids. In May, the FDA issued an official warning, calling tianeptine "a dangerous and growing health trend", and urged immediate regulatory action to prevent further harm. Alarming health effects related to the substance include seizures, low blood pressure, rapid heart beat and severe distress.

Several cases of severe illness and death have been reported, particularly among young users. Between 2018 and 2021, Alabama poison control centers reported a 1,400% increase in emergency calls related to tianeptine. Strict regulations later helped to reduce case numbers.