Photo submitted to Times Observer Tidioute Community Charter School senior fishing club member Jadyn Bynum poses with a fish he caught during a recent fishing club outing to the Lodge at Glendorn.

State legislators may be asked to consider a ban on tianeptine, commonly referred to as “gas station heroin.”

Rep. Andrew Kuzma, R-Allegheny/Washington, is circulating a co-sponsorship memorandum for legislation that would prohibit tianeptine, an antidepressant that is typically available at service stations and other retail establishments in the U.S. According to the U.S. Food and Drug Administration, tianeptine has no known medical use and poses a “significant potential for abuse.” According to reports, common names for this drug include ZaZa (red, white, or silver), Tianna (green, red, or white), TD Red, and Pegasus. Additionally, any “dietary supplement” or product that has product labeling indicating the presence of tianeptine or tianeptina.

According to the Ohio Board of Pharmacy, which was allowed to ban tianeptine in Ohio starting in December, the availability of an unregulated, tricyclic antidepressant without any medical supervision presents a serious risk to public health. Board members said media reports indicate that patients are utilizing tianeptine to either manage withdrawal or initiating use based upon the reported opioid-like effects. Because there are no regulations for tianeptine many patients have been consuming the drug at doses higher than the doses prescribed in the countries where the drug has been approved. Quality can differ as well because tianeptine is not subject to the same FDA regulatory scheme — including inspections of manufacturing facilities, quality assurance testing and adverse event monitoring — as similar antidepressants approved for use in the United States.

“As you are undoubtedly aware, overdose deaths have skyrocketed in our nation in recent years,” Kuzma wrote in his legislative memorandum. “According to the FDA, tianeptine has been linked to hundreds of overdoses and deaths. As the use of this drug becomes more prevalent, it is imperative that we act to protect our constituents and prohibit the trafficking of this dangerous substance on our streets. Numerous states, including Tennessee and Michigan, have recently passed laws that prohibit the sale and manufacture of this deadly substance. I believe it is time that we do the same.”

Side effects from abusing or misusing tianeptine by itself or with other drugs include agitation, drowsiness, confusion, sweating, rapid heartbeat, high blood pressure, nausea, vomiting, slowed or stopped breathing, coma and death. People with a history of opioid-use disorder or dependence may be at particular risk, Beshear said, citing the FDA. The drug (marketed as Coaxil or Stablon) is approved for use in in Europe, Asia, and Latin America. According to the U.S. Centers for Disease Control and Prevention (CDC), case reports demonstrate that tianeptine toxicity mimicked opioid toxicity and that naloxone was an effective therapy. Neonatal abstinence syndrome mimicking opioid neonatal abstinence syndrome has occurred after tianeptine dependence during pregnancy. Kentucky is the latest state to ban the drug after Gov. Andy Beshear signed an emergency regulation March 23 that applies to products containing tianeptine.

Photo submitted to Times Observer Tidioute Community Charter School senior fishing club member Caitlyn Banister fishes at the Lodge at Glendorn during a recent club outing.

“Cases described in medical journals, calls to poison control centers and reports to the FDA suggest this drug has a significant potential for abuse,” Beshear said.

Ohio Gov. Mike DeWine signed an executive order in December allowing the state Board of Pharmacy to ban all products containing tianeptine. That ban took effect on Dec. 22, 2022. In February 2022, the FDA issued a consumer update on tianeptine products linked to serious harm, overdoses, and death. In the alert, the agency notes that it has identified cases in which people experienced other serious harmful effects from abusing or misusing tianeptine by itself or with other drugs, including antidepressants and anti-anxiety medicines. These effects included agitation, drowsiness, confusion, sweating, rapid heartbeat, high blood pressure, nausea, vomiting, slowed or stopped breathing, coma and death.

Legislation banning tianeptine was introduced in the New York state Senate in 2020, but has not been passed by the state Legislature.

Photo submitted to Times Observer Tidioute Community Charter School senior fishing club member Arreanna Anderson poses with Lodge at Glendorn Guide Jim Minich and a fish she caught during a recent fishing club outing to Glendorn.