Editorial: 'Gas-station heroin' is dangerous. State must regulate it now

CBC Editorial: Wednesday, Jan. 17, 2024; #8899

The following is the opinion of Capitol Broadcasting Company

It is sold as an ingredient in dietary supplements – easy to buy at the counters of gas stations, convenience stores or smoke shops. But tianeptine, known as “gas-station heroin” on the streets, offers an opioid-like high when taken in larger amounts, can be similarly addictive and produce overdose symptoms.

Two months ago, the federal Food & Drug Administration warned that tianeptine is “‘a potentially dangerous substance that is not FDA-approved for any medical use but is illegally sold with claims to improve brain function and treat anxiety, depression, pain, opioid use disorder and other conditions.” It cautioned consumers “not to purchase or use” any products with tianeptine.

Still, it is readily available in North Carolina and sold under product names “Neptune’s Fix.” Abuse can result in loss of consciousness and seizures and require emergency medical attention.

“Tianeptine is an emerging threat,” Kaitlyn Brown, clinical managing director of America’s Poison Centers, told the New York Times. Her organization represents and collects data from 55 centers nationwide. “We have people who are able to get a substance that’s not well regulated, that has abuse potential and that, in high doses, can cause similar effects to opioids, leading to really harmful outcomes.”

The Times reported that the FDA’s enforcement powers are limited by law, so many products with tianeptine have been able to dodge labeling requirements.

A decade ago, four cases of tianeptine exposure were reported nationwide, according to the Times. Last year it jumped to 391 cases, according to America’s Poison Centers.

Bordering states of Tennessee and Georgia – along with seven other states around the nation – have already acted to ban the unregulated sale of products with tianeptine.

Timothy Ives, a professor at the UNC Eshelman School of Pharmacy, specialized on internal medicine and pain medicine, said he’s observed with concern the growing abuse of readily available products containing tianeptine.

“It’s totally unregulated,” he said in an interview with WRAL news.

“It's time for North Carolina to take a look at this. Look at the dangers and look at the population that could be getting this,” Ives said. “What's stopping anyone -- a 16-year-old -- from getting it. there are no inhibitions on that.”

In Florida, that state’s attorney general issued an emergency rule making tianeptine illegal. North Carolina’s Attorney General Josh Stein needs to review his authority to do the same.

Similarly, Gov. Roy Cooper needs to direct N.C. Secretary of Health and Human Services Kody Kinsley and those in the Substance Abuse Division to determine what action can be immediately taken to make sure such harmful products are not so readily available for abuse.

A product, displayed beside candy and cough drops, can be mistakenly assumed to be safe. Elixirs with tianeptine can be addictive and deadly.

As a matter of public health and safety, state officials need to act to limit access to this dangerous substance now.

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