How Tianeptine Supplements Feed the Opioid Epidemic

August 19, 2022

Table of Contents

Tianeptine is an antidepressant medication used in Europe but not in the United States. Its pharmacology is a little complicated - it has properties of both tricyclic antidepressant medications but is also partially an opioid medication. It is not regulated here in the US and is therefore not considered legal or safe for use.

If you're in recovery from an opioid use disorder (OUD), these pills could trigger a relapse. If you've never taken opioids before, Tianeptine is considered dangerous as it is an opioid medication and, like other opioid medications, carries the risk of overdose.

Tianeptine misuse is on the rise in the United States.[1] Here's what you need to know about Tianeptine. 

What Is Tianeptine?

Tianeptine is a tricyclic antidepressant which also has some opioid properties. It has a half-life of two to four hours.[2] It's not prescribed in the U.S. Instead, it's considered a dietary supplement and is included in products like ZaZaRed or Tianna.

Tianeptine products are regulated via the 1994 Dietary Supplement Health and Education Act (DSHEA). Under DSHEA, pre-market testing is not required to assess the purity, efficacy, or safety of substances marketed as supplements. Manufacturers also don’t have to tell their customers about the harm their products can cause.

Tianeptine works on opioid receptors, and it’s inherently dangerous. But manufacturers aren’t required to disclose this fact on their labels.

Dangers of Tianeptine for Those With OUD 

Any supplement you buy could be dangerous because supplements are not regulated by the FDA in the same way that medications are. Tianeptine could be particularly risky for people with an OUD for the following reasons:

Contamination 

Substances that claim to contain Tianeptine can often obtain other substances or other opioids instead. If you purchase Tianeptine illegally, you don’t really know what substance you are getting, or how much[3] 

Risk of Opioid Misuse

You might buy Tianeptine products to help treat cravings or withdrawal symptoms for opioids, however Tianeptine has misuse potential for people in recovery from OUDs.[4]

Risk of Overdose 

Tianeptine is an opioid medication and thus carries the same risks of other opioids, including respiratory suppression and overdose. 

How to Stay Safe 

Don't trust supplement suppliers. If you can't tell exactly what's inside a packet or pill you're about to buy, don't take it.

If you’re tempted to use Tianeptine to treat an OUD, reach out to your doctor. There are much safer, regulated, FDA approved medications to treat OUD that are available to you, including MAT (Suboxone, Methadone, and Naltrexone).

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

Reviewed By

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Citations

  1. Tianeptine Use: Another Dangerous Substance Emerges During Opioid Crisis. Healio. https://www.healio.com/news/primary-care/20201201/tianeptine-use-another-dangerous-substance-emerges-during-opioid-crisis. December 2020. Accessed July 2022. 
  2. Pharmacokinetic Study of Tianeptine and Its Active Metabolite MC5 in Rats Following Different Routes of Administration Using a Novel Liquid Chromatography Tandem Mass Spectrometry Analytical Method. Naunyn-Schmiedeberg's Archives of Pharmacology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5778159/. December 2017. Accessed July 2022.
  3. Tianeptine. Drug Enforcement Administration. https://www.deadiversion.usdoj.gov/drug_chem_info/tianeptine.pdf. May 2019. Accessed July 2022.
  4. Characteristics of Tianeptine Exposures Reported to the National Poison Data System, United States, 2000 to 2017. Centers for Disease Control and Prevention. https://www.cdc.gov/mmwr/volumes/67/wr/mm6730a2.htm. August 2018. Accessed July 2022.
  5. Supplements Sold at Alabama Gas Stations Causing Spike in Overdoses. Fox 17 Nashville. https://fox17.com/amp/news/local/supplements-sold-at-gas-stations-causing-spike-in-overdoses-according-to-health-experts. March 2021. Accessed July 2022.

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