Tianeptine: Safe Antidepressant or "Gas Station Heroin"?

Alright News Nation, you just lost yourself a follower.  

Well folks, I regret to inform you we're doing this again.  The thing where enterprising Americans learn of an obscure mind-altering substance, use it to spike some random concoction, sell the concoction to kids in shady places like gas stations & truck stops, and then the world acts surprised when people die from it.  The media labels it a menace & then the really tragic part inevitably follows:  it's moved to Schedule I where the supply gets even MORE tainted & we lock more Americans up for its possession.  That hasn't happened to tianeptine yet but it's guaranteed to at this rate.



Tianeptine Sodium vs. Dirty Tianeptine 

Tianeptine sodium (Stablon®, Coaxil®) is a tricyclic antidepressant prescribed in Europe & Asia.  Its mechanism of action wasn't known for a long time.  It was thought to be an SSRE, that's Selective Serotonin Reuptake Enhancer--the opposite of what SSRI's like Prozac and Zoloft do.  But it's now known to be a mu-opioid agonist which explains its uplifting effects on mood that kick in immediately after the 1st dose--a benefit over antidepressants prescribed in the States that have to build up in your system for weeks or a month before you feel anything.  A downside is the effects are short-lived & require dosing multiple times a day.  The typical starting dose is 12.5 mg three times daily for depression.  The related drug amineptine was placed in Schedule I in July 2021 despite NO recorded history of use or abuse in the United States.  

Legitimate tianeptine

 


In 2016 there was a shortage of tianeptine sodium so research chemical manufacturers started making tianeptine sulfate--a longer-acting form of the drug that's not approved anywhere.  And now shady vendors are marketing all manner of tianeptine products with names like "Tianaa Red" and "Neptune's Fix" in the form of capsules, liquid "shots" & more.  Like kratom, anyone of any age can purchase these potions which is a problem.  The dosage is often incredibly, dangerously high or unknown and they may contain other listed or unlisted ingredients.  (Neptune's Fix was found to contain two synthetic cannabinoids & kava when tested in a lab).  This is just plain retarded.  Forgive my language but this should be illegal for ANY supplement & the manufacturers should be locked up for reckless endangerment via overdosing the product or failing to appropriately label it.  Simply "recalling" it doesn't suffice.

Illegitimate tianeptine

Unlike depression patients who are prescribed the drug, recreational tianeptine users often take gargantuan doses alone or in conjunction with other substances, and sometimes they inject it.  When injected, tianeptine has a similar effect on the veins (warning: graphic!) to krokodil due to its tendency to clump & gum up when wet.  In lower doses it lacks the physical warmth of opioids but apparently at high doses it's incredibly addictive.  (I wouldn't know:  I used tianeptine, both the sodium & sulfate forms, for about 2 years to help with benzo withdrawal & had no such problems because I stuck to a sane oral dose & didn't buy it at a gas station.  Funny how that works).  In a blind test I wouldn't have even labeled it an opioid as it wasn't discovered to be one until the tail end of my usage & didn't feel like one in recommended doses.

Another Day, Another Drug War Casualty

The U.S. leads the world in overdose & addiction.

We live in a nation where people abuse diarrhea drugs and antihistamines for a buzz, so it should come as no surprise they would resort to abusing an antidepressant to get high.  You can ban tianeptine, but then what?  The real question is:  At what point will lawmakers start looking at the demand side of the supply-demand equation of the drug problem?  What is it that drives Americans to abuse drugs to this degree and become addicted/overdose at rates that exceed any other country on Earth?  When should we cut our losses with the Drug War & admit defeat, opting instead for harm reduction & sane drug laws that will demotivate users to resort to such extreme measures to obtain a head change?

Meta-analyses have found that recreational tianeptine users in the U.S. use the drug for 3 main reasons:  to mitigate drug withdrawal symptoms; to treat psychiatric symptoms & to improve overall quality of life/mood/performance.  Are those even "recreational" purposes?  I don't know about you, but I don't see "party my ass off," "escape my problems" or "get shitfaced" anywhere in that list.  Those are all legitimate reasons for using a drug even if their methods are not.  Maybe if we had universal healthcare that included mental healthcare and addiction treatment, some of these users wouldn't resort to using a cornerstore concoction for their health needs.  And if safer drugs were legal there wouldn't be a market for bizarre shit like this.   

That's the thing about "demand":  banning the thing in demand doesn't make it go away, it only makes it more dangerous.  This is true for drugs, porn, abortion, gambling & anything else a large number of humans partake in.  You haven't really 'banned' anything--you've just driven it underground where criminals control the supply & profits.  And in the case of drugs, banning one novel chemical only leads to a more exotic/less researched one popping up in its place.  Arresting one dealer only allows the one beneath him to move up the ranks.  Our drug laws unfortunately make both legal and illegal drugs more dangerous as regulators refuse to oversee their sale or enact sane regulations (age restrictions, labeling laws, purity/quality testing, etc) on both black market drugs (heroin-now-known-as-fentanyl, crack) and grey market substances like kratom or tianeptine.  It's a hands-off approach where only law enforcement steps in and only when things have reached an advanced stage.  Everyone loses except those who profit from keeping certain drugs illegal.

Some addiction center's lame ad.  Drug treatment is a $42 billion/year industry in the U.S.

Whether the drug in question is bath salts, kratom, Spice/K2, salvia, tianeptine or something else, it's not so much the drug that's killing people but lack of education about its effects and reckless use/marketing.  If you were to take an equivalent (over)dose of aspirin or Tylenol you'd die a horrible death as well.  People who expire from these drugs are almost always overdosing on them and often mixing them with other drugs and/or have pre-existing health conditions.  Thus, there's nothing inherently deadly or harmful about tianeptine when it's used correctly.  It's neither a miracle nor demon drug, just like Ozempic, kratom & every other drug we have this debate about.  The dose makes the poison, period.  What sucks is that people who might actually benefit from its medical use will no longer be able to access it once it's placed in Schedule I, at least not from a safe/reliable source.  Scientific research will be halted & the same people abusing it now will continue abusing tianeptine or some similar substance for a high.  You've saved no lives & ruined many.

If you think locking users in prison (i.e. what happens when we ban a drug) is the solution, you haven't been paying attention for the last 80+ years.