The Opioid Epidemic And Tianeptine Supplements

Most people think of heroin, prescription painkillers like oxycodone, or - more recently – the strong synthetic opioid fentanyl when they hear "opioid crisis."

12/21/20223 min read

What Is The Current State Of The Opioid Crisis?

Most people think of heroin, prescription painkillers like oxycodone, or - more recently – the strong synthetic opioid fentanyl when they hear "opioid crisis." Fewer individuals are aware of novel opioids like tianeptine, despite the fact that a growing number of Americans have taken it in the form of over-the-counter supplements like ZaZaRed or Tianna, frequently without realizing it has opioid qualities that can lead to addiction and overdose.

The complicated biology and marketing of tianeptine provide an educational framework for focusing and improving regulations surrounding addictive chemicals.

What is Tianeptine And How Does it Work?

Tianeptine is a short-acting tricyclic antidepressant (half-life of 2-4 hours) that interacts to a variety of human receptors, including opioid receptors. In most American states, tianeptine is sold as a dietary supplement alongside the usual selection of five-hour energy drinks and male enhancement pills found at local gas stations.

It is marketed for its antidepressant effects in a number of countries but has never been approved in the United States.

Who Controls Dietary Supplements, And Why Are They Regarded as Potentially Dangerous?
Because tianeptine products lack formal classification in the United States, they are covered by the 1994 Dietary Supplement Health and Education Act (DSHEA), which was intended to protect access to "natural" products like herbal remedies but ended up allowing legal sales of products with questionable origins, such as manufactured substances like tianeptine.

Pre-market testing to determine the purity, efficacy, or safety of substances sold as supplements is not needed under the DSHEA. In practice, lax regulation means that supplements routinely enter the American market unregulated, and "natural" products frequently contain unlisted ingredients such as steroids, Viagra, and sibutramine, a weight-loss drug that was withdrawn from the market in 2010 after studies revealed an increased risk of cardiovascular events.

The opioid characteristics of tianeptine are not revealed on the labels of common supplements containing this chemical, and the manufacturers instead praise the qualities of their products with dazzling claims like "alertness and a capacity to focus, without the crash that you experience with caffeine." Tianeptine is the newest addition to the list of uncontrolled drugs that pose a health hazard.

What Are The Consequences of Unregulated Supplement Management?

Sudden embargoes as health risks are discovered can further complicate the management of unregulated supplements. By putting tianeptine to the state's controlled substance list in March 2021, Alabama became the second state after Michigan to outlaw the drug.

While well-intentioned, the sudden prohibition resulted in a stampede for remaining supplies (one person reported spending hundreds of dollars to stock up ahead of the impending ban) and a rush to treatment for those who could no longer self-regulate in the absence of a legal supply they had grown accustomed to. (Unfortunately, anecdotal evidence suggests that tianeptine provides significant challenges when transferring to buprenorphine treatment, with patients reporting extended withdrawal symptoms that necessitate substantial doses of buprenorphine to consistently overcome the tianeptine's effects.)

Because tianeptine lacks the lengthy half-life and ability to store in fat cells that explains why methadone and fentanyl, for example, present difficult transitions to buprenorphine, more research is needed to better understand this observed behavior.)

A planned phase-out followed by teaching programs to help people understand that the disease induced by abrupt tianeptine discontinuation is, in reality, opioid withdrawal would have been a preferable approach.

What Are The Dangers of Other Unregulated Supplements?

Another unregulated supplement was offered as a tianeptine detox replacement, which was alarming. Phrenze Red claims to include phenibut, a sedative that is more related to gabapentinoids than opioids. Phenibut is unlikely to aid with opioid withdrawal, but it can cause toxicity when doses are increased to dangerous levels, leading to a rash of hospitalizations for side effects and overdose.

Phenibut is likely to become addictive on its own. When a relatively safe and well-understood narcotic is banned, experimental compounds not yet subject to prohibition rush onto the market, putting the dependent populace in even more danger. When poorly researched novel chemicals enter the market, people who believe they are getting the same substance or a rough equivalent are surprised by their toxicity - an iterative process that has left us with a slew of substances like flakka in place of the mild cathinones present in traditional East African khat preparations, and tianeptine in place of oxycodone.


The example of tianeptine exemplifies the difficulties of drug control and prohibition in a globalized market where innovative and untested compounds have become the standard. Tighter regulation of tianeptine supplements, rather than criminalization, harm-reduction approaches, and fact-based education on the risks and harms of novel psychoactive substances would alleviate the problems caused by the cyclical whiplash between the unregulated market of dietary supplements and the harsh consequences of drug prohibition.

Health Benefits of Cycling

Suboxone clinic is a telemedicine startup that distributes buprenorphine/naloxone (Suboxone) to people suffering from opioid addiction and dependency across the United States. With precise guidelines and clinical support services, we provide patients with strong support during the buprenorphine/naloxone induction phase. We also provide follow-up care to ensure that patients' recovery is as smooth as possible.