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Ohio Joins U.S. States Banning Tianeptine: Understanding the Issue

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The State of Ohio recently (on Dec. 22, 2022) banned Tianeptine, an antidepressant drug with significant potential for abuse. Retailers in Ohio cannot stock Tianeptine or products containing it. If they possess any products that contain the drug, they must remove them from their shelves and dispose of them. The Ohio Board of Pharmacy issued an official news release written by Cameron McNamee’s which highlights the Tianeptine ban as directed by the Governor, describing the justifications and background for the rule and its intended effects.

Tianeptine is commonly used to combat depression, has several other common street names, and exists mainly under two brand names. While it is viewed by many an antidepressant and is even prescribed in some countries as treatment, it does not have the approval of the US Food and Drug Administration which has become only increasingly apprehensive of the substance over recent years. This is one of the significant reasons for Ohio’s banning it altogether. In this review we seek to explain the details of the new State rule and provide some context and background on the issue of Tianeptine.

In this Article

Outside of the U.S. particularly in Asia, Europe, and Latin America, Tianeptine exists -often legally- under the brand name Coaxil or Stablon. In the U.S.A. where the drug has no approved medical use consumers refer to the substance available as supplements for health and mood enhancers under brand names and street names which include Zaza, TD Red, Tianna and Gas Station Heroin among others.

While some indeed use the substance for health reasons, believing that it has various medical benefits, the drug is also often used in more problematic ways and as a means for achieving a constant mood boost or an opioid-like euphoric high.

Problems and Dangers Associated with Tianeptine

Tianeptine has a high potential for abuse. For example, a 2017 medical literature review indicated that women and men aged between 30-45 years old had a higher frequency of Tianeptine abuse. They would increase their Tianeptine uptake ten times more than the recommended daily dosage.

Of course, many just abuse Tianeptine because they were made aware through social circles of the “high” it can bring. In some cases, people with major depressive disorder self-medicate with Tianeptine to treat apathy and boredom. However, often they eventually escalate the dosage and suffer withdrawal syndrome, making it challenging to discontinue the drug intake. The same is true for many who turn to the drug for other purported health benefits, who often find themselves eventually dependent on Tianeptine’s mood enhancements. But the FDA counters that there is no known and proven medical benefit for the drug. As such, the Ohio Board of Pharmacy classified Tianeptine as a Schedule I controlled substance, indicating that it has no acceptable medical use to even consider for weighing its possible benefits against the real risks it presents.

On the down side, an overdose or misuse of Tianeptine can cause addiction, adverse physical reactions, withdrawal symptoms similar to strong opioids, and even death. For instance, some adverse physical reactions caused by Tianeptine overdose can include dizziness, nausea, high blood pressure, agitation, rapid heartbeat, confusion, slowed breathing, and even a coma. Some of the worst outcomes are born of abusing Tianeptine together with certain other drugs, but evidence also suggests that the drug itself can be fatal. For instance, the State of Ohio Board of Pharmacy’s release includes a review conducted in 2018 that revealed that nine deaths occurred because of a Tianeptine overdose. And the FDA reports that “Poison control center cases involving tianeptine exposure have increased nationwide, from 11 total cases between 2000 and 2013 to 151 cases in 2020 alone”. Tianeptine seems to also have a uniquely difficult withdrawal reaction, causing a prolonged cycle of use and increasing dosages.

Recognizing the popularity of the drug and the severe problems often caused by Tianeptine, the online community has organic active conversations and even forums discussing the issue. For example, Reddit has a forum named r/Quittingtianeptine that provides some (non-scientific) information on the adverse effects of using Tianeptine and the difficulty of withdrawal, uniting users and abusers with perspectives and ideas. Online forums offer warnings on some of the most dangerous ways to take the drug, and also psychosocial support to individuals addicted to Tianeptine through advice, tips, and encouraging stories about sobriety.

State of Ohio's Reasons for Banning Tianeptine

The State of Ohio Board of Pharmacy notes that Tianeptine poses a severe risk to public health, warranting the need to restrict its selling, possession, and use. It is worth noting that despite lacking FDA approval, Tianeptine is still readily available online, in gas stations, and in convenience stores across the US -including in Ohio. As such, individuals can self-medicate without professional help or monitoring, resulting in misuse, overdose, and other related issues, like death. In a 2022 update, FDA warned consumers that it has identified cases in which people experienced various, serious harmful effects from abusing or misusing tianeptine by itself or with other drugs, including antidepressants and anti-anxiety medicines.

Moreover, false advertising of Tianeptine makes people vulnerable to commercial exploitation. For example, most firms illegally market Tianeptine products as beneficial for anxiety, opioid disorder, depression, and even dietary purposes. The companies sell the drug without FDA approval and scientific evidence to prove the claims. They also market the supplements without clearly noting that the main ingredient is Tianeptine. Hence, the public is at risk of dependency and addiction to Tianeptine. Given these reasons, banning Tianeptine in Ohio was seen by the health care field as a prudent administrative decision. Ohio now joins a small list of states where the drug is already banned: Michigan, Alabama, Minnesota, Tennessee, Georgia, and Indiana.

The Ohio Board of Pharmacy release also provided some images of a few of the common Tianeptine supplement brands widely available online and in stores, to help visualize and identify the products. These images can be found here.

The Ohio Order's Directive and New Rules for Tianeptine, Zaza, Tianaa and Gas Station Heroin

The Ohio ban on Tianeptine will prevent all retailers and users of the drug from accessing it. Any product containing Tianeptine is illegal in the state; no one should sell or possess it. With no acceptable or recognized medical use, the drug poses an imminent hazard or danger to the Ohio state’s public health, safety, or welfare. Based on the Board’s findings, Ohio State had to classify Tianeptine as illegal.

In addition, the Board’s directives provide the course of action necessary for Tianeptine. First, the State of Ohio Board of Pharmacy recommends placing Tianeptine under Schedule 1. As mentioned, Schedule 1 drugs have no proven medical use and, thus, mainly pose severe health risks to their users. Second, the Board provides retailers direction on identifying Tianeptine products. For instance, any supplement whose label indicates that the product contains Tianeptina or Tianeptine is a Tianeptine product. Names such as Za Za (red, silver, or white), Pegasus, Tia (mega, red, gold, silver, white) and Tianna or Tianaa (white, red, and green) also refer to Tianeptine. These unique names and labels should guide retailers in identifying Tianeptine products.

Lastly, the Board directives recommend the course of action upon the discovery of Tianeptine products. Retailers must remove the medicines from the shelves and dispose of them immediately. Therefore, classifying Tianeptine and its products as Schedule 1 drug means it is felonious for any retailer or consumer to sell or possess it. Based on the State of Ohio Board of Pharmacy findings, Governor DeWine authorized the Board to adopt an emergency rule, thereby banning the sale and use of Tianeptine.

Getting help for Tianeptine Dependency and Addiction in Ohio

If you or someone you know may be struggling with unwanted Tianeptine misuse, they may be stuck in a cycle of addiction, which can be almost impossible to break out of alone. Addiction usually causes one to obsess over the substance they have developed a dependency on, and to seek it out and use it at all costs, even when it may be detrimental to them or their relationships. Additionally, most addictions stem from an underlying emotional or mental cause which may need to be addressed professionally and carefully in a thorough and deep manner.

If someone you care about is exhibiting signs of social or emotional deterioration, as well as other behaviors that may hint at a substance misuse or addiction, you might want to help them research the best available options for caring for and recovering from addiction. Someone stuck in a cycle of addiction may need longer term inpatient care, or a lower level of care, depending on their situation and circumstances. This evaluation is best done by a trained and certified addiction treatment specialist or a doctor. All quality addiction rehabilitation facilities provide access to proper evaluation of treatment needs, along with full applicable health screenings.

Along with finding the suitable care options, you may want to turn to an addiction care provider to assist you in finding a way to encourage and convince the one struggling with addiction to go ahead and commit themselves to treatment. Usually, this intervention is successful only when approached with sincere respect and compassion.

For more information and to take the first steps toward recovery, give us a call at (855) 443-6075 to speak to one of our compassionate team members in confidence.