First there was poppers, next came K2 & spice, then bath salts, then kratom, and now… Zaza red. All of these drugs, at one point or another, could be bought at gas stations and smoke shops across the country and promise to deliver a high without the consequences and hassle associated with illegal narcotics. Except like all of it’s predecessors, “gas station heroin” as some are calling it is turning out to be anything but harmless.
What is Zaza Red?
Tianeptine, sold under the brand names Za Za and Tianaa, is approved as an antidepressent in several European countries. Structurally, it is similar to tricyclic antidepressants (TCAs) like amitriptyline, but what makes the drug unique is that it binds to mu-opioid receptors in the brain. These receptors are the same ones that opioid drugs like oxycodone, heroin, and fentanyl bind to. The results are an increase in extracellular dopamine, a decrease in stress hormones, an enhanced serotonin uptake.
The drug is typically sold in powder or tablet form online, in convenience stores, and in gas stations. And while the drug may be approved in other countries, the FDA warns,
“Tianeptine is not approved by the U.S. Food and Drug Administration for any medical use. Despite that, some companies are illegally marketing and selling products containing tianeptine to consumers. They are also making dangerous and unproven claims that tianeptine can improve brain function and treat anxiety, depression, pain, opioid use disorder, and other conditions.”
They go on to note than in other countries where the drug is approved, restrictions have been placed on prescribing and dispensing the drug including warnings of potential for abuse and addiction.
Effects of Tianeptine
At clinically recommended doses, the drug is used to treat depression and anxiety. To experience a high, the people who are buying this gas station dope are taking the drug at much higher doses than what would be prescribed in a clinical setting. When an individual uses tianeptine in these quantities, they experience reduced anxiety and a sense of euphoria and relaxation. But while the drug can produce sedation, the effects are typically much less intense than those produced by more commonly misused and abused opioids. In fact, an analysis of online communities of zaza users found that “the users were not necessarily seeking a recreational high or euphoric experience but, as the authors term it, were chasing the ‘Ok-ness’.”
The same analysis found that many users were combining Tianaa with kratom and so-called cognitive enhancers like phenibut and racetams, all of which can be bought in the same places that sell tianeptine.
Alabama Poison Information Center Suddenly Overwhelmed by Cases Involving Tianeptine
What started as an isolated outbreak of substance use disorders involving the drug in Jefferson County had spread to the rest of the state by November of 2019, according to the Alabama Department of Public Health. Emergency departments throughout the state had been reporting to the poison control center that patients had started coming in for both overdoses resulting from tianeptine exposure and for withdrawal from the drug. William Rushton, who runs UAB’s Medical Toxicology program claimed that nearly a third of the patients who came to the hospital for issues related to the drug were admitted to the intensive care unit.
According to Dr. Rushton, the withdrawal symptoms associated with discontinuing Zaza red are similar to normal opioid withdrawal symptoms: anxiety, nausea, muscle twitches, etc. Unlike other opioids that frequently contribute to substance use disorders though, tianeptine withdrawal seems to start within an hour or two of stopping the drug. And in many of the cases that required admission to the ICU, patients experienced delirium requiring high doses of sedatives.
After another spike in March of 2021, the Alabama state government reviewed the shocking data collected by the APIC and ADPH and passed a state-wide ban on the drug. While the drug still has not been entirely eradicated in Alabama, the ban has made it less accessible. Officials worry that the ban in Alabama may result in a Zaza explosion in bordering states Georgia, Tennessee, and possibly even Florida.
Substance Use Disorder Treatment
The production of new synthetic drugs that produce cheap highs will continue to outpace the legislation aimed at stopping their spread. Addiction and substance use disorders are the inevitable consequence. As Zaza starts to make it’s way into states across the country, All In Solutions Counseling Center will be here to provide caring and effective addiction treatment. To learn more about our programs, give us a call or check out our Florida treatment program and New Jersey treatment program.