While tianeptine is not listed in the federal Controlled Substances Act, which bans drugs like heroin and cocaine that have no medical use or a high likelihood of abuse. But about a dozen states, including Alabama, Georgia, Michigan, Tennesee and Ohio, restrict or ban it.

U.S. cases of severe side effects from exposure to tianeptine have increased from 11 in total between 2000 and 2013 to 151 in 2020 alone.

The Federal Drug Administration is warning people about a substance that has earned the nickname "gas station heroin," called tianeptine. The product, which is typically marketed as an energy shot or cognitive supplement, is often sold at gas stations, convenience stores, and smoke shops in brightly colored, small bottles.