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Notes from the Field: Cluster of Severe Illness from Neptune’s Fix Tianeptine Linked to Synthetic Cannabinoids — New Jersey, June–November 2023

NCJ Number
Morbidity and Mortality Weekly Report Volume: 73 Issue: 4 Dated: February 1, 2024 Pages: 89-90
Date Published
February 2024
2 pages

This report describes a review of New Jersey exposure calls involving tianeptine, an atypical tricyclic antidepressant that has not been approved by the Food and Drug Administration, but which is available for purchase in elixir formulations online and in gas stations.


This article reports on a retrospective review of exposure calls involving tianeptine exposure which were identified in the New Jersey Poison Information and Education System’s Toxicall database, from June 17 to November 6, 2023. It describes 20 cases of tianeptine ingestions (often sold as “gas station heroin”) during that time period, with severe associated clinical effects with synthetic cannabinoid receptor agonists (SCRAs) identified in samples of the ingested products. The article emphasizes that postmortem forensic toxicology testing suggests a high potential for substantial clinical effects of tianeptine products, and encourages members of the public and health care professionals to be aware that it is an unregulated drug which may cause adverse effects as well as dependence, and is sold under several product names, including Neptune’s Fix, Pegasus, and Zaza.

Date Published: February 1, 2024