Outpatient treatment for tianeptine dependence — the gas-station drug sold as Zaza, Tianaa, Neptune's Fix, and Pegasus — using the same buprenorphine-based medication-assisted treatment we use for opioid, kratom, and 7-OH dependence, at four clinics across Southeast Tennessee and North Georgia.
CARF AccreditedLicensed in Tennessee & GeorgiaSame-day appointments availableConfidential from your first call
At a glance
How we treat tianeptine addiction
Read summaryHide+
Restoration Recovery treats tianeptine dependence — the gas-station drug sold as Zaza, Tianaa, and Neptune's Fix — at four outpatient clinics across Tennessee and North Georgia. Tianeptine is an antidepressant used in some other countries but not approved by the FDA for any use in the United States. At the high doses people misuse it, it acts on the brain's mu-opioid receptors — the same target as heroin and prescription opioids — which is why it causes opioid-type dependence and withdrawal and earned the nickname “gas station heroin” (DEA; Poison Control).
Because tianeptine acts on the same receptor as the substances we already treat, the same buprenorphine-based medication-assisted treatment (Suboxone and long-acting buprenorphine) used for opioid use disorder can manage tianeptine dependence — used off-label, on a case-by-case basis, and supported by published medical case reports. Tennessee schedules tianeptine as a controlled substance and Georgia bans it outright, but you can get confidential treatment regardless of legal status. First visits run about 2 to 3 hours; same-week appointments; TennCare, BlueCare, BCBS, UHC, and most commercial insurance accepted.
Updated June 2026 · Published June 16, 2026
What Is Tianeptine? The “Gas Station Heroin”
Tianeptine is an antidepressant prescribed in some other countries but not approved by the FDA for any use in the United States. At the high doses people take it for euphoria, it acts on the brain's mu-opioid receptors — the same receptors as heroin and morphine — which is why it produces opioid-type dependence and withdrawal.
In the United States, tianeptine is sold at gas stations, convenience stores, smoke shops, and online under brand names like Zaza and Zaza Red, Tianaa, Neptune's Fix, Pegasus, and TD Red. It comes as capsules, flavored liquid “elixir” shots, and pressed pills, and it is marketed as a mood, focus, or “wellness” supplement. None of that marketing is accurate: the FDA has stated that tianeptine is not approved for any medical use, does not meet the legal definition of a dietary ingredient, and is an unsafe food additive, so any supplement containing it is considered adulterated.
Where tianeptine is prescribed abroad as an antidepressant, the dose is small — about 12.5 mg, three times a day. The doses people use recreationally are far higher, often many times the recommended daily amount. At those doses, tianeptine's activity at the mu-opioid receptor takes over, producing opioid-like euphoria along with the tolerance, dependence, and withdrawal that come with any opioid. That receptor activity is also why the drug picked up the street name “gas station heroin.”
This is a fast-growing problem. Calls to U.S. poison centers about tianeptine rose from single digits in the mid-2010s to hundreds a year, and the FDA has issued repeated consumer warnings and oversaw a nationwide recall of all Neptune's Fix products in 2024. Many families first encounter the word “tianeptine” only after they find a bottle of Zaza or Neptune's Fix and search the brand name. If that is how you got here, you are in the right place — Restoration Recovery treats tianeptine dependence at four outpatient clinics across Tennessee and North Georgia, and you can call us before your loved one is ready.
Sources: U.S. Drug Enforcement Administration, Diversion Control Division, “Tianeptine” drug fact sheet (2026); U.S. Food & Drug Administration, “Tianeptine in Dietary Supplements” and consumer warnings on tianeptine products; America's Poison Centers / Poison Control, “Tianeptine.”
Tianeptine calls to U.S. poison centers
National Poison Data System (CDC / America's Poison Centers)
52014
832016
3892023↑ rising sharply
U.S. poison-center calls about tianeptine climbed from single digits in 2014 to 389 in 2023. (The 2014–2017 and 2023 figures come from different annual reports.)
Prescribed dose vs. misuse dose
Recommended antidepressant dose abroad vs. reported U.S. use
12.5 mg3×/day abroad
1.3–250×reported U.S. misuse↑ far beyond medical use
U.S. consumers have been reported taking 1.3 to 250 times the recommended daily dose of the products tianeptine is sold in. (FDA)
The Tianeptine Picture in 2026
Tianeptine sits at the center of the “gas station drug” wave — products sold legally-looking on a shelf that behave like controlled opioids once someone starts using them daily.
It is not an approved supplement. The FDA says tianeptine is not approved for any medical use, does not qualify as a dietary ingredient, and is an unsafe food additive — so dietary supplements containing it are adulterated under federal law.
It is sold under shifting brand names. Zaza, Tianaa, Neptune's Fix, Pegasus, and TD Red are the common ones; as states ban it, products are relabeled and reappear, which is part of why families have trouble pinning down what their loved one is taking.
It is short-acting, so misuse escalates fast. Tianeptine's effects wear off quickly, which pushes people who misuse it to redose every few hours. That cycle is how a “mood supplement” becomes a multiple-times-a-day dependence.
Polysubstance use is common, and so is danger. Tianeptine is frequently used alongside other substances, and in real-world fatal overdoses it is most often found in combination with other opioids such as fentanyl rather than on its own.
It is controlled across our region. Tennessee schedules tianeptine as a controlled substance, Georgia bans it as Schedule I, and Alabama bans it as well. Treatment access at Restoration Recovery does not depend on the legal status of the substance — we treat the dependence regardless of where or how it started, and clinical conversations are protected by 42 CFR Part 2 confidentiality rules.
The practical takeaway: if someone is buying tianeptine several times a week, getting sick or irritable between doses, or ordering it online now that local stores have stopped carrying it, that is the pattern of an opioid-type dependence — and it responds to the same medication-based treatment used for opioids.
Sources: DEA Diversion Control Division, “Tianeptine” drug fact sheet (2026); FDA, “Tianeptine in Dietary Supplements” and tianeptine consumer warnings; CDC, MMWR 2018;67(30):815–818 (El Zahran et al.); Gummin et al., 2023 Annual Report of the National Poison Data System; Legislative Analysis and Public Policy Association, Tianeptine fact sheet (2025).
Recognizing it
Signs of Tianeptine Dependence
The clearest sign that tianeptine use has crossed into dependence is the cycle of redosing to avoid feeling sick — using not to get high, but to keep withdrawal away.
Tianeptine dependence develops the way other opioid dependence does: tolerance climbs, the dose goes up, and stopping brings on withdrawal. Because it is short-acting, that withdrawal can start within hours, which traps people in a frequent-redosing pattern. Common signs in someone using a tianeptine product (Zaza, Tianaa, Neptune's Fix, Pegasus, or TD Red) include:
Redosing every few hours. Taking it multiple times a day, often on a schedule built around staving off withdrawal rather than getting an effect.
Running out early and escalating. Going through product faster than expected, needing more to feel normal, and buying in larger quantities.
Ordering online after local bans. Switching to online sellers or to relabeled brands once gas stations and smoke shops in Tennessee or Georgia stop carrying it.
Getting sick between doses. Sweating, nausea, anxiety, irritability, or a racing heart when a dose is late or missed.
Using to function, not to feel high. Needing it to get through the morning or the workday, and feeling unable to stop without getting sick.
Empty bottles and secrecy. Accumulating empty Zaza or Neptune's Fix bottles, hiding use, or unexplained spending on convenience-store products.
Mixing with other substances. Using tianeptine alongside kratom, alcohol, benzodiazepines, or opioids — which raises the risk and changes the treatment plan.
Failed attempts to quit. Trying to stop on your own and returning to use within a day or two because the withdrawal is too uncomfortable to push through alone.
Many people who become dependent on tianeptine started taking it to cope with depression, anxiety, or chronic pain — that is how it is marketed. Because of that, treatment looks at the underlying condition as well as the dependence. If several of these signs apply to you or someone you care about, a professional evaluation can clarify where things stand and what the options are. You do not need to hit a crisis before reaching out.
Tianeptine Withdrawal: What to Expect
Tianeptine withdrawal closely resembles opioid withdrawal, and because the drug is short-acting, symptoms can start within hours of the last dose.
When someone who is dependent on tianeptine stops or cuts back, the body reacts the way it would to stopping any opioid. Reported withdrawal symptoms include agitation and anxiety, sweating, nausea and other stomach upset, muscle aches, strong cravings, and an elevated heart rate and blood pressure. The short duration of tianeptine's effects is part of why withdrawal can come on quickly and why dependence escalates — people redose to stay ahead of feeling sick.
Within hours of last dose
Early symptoms
Agitation and anxiety, sweating, and the first cravings — coming on quickly because tianeptine is short-acting.
Peak symptoms
Peak physical symptoms
Nausea and stomach upset, muscle aches, strong cravings, and an elevated heart rate and blood pressure. Withdrawal can be severe, and hospitalizations have been reported.
This is where the medication helps most. Because tianeptine acts on the opioid receptor, the same buprenorphine-based medication used for opioid withdrawal works here too, and published cases describe symptoms improving within a few days of starting treatment.
With buprenorphine and supportive care, withdrawal is controlled while treatment begins — we stabilize you on medication on an outpatient basis rather than running a cold-turkey detox.
One practical note that matters clinically
Tianeptine usually does not show up on routine drug screens. If you or a loved one has been using it, say so directly at intake — a negative drug test does not rule it out, and telling the clinician is what makes the right treatment plan possible.
How We Treat Tianeptine Dependence
Because tianeptine acts on the same mu-opioid receptor as opioids, kratom, and 7-OH, we treat it with the same buprenorphine-based medication-assisted treatment (MAT) — Suboxone and long-acting buprenorphine — combined with counseling and peer support. Buprenorphine is FDA-approved for opioid use disorder and used off-label for tianeptine; published medical case reports describe patients stopping tianeptine and staying off it with this approach.
At Restoration Recovery, tianeptine dependence is treated as the opioid-receptor problem it is, on an outpatient basis. The components of care include:
A daily film or tablet that stabilizes the same mu-opioid receptors tianeptine acts on, which stops withdrawal and quiets cravings without the cycle of getting high and getting sick. A same-day prescription is the standard at your first visit, so you can start the same day you come in. Buprenorphine is FDA-approved for opioid use disorder and used off-label for tianeptine — the same medication, applied to the same receptor.
Long-acting
Long-acting buprenorphine injections
For patients who prefer not to take a daily medication, Sublocade (monthly) and Brixadi (weekly or monthly) deliver buprenorphine as an injection. Injections are available at our Chattanooga, Cleveland, and Ringgold clinics; our Soddy-Daisy clinic provides oral medication.
Individual counseling
Licensed therapists use evidence-based approaches including cognitive-behavioral therapy. Because many people use tianeptine to self-treat depression, anxiety, or pain, counseling addresses the reasons behind the use, not just the use itself.
Intensive outpatient (IOP)
Our IOP serves patients who benefit from a more structured schedule — clinician-led sessions delivered in a group format by design. IOP is the only group-setting service we offer.
Certified peer support
Specialists with lived recovery experience, who can talk through what the first weeks actually feel like.
Naloxone (Narcan) and safety planning
Because tianeptine acts like an opioid, naloxone may reverse the effects of a tianeptine overdose while you wait for help, so we provide naloxone and education. A suspected overdose is an emergency — call 911 and Poison Control at 1-800-222-1222; naloxone is a bridge to emergency care, not a replacement for it.
Integrated care for co-occurring conditions
Co-occurring conditions and, for patients with risk factors, hepatitis C screening and treatment — addressed alongside MAT.
Restoration Recovery is an outpatient clinic, and most patients with tianeptine use disorder start medication-assisted treatment right here — buprenorphine can begin at the appropriate point after last use, under clinical supervision. Established patients can move to telehealth follow-up after the first in-person visit.
One honest note about the evidence: there is no medication FDA-approved specifically for tianeptine, and the published research on treating it is still limited to case reports rather than large clinical trials. What those reports and the shared opioid-receptor biology both point to is buprenorphine-based MAT — the most established, evidence-based treatment for opioid-receptor dependence. Your treatment is individualized and directed by a licensed clinician.
Start the same day
Most patients who come in for tianeptine dependence leave their first visit with a same-day buprenorphine prescription. First visits run about 2 to 3 hours, and our team verifies your insurance before you arrive so there are no surprises.
Your first visit typically lasts 2 to 3 hours and follows a four-step clinical flow, and most patients leave with a same-day buprenorphine prescription so treatment starts the same day.
01
Intake
You will complete paperwork and a clinical intake covering what you have been using and when your last dose was, your medical history, current medications, and any co-occurring mental health conditions. Because tianeptine dependence is opioid-type, the intake includes a COWS (Clinical Opiate Withdrawal Scale) assessment of your withdrawal. Tell the team it is tianeptine even if a drug screen comes back negative — it often does not appear on routine tests.
02
Counseling
You will meet with a counselor to talk through your use history, prior attempts to stop, current stressors and triggers, and your goals. Many people who use tianeptine are managing depression, anxiety, or pain underneath the use, and this conversation helps shape the plan.
03
Doctor evaluation
A medical provider reviews your intake and counselor notes, confirms the opioid-type dependence, screens for other substances and co-occurring conditions, decides on the right buprenorphine plan, and answers your questions.
04
Treatment plan
You leave with a personalized plan. For tianeptine dependence, a same-day buprenorphine (Suboxone) prescription is the standard, so you can begin treatment that day; we will also discuss long-acting injection options if you prefer them, counseling, IOP if appropriate, and a connection to peer support. Your first follow-up is scheduled before you leave.
About 2–3 hours.Most patients leave the same day with a buprenorphine prescription.Bring a photo ID, insurance card, and a list of any medications.
What to bring — and why the product label helps+
Bring a valid photo ID, your insurance card if you have one, and a list of any medications you currently take. If you still have the product or its bottle — Zaza, Tianaa, Neptune's Fix, or another brand — bring it or a photo of the label; knowing the exact product helps. If other substances are part of the picture (kratom, alcohol, opioids, benzodiazepines), bring that history too.
Is Tianeptine Legal in Tennessee, Georgia, and Federally?
Tennessee classifies tianeptine as a Schedule II controlled substance, Georgia bans it as a Schedule I controlled substance, and neighboring Alabama bans it as well. It is not yet federally scheduled, but the FDA has warned against it repeatedly and a federal bill to restrict it is pending.
Tennessee — Schedule II. Tennessee added tianeptine to its controlled-substances schedule effective July 1, 2022 (Public Chapter 1135). Selling it over the counter is illegal, and knowing possession without a valid prescription is a Class A misdemeanor.
Georgia — Schedule I. Georgia bans tianeptine more strictly, classifying it as a Schedule I controlled substance, added by House Bill 963 in 2022 (O.C.G.A. § 16-13-25).
Alabama and beyond. Alabama also bans tianeptine as a Schedule I substance, so all three states in our service area control or ban it — and a growing number of other states have done the same.
Federal. Tianeptine is not a DEA-scheduled controlled substance at the federal level, but the FDA treats it as an unapproved drug and an unsafe food additive, has issued repeated consumer warnings, and oversaw the 2024 nationwide recall of all Neptune's Fix products. A federal bill, the Prohibiting Tianeptine and Other Dangerous Products Act, was introduced in 2026 and is pending in Congress.
These bans are making tianeptine harder to buy legally, but they do not change your ability to get help. Treatment at Restoration Recovery does not depend on where or how the dependence started, and your clinical conversations are protected by HIPAA and 42 CFR Part 2 confidentiality. If local stores have stopped selling it and you are now ordering online or feeling sick between doses, that is a sign it is time to talk to a clinician.
Why Restoration Recovery
Restoration Recovery is one of Chattanooga's longest-running outpatient addiction clinics: CARF-accredited, with four locations across Southeast Tennessee and North Georgia, same-day appointments available, and most major insurance accepted — including TennCare and Georgia Medicaid.
Choosing where to start treatment matters. Restoration Recovery brings together the clinical depth, the practical access, and the kind of care that keeps patients in treatment long enough to get well.
One of Chattanooga's longest-running outpatient addiction treatment clinics. Our providers have decades of clinical experience treating opioid and opioid-type use disorders in Southeast Tennessee — including the newer gas-station drugs like tianeptine, kratom, and 7-OH.
CARF accredited. The Commission on Accreditation of Rehabilitation Facilities is the gold standard for outpatient addiction care — our accreditation is reviewed on an ongoing basis, not a one-time stamp.
Four clinic locations across Southeast Tennessee and North Georgia, with telehealth follow-up available for established patients.
Most major insurance accepted — TennCare, Georgia Medicaid, commercial plans, Medicare, and supplemental Medicare. Our patient services team verifies your benefits before your first visit so there are no surprises.
Same-day appointments available. You don't have to wait weeks to start.
One integrated team. Medical providers, counselors, certified peer support specialists, and psychiatric care under one roof — not parallel referral tracks that leave you coordinating your own care.
Licensed in both states. Licensed in Tennessee and Georgia, HIPAA compliant, 42 CFR Part 2 compliant — your treatment is confidential from the first phone call.
Polysubstance-ready clinical team. Most patients use more than one substance at presentation. We are built to treat the whole picture, not just the drug at the top of the intake form.
CARF-accredited outpatient addiction care
TennCare, BlueCare, BCBS, UHC, Medicare & most commercial insurance accepted. We verify your benefits before your first visit — no surprises. Licensed in TN & GA · HIPAA · 42 CFR Part 2.
Insurance and Access
Restoration Recovery accepts most major insurance plans, including TennCare, Georgia Medicaid, a broad range of commercial plans, and Medicare (plus supplemental Medicare plans). Our patient services team can verify your benefits before your first appointment so you know exactly what to expect in terms of cost.
If you do not have insurance, contact us anyway. Self-pay is a flat $250 per month, with medication billed separately, and we will walk you through it. For a full list of accepted carriers and details on the verification process, visit our insurance page.
We operate four outpatient clinics across Southeast Tennessee and North Georgia. All locations offer tianeptine addiction treatment with same-day appointments available:
Telehealth follow-up visits are available for established patients who have completed their initial in-person evaluation. For directions, hours, and contact information, visit our locations page.
Take the Next Step
Tianeptine dependence is treatable, and because it acts on the opioid receptor, it responds to a well-established medication. You don't need to have all the answers before you call, and you don't need to be off the product before your first appointment. Our team will walk you through the process from your first phone call to your first visit and every follow-up after that.
Same-day appointments are available. Contact us today to schedule your evaluation, or call 423-498-2000 to speak with our team directly.
Questions
Frequently Asked Questions
Is tianeptine (Zaza) addictive?+
Yes. Tianeptine is an antidepressant sold abroad but not approved by the FDA for any use in the United States. At the high doses people take it for euphoria, it acts on the brain's mu-opioid receptors — the same receptors as heroin and prescription opioids — which is why long-term use can lead to tolerance, dependence, and opioid-type withdrawal when someone stops. That is why it is nicknamed “gas station heroin.” If you or someone you love is using a tianeptine product daily — Zaza, Tianaa, Neptune's Fix, Pegasus, or TD Red — it is reasonable to treat it as a habit-forming, opioid-like substance and talk to an addiction clinician.
Can Suboxone or buprenorphine help with tianeptine withdrawal?+
Because tianeptine acts on the same mu-opioid receptor as opioids, the same buprenorphine-based medications used for opioid use disorder can be used to manage tianeptine dependence and withdrawal. Buprenorphine (the active medication in Suboxone) is FDA-approved for opioid use disorder, not specifically for tianeptine, so this is off-label, case-by-case treatment directed by a clinician. The published medical evidence is still limited to case reports rather than large trials, but those reports describe patients successfully stopping tianeptine and staying off it with buprenorphine-based treatment, including people who were still using daily when they started. It is the same medication approach Restoration Recovery already uses for opioid, kratom, and 7-OH dependence.
What does tianeptine withdrawal feel like?+
Tianeptine withdrawal closely resembles opioid withdrawal. Common symptoms include agitation and anxiety, sweating, nausea and other stomach upset, muscle aches, strong cravings, and a racing heart and elevated blood pressure. Because tianeptine is short-acting, symptoms can begin within hours of the last dose, which is part of why people end up redosing every few hours. Withdrawal can be severe, and hospitalizations have been reported, so it is not something to try to white-knuckle alone. With buprenorphine-based medication and supportive care, published cases describe withdrawal symptoms improving within a few days of starting treatment. We stabilize you on medication on an outpatient basis rather than running a cold-turkey detox.
Is tianeptine legal in Tennessee or Georgia?+
No, not for retail sale. Tennessee classifies tianeptine as a Schedule II controlled substance (effective July 1, 2022), so selling it over the counter is illegal and knowing possession without a valid prescription is a Class A misdemeanor. Georgia bans it more strictly, as a Schedule I controlled substance (added by House Bill 963 in 2022). Neighboring Alabama bans it as well, and a growing number of other states have followed. Tianeptine is not yet a federally scheduled drug, but the FDA treats it as an unapproved, unsafe ingredient, has warned consumers repeatedly, and oversaw the 2024 nationwide recall of Neptune's Fix. Getting treatment does not depend on the legal status of the substance — your clinical conversations are confidential and protected by HIPAA and 42 CFR Part 2.
Can you overdose on tianeptine or Zaza?+
Yes. Because tianeptine acts like an opioid in the brain, high doses can cause opioid-type toxicity, including severe sedation, slowed or depressed breathing, loss of consciousness, and seizures. Fatal overdoses have occurred, most often when tianeptine is combined with other opioids such as fentanyl. Because it acts on the opioid receptor, naloxone (Narcan) may reverse some of the effects of a tianeptine overdose while you wait for help — but a suspected overdose is a medical emergency: call 911 and Poison Control at 1-800-222-1222. Naloxone is a bridge to emergency care, not a substitute for it. Also, tianeptine often does not show up on routine drug screens, so tell any treating clinician if it has been used.
How do I help a family member who is using Zaza or Neptune's Fix?+
Many families first hear the word tianeptine when they find a bottle of Zaza, Tianaa, or Neptune's Fix and search the brand name. Warning signs include redosing every few hours, ordering online after local stores stop carrying it, getting sick or irritable between doses, empty bottles, and secrecy or spending around the product. You do not have to wait until your loved one is ready or has hit a crisis to reach out. You can call Restoration Recovery and talk through the situation confidentially before they are ready, and our team can explain what treatment looks like and how to start. Many people who use tianeptine began taking it to cope with depression, anxiety, or pain, so treatment addresses the underlying condition as well as the dependence.
A place for hope & healing
Ready to stop using tianeptine?
Same-day appointments available. Most major insurance plans accepted.
