What Gas Station Drugs Reveal About America's Supplement Problem
What Gas Station Drugs Reveal About America's Supplement Problem
Walk into any gas station along an American highway and you will find a small, brightly lit display near the register. Tucked between the energy shots and the breath mints sit blister packs of pills, foil pouches of powder, and gummies in flavors borrowed from candy aisles. The packaging is glossy. The promises are bold. Words such as natural, botanical, focus, calm, and relief repeat across the labels in confident type. To the average shopper picking up a soda and a bag of chips, these products read as harmless wellness items, no different in spirit from a multivitamin.
They are not. A growing share of these convenience store offerings contain compounds with the pharmacological strength of prescription opioids, with documented histories of dependence, hospitalization, and death. They are sold without a prescription, without age verification in many states, and without the safety review that any consumer would reasonably assume must exist before a substance is placed within arm's reach of a child buying gum. The story of how these products reached the counter is a story about a much larger gap in American health policy, one that touches nearly every bottle on the supplement shelf.
Kratom: A Plant With a Complicated Reputation
Kratom comes from Mitragyna speciosa, an evergreen tree in the coffee family that grows across Thailand, Malaysia, Indonesia, and Papua New Guinea. For generations, agricultural laborers in the region have chewed its leaves or brewed them into tea to push through long days of physical work, ease minor aches, and lift fatigue. The plant contains more than forty alkaloids, the two most studied being mitragynine and 7-hydroxymitragynine. At low doses, mitragynine produces stimulant-like effects similar to a strong cup of coffee. At higher doses, the same compound binds to mu-opioid receptors in the brain and produces sedation, euphoria, and pain relief.
In the United States, kratom arrived as an herbal supplement marketed for energy, mood elevation, and pain management. It is sold as loose powder, capsules, extracts, and pre-mixed beverages. Estimates from the American Kratom Association place American consumption somewhere between two and fifteen million users, a wide range that itself reflects how little formal data exists. Many of those users are adults attempting to manage chronic pain, opioid withdrawal, anxiety, or depression on their own, often because formal medical care has either failed them or remained out of reach.
The plant is not without genuine risk. The Centers for Disease Control and Prevention reviewed more than 27,000 overdose deaths recorded between July 2016 and December 2017 and found kratom listed on the toxicology report in 152 cases, with the drug identified as a cause of death in 91 of them (Olsen et al.). Most of those cases involved other substances as well, particularly fentanyl, but the data make clear that kratom is pharmacologically active and capable of contributing to fatal outcomes. Reports of liver injury, seizures, and dependence have appeared steadily in the medical literature since the mid-2010s.
Still, traditional kratom leaf, taken in modest amounts, behaves much like any plant containing psychoactive alkaloids. It carries risk, it deserves caution, and it warrants honest labeling. What it is now competing against on the convenience store shelf is something quite different.
7-Hydroxymitragynine: A Designer Opioid in Botanical Clothing
7-Hydroxymitragynine, usually labeled 7-OH, occurs naturally in kratom leaves at concentrations of roughly two percent of total alkaloid content, often less. Researchers studying the compound in isolation have found that it binds to mu-opioid receptors with a potency estimated at roughly thirteen times that of morphine on a milligram-for-milligram basis (Kruegel et al.). In a kratom leaf, this potency is buffered by the presence of mitragynine and dozens of other alkaloids that modulate the overall effect. In a purified or semi-synthetic tablet, the buffering is gone.
Over the past two years, products containing concentrated 7-OH have flooded American convenience stores. They are sold as orange-flavored gummies, dissolvable strips, shots, and chewable tablets under brand names that suggest energy drinks or candy rather than controlled substances. Independent laboratory testing commissioned by industry watchdogs and reported in coverage of the United States Food and Drug Administration's recent enforcement push has found 7-OH concentrations in some products that exceed what could ever occur in raw plant material, indicating chemical extraction, concentration, or outright synthesis (FDA, "FDA Takes Steps").
In July 2025, the FDA took the unusual step of formally recommending that 7-OH be scheduled under the Controlled Substances Act and issued warning letters to seven companies marketing the compound (FDA, "FDA Takes Steps"). The agency's announcement described 7-OH products as posing a serious risk of opioid use disorder, respiratory depression, and overdose, and noted that the candy-like presentation of many products created a clear danger to children. As of this writing, the recommendation has not yet produced federal scheduling, and the products remain widely available in states that have not passed their own restrictions.
The clinical picture is consistent with what one would expect from a potent mu-opioid agonist sold without medical supervision. Emergency physicians and addiction specialists have reported patients arriving in withdrawal syndromes that resemble heroin or oxycodone discontinuation, including severe gastrointestinal distress, agitation, sweating, insomnia, and protracted cravings. Patients are often startled to learn that the gummy they purchased at a gas station has produced a physical dependence comparable to a prescription opioid. They had assumed, reasonably, that anything sold so openly must have passed some form of safety review.
It had not.
Tianeptine: The Antidepressant That Became a Street Drug
Tianeptine is an atypical tricyclic compound originally developed in France in the 1960s and approved in several European, Asian, and Latin American countries as a prescription antidepressant. At therapeutic doses of 12.5 milligrams taken three times daily, it appears to modulate glutamate signaling and produce modest mood improvement. It is not approved by the United States Food and Drug Administration for any medical use.
The complication is that tianeptine, at doses several times higher than the therapeutic range, becomes a full agonist at the mu-opioid receptor (Gassaway et al.). Recreational users discovered this property quickly, and a market emerged for products sold as dietary supplements or nootropics under brand names such as Zaza, Tianaa, Neptune's Fix, and Pegasus. These products are typically sold in small bottles or blister packs at gas stations, smoke shops, and online retailers. The active dose per unit often exceeds one hundred milligrams, an order of magnitude above any clinical recommendation.
The street name gas station heroin is not marketing exaggeration. Cases of severe withdrawal, seizures, cardiac arrhythmias, prolonged psychiatric symptoms, and death have been documented in growing numbers. The America's Poison Centers network reported a nearly hundredfold increase in tianeptine-related calls between 2014 and 2020, and the trajectory has continued upward (Rushton et al.). New Jersey issued a state of emergency response in 2023 after Neptune's Fix products were linked to a cluster of seizures, loss of consciousness, and at least one death (FDA, "FDA Warns Consumers").
Eleven states have now banned tianeptine outright, including Alabama, Florida, Georgia, Indiana, Kentucky, Michigan, Minnesota, Mississippi, Ohio, Oklahoma, and Tennessee. The FDA has issued warning letters to manufacturers and import alerts blocking shipments of the bulk powder. None of this has removed the substance from the wider American market. A consumer in a state without specific legislation can still buy a bottle of tianeptine tablets at the same counter where they pay for fuel.
How Did These Products Reach the Counter?
The answer requires a brief look at a piece of legislation that most consumers have never heard of. The Dietary Supplement Health and Education Act of 1994, known as DSHEA, created a regulatory category for vitamins, minerals, herbs, amino acids, and related products that sits separately from both food and pharmaceuticals. Under DSHEA, a manufacturer does not need to prove that a supplement is safe or effective before selling it. The FDA may act against a product only after it reaches the market, and only if the agency can demonstrate that the product is adulterated, misbranded, or poses a significant risk (U.S. Food and Drug Administration, "Dietary Supplements").
In practical terms, this reverses the burden of proof that governs prescription drugs. A pharmaceutical company seeking approval for a new medication must conduct years of preclinical and clinical research, submit thousands of pages of data, and satisfy the FDA that the benefits outweigh the harms. A supplement company can place a product on a shelf today and wait to see whether anyone gets hurt. If illness or death follows, the FDA must build a case product by product, manufacturer by manufacturer, often without subpoena power over the original ingredient suppliers.
The scale of the resulting market is difficult to overstate. The Council for Responsible Nutrition estimates that more than 80,000 distinct supplement products are sold in the United States, and roughly three out of four American adults report taking at least one regularly. A 2018 analysis published in JAMA Network Open identified 776 dietary supplements found by the FDA to contain unapproved pharmaceutical ingredients between 2007 and 2016, with most products remaining on the market even after agency warnings (Tucker et al.). A frequently cited New England Journal of Medicine study estimated that adverse events from dietary supplements account for approximately 23,000 emergency department visits in the United States each year (Geller et al.).
These numbers describe products that consumers picked up believing they were safe. Weight loss capsules adulterated with sibutramine, a drug withdrawn from the United States market for cardiovascular risk. Sexual enhancement pills containing undeclared sildenafil. Bodybuilding supplements spiked with anabolic steroids or designer stimulants chemically related to amphetamine. Sleep aids containing benzodiazepine analogs. Each category has its own case reports, its own injuries, and its own quiet recalls that rarely reach the evening news.
The gas station opioids represent the sharpest edge of this problem, the point at which the regulatory gap becomes impossible to ignore. They are not, however, a separate phenomenon. They are what happens when an entire industry is allowed to define its own safety standards and a federal agency is left to chase consequences rather than prevent them.
What a Cautious Consumer Can Do
Until the regulatory framework changes, the burden of safety falls largely on the individual shopper. A few practical habits can reduce risk substantially.
Read the supplement facts panel carefully and look up every ingredient that is unfamiliar. If a product contains a proprietary blend that does not disclose individual ingredient amounts, treat that as a meaningful warning sign. Verify that the manufacturer participates in third-party quality programs such as USP Verified, NSF International, or ConsumerLab, all of which test finished products for identity, potency, and contamination. Be skeptical of any supplement that promises drug-like effects, particularly pain relief, sedation, euphoria, rapid weight loss, or sexual enhancement. Effects of that magnitude usually require pharmacologically active compounds, and pharmacologically active compounds belong under medical supervision.
Anyone who finds themselves using kratom, 7-OH products, or tianeptine should speak with a clinician experienced in addiction medicine before attempting to stop. Withdrawal from these substances can be physically dangerous and is rarely something to manage alone. Most major cities now have outpatient programs familiar with novel opioid agonists, and buprenorphine-based treatment is often effective for kratom and tianeptine dependence specifically.
Parents and caregivers should know that products containing 7-OH and tianeptine are frequently packaged in forms that appeal to adolescents. A check of the gummies, vapes, and small foil packets in a teenager's belongings is a reasonable precaution in the current market environment.
The convenience store opioid problem will eventually be addressed, either through federal scheduling, aggressive state legislation, or a wave of litigation that prices manufacturers out of the market. The larger question of how a country came to permit eighty thousand untested supplement products on its shelves will outlast any single enforcement action. Until DSHEA is meaningfully reformed, every consumer reaching for a bottle on a wellness shelf is performing a small, private act of trust in a system that has not earned it.
The pills behind the gas station counter are the most visible symptom of that mismatch. They are also a useful reminder that natural, herbal, and supplement are marketing words, not safety guarantees, and that a label printed in confident type is no substitute for a regulator who has actually looked inside the bottle.
Works Cited
Gassaway, Madalee M., et al. "The Atypical Antidepressant and Neurorestorative Agent Tianeptine Is a μ-Opioid Receptor Agonist." Translational Psychiatry, vol. 4, no. 7, 2014, e411. doi:10.1038/tp.2014.30.
Geller, Andrew I., et al. "Emergency Department Visits for Adverse Events Related to Dietary Supplements." New England Journal of Medicine, vol. 373, no. 16, 2015, pp. 1531–1540. doi:10.1056/NEJMsa1504267.
Kruegel, Andrew C., et al. "Synthetic and Receptor Signaling Explorations of the Mitragyna Alkaloids: Mitragynine as an Atypical Molecular Framework for Opioid Receptor Modulators." Journal of the American Chemical Society, vol. 138, no. 21, 2016, pp. 6754–6764. doi:10.1021/jacs.6b00360.
Olsen, Emily O'Malley, et al. "Notes from the Field: Unintentional Drug Overdose Deaths with Kratom Detected — 27 States, July 2016–December 2017." Morbidity and Mortality Weekly Report, vol. 68, no. 14, Centers for Disease Control and Prevention, 2019, pp. 326–327.
Rushton, William, et al. "Tianeptine Exposures Reported to United States Poison Centers, 2000–2017." Clinical Toxicology, vol. 59, no. 2, 2021, pp. 152–157. doi:10.1080/15563650.2020.1781132.
Tucker, Jenna, et al. "Unapproved Pharmaceutical Ingredients Included in Dietary Supplements Associated with US Food and Drug Administration Warnings." JAMA Network Open, vol. 1, no. 6, 2018, e183337. doi:10.1001/jamanetworkopen.2018.3337.
U.S. Food and Drug Administration. "Dietary Supplements." FDA.gov, U.S. Department of Health and Human Services, 2024, www.fda.gov/food/dietary-supplements.
U.S. Food and Drug Administration. "FDA Takes Steps to Restrict 7-OH Opioid Products Threatening American Consumers." FDA.gov, 15 July 2025, www.fda.gov/news-events/press-announcements/fda-takes-steps-restrict-7-oh-opioid-products-threatening-american-consumers.
U.S. Food and Drug Administration. "FDA Warns Consumers Not to Purchase or Use Neptune's Fix or Any Tianeptine Product Due to Serious Risks." FDA.gov, 9 Nov. 2023, www.fda.gov/food/alerts-advisories-safety-information/fda-warns-consumers-not-purchase-or-use-neptunes-fix-or-any-tianeptine-product-due-serious-risks.