CDC warns that Neptune's Fix — 'gas station heroin' — may contain synthetic pot

By Berkeley Lovelace Jr.

The highly addictive and dangerous supplement Neptune’s Fix — also known as gas station heroin — may be contaminated with different types of synthetic pot, chemicals that have been linked to life-threatening effects such as seizures, brain swelling and hallucinations, the Centers for Disease Control and Prevention reported Thursday.

The CDC’s findings were based on a 2023 investigation of 17 adults in New Jersey who had severe reactions after consuming Neptune’s Fix or other products that contain tianeptine. Of them, 13 were hospitalized in intensive care.

Tianeptine, an antidepressant that can mimic the euphoric and sedative effects of opioids, is sold as a dietary supplement at gas stations and convenience stores across the United States. It’s often marketed for pain relief, depression or anxiety. It’s approved in some European, Asian and Latin American countries, but not in the U.S. 

The Food and Drug Administration doesn’t approve dietary supplements, which means they aren’t reviewed for safety or effectiveness. In January, House lawmakers called on FDA Commissioner Dr. Robert Califf to crack down on the use of tianeptine. 

Doctors in New Jersey — which says it is currently seeing a dramatic increase in reports of poisonings in adults who have consumed tianeptine — tested six samples of Neptune’s Fix consumed by two of the patients. In addition to tianeptine, the products also contained kavain, a substance used for anxiety, as well as two different types of synthetic pot. 

“It was a surprise to find those compounds in there at all,” said the study’s senior author Dr. Diane Calello, the medical director of the New Jersey Poison Control Center. “That’s probably not what the people who bought those products were looking for.”

She said it is not yet clear whether all 17 patients, who ranged in age from 28 to 69, were exposed to the synthetic pot, which can often cause unpredictable but severe side effects, including seizures and coma.

Multiple patients experienced high blood pressure and seizures, as well as irregular or rapid heartbeats, and at least one patient had a heart attack, according to the CDC report. Among the 13 admitted to the ICU, seven had to be intubated, according to the report. No deaths were reported.

Dr. Pieter Cohen, an associate professor at Harvard Medical School who studies the regulation of supplements, called the reported symptoms “dramatic and alarming.”

“Usually we might see something like this in 1 in 100 poisonings,” he said. “That’s potentially an incredibly potent mixture of drugs.”

On Jan. 24, the FDA warned that the products had been linked to serious side effects including seizures, loss of consciousness and death. The FDA alert didn’t mention synthetic pot, although  tianeptine can also cause serious side effects, including rapid heart rate, vomiting, agitation, confusion and hallucinations. The FDA first warned consumers not to buy or use Neptune’s Fix in November, noting that the vials could contain other harmful ingredients. 

In January, Neptune Resources, the maker of Neptune’s Fix, agreed to voluntarily recall its products, which include Neptune’s Fix Elixir, Neptune’s Fix Extra Strength Elixir and Neptune’s Fix Tablets.

Dr. William Rushton, a medical toxicologist and director of the Alabama Poison Information Center, said he and his colleagues began sounding the alarm about Neptune’s Fix in his state in 2019. Some patients were admitted to ICUs with symptoms of withdrawal.

The problem is now growing, he added, with more reports of people consuming the product in the Northeast.

Cohen said that there needs to be more regulations around supplements in the U.S., noting that the FDA’s current power is “very limited.” 

“Consumers remain at risk when they consume dietary supplements here in the United States,” he said.