A new government report sheds light on a new trend that suggests those who abuse opioids might be turning to a new fix: tianeptine.

An unapproved antidepressant, tianeptine (Coaxil, Stablon) is used in Europe, Asian and Latin American countries, but in the United States the FDA hasn’t approved it.

Despite this, within the last four years there have been more than 200 calls to poison control centers regarding tianeptine; in the 14 years prior there was a total of 11, according to a recent report in the CDC’s Morbidity and Mortality Weekly Report. And there were 83 reports of tianeptine being used with other substances, including opioids, benzodiazepines, ethanol and phenibut, an anti-anxiety medication sold abroad. Like opioids, tianeptine overdose can be reversed with the lifesaving drug naloxone (Narcan).

Since the drug produces effects similar to opioids, officials suspect that people are using the drug as an alternative to painkillers. Tianeptine leads to euphornia and a high but also severe withdrawal in casual users who abuse the drug. There have been two recent deaths in the U.S. attributed to “tianeptine toxicity” after the drug was purchased on the Internet. There have also been reports of vomiting, confusion, kidney failure and coma, according to reports by CNN.

“I don’t think it’s a coincidence that the uptick in these tianeptine reports coincides with some of the broader changes in [tightening] prescribing policies” for opioid painkillers, Dr. Harshal Kirane, director of addiction services for Staten Island University Hospital in New York City, told HealthDay.

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