dietary supplement that people started to take and abuse and when they say that it has less overdose potential I disagree hey everybody welcome back to the channel this is Dr B Dr B addiction recovery and the topic I want to briefly give you an overview on today is gas station heroin what is it so let’s get started I’m going to break this down and to present to you what the issue that’s
presenting itself currently is and it’s all over the media then I’ll get into a little bit of detail about the background and the details of what’s inside this stuff and then I’ll talk about some of the intoxication withdrawal symptoms and give you a brief recap and my thoughts on it let’s get going gas station heroin this stuff’s actually been around for about 20 plus years it’s making the news at this time more particularly so in some of the states that are more affected with the
opiate epidemic and addiction than other states and it might be spreading but at this time I know about Mississippi I know about Kentucky I’m not sure if it’s in Ohio as well I know about Indiana it’s really making its presentation and its presence well known there how’s it doing that people are buying this stuff over the counter at the gas station as a dietary supplement sometimes online on
the web as a mood enhancer or cognitive enhancer remember that whole thing cognitive enhancement drug they’re buying it and they’re starting to really abuse it get addicted to it have serious Cravings withdrawals intoxication and now it’s starting to be banned in multiple States we’ll see how this goes and how it’s going to develop but hopefully it’ll be getting taken off the
market in a lot of these states we do know that over the last 20 years so remember it’s not new there’s been over 200 calls at least to poison control centers some of those have been for severe intoxication which seems like the Hallmark of it as they describe it is lethargy and anxiety or agitation or people going into severe withdrawals which present themselves like opiate withdrawals
agitation sweating muscle aches GI issues okay so that’s how it’s presenting we know that there’s been at least four deaths we know there’s been ICU admissions again it’s not that new it’s been around for about 20 years and it’s giving people an opiate like hi let’s move on to what’s actually in gas station Heron which goes
by the name of Zaza red Zaza white Tiana Pegasus sold as a mood enhancer sometimes sold as a cognitive enhancer sometimes and a dietary supplement let’s move forward what is this stuff it’s an atypical anti-depressant approved in Europe in the 80s what is an atypical antidepressant briefly let’s go to the history of that and get to where we are
now in the 50s they realize that Medicaid locations for example some tuberculosis medications were able to treat depression and they came up with the monoamine theory or the catecholamine theory or let’s just call it a serotonin Theory which you know depression has something to do with lack of or some sort of imbalance of
serotonin in your brain so they moved to try to see what they can do about that as this kind of medication which was initially for tuberculosis and a couple of other ones were treating depression but there was quite a few side effects with that and they’re like well we need to hone it in on serotonin next we went to Prozac selective serotonin re-uptake inhibitor which made it more available in What’s called the kind of
neurosynaptic space so it could be uptaken by the neuron and sort of increase your serotonin transmission as time went on they realized that well you know this isn’t hitting everybody and a whole bunch of nuances occurred that we really realized that the story is a lot more complex than just serotonin or even other monoamines okay we even have theories now about inflammation of glia
cells and so forth and they started to sort of develop Second Generation and even now third generation antidepressants that hit multiple other neurotransmitters and receptors that’s for another place the efficacy of that how that works but in this Pursuit I’m sure right this medication to Neptune came about and it’s very complex and hits glutamine receptors it has to you
know it has something to do with nmda and so it’s really a serotonin modulating product right and serotonin enhancer but the longest Road in the last 20 years they also realized whoa this stuff is hitting opiate receptors it’s hitting the mule receptors which have to have to do with addiction it’s hitting other opiate receptors it’s really also the nucleus accumbens which is known as part of the reward circuitry
placed on the big place for dopamine and addiction it’s really hitting there and then you know they realize it’s this stuff is really increasing dopamine levels in the central nervous system in addition in Europe although there was initially no thought that this stuff can be abused and there could be addiction and abuse potential they started noting even in psychiatric patients that were inpatient just across the board that
this stuff has pretty significant abuse and misuse liability in particular in particular for those that have a substance abuse history now in Europe Asia this stuff is starting to be more and more and more regulated never got approved in the U.S why I’m not sure right I don’t think it was because it had very negative side effects in fact I think this drug would further
investigation very tight regulation dosing regulations by the doctors can have significant impact on depression anxiety in fact it’s also used for asthma IBS potentially PTSD I don’t know but I’m saying it’s not a bad drug just like many drugs can have an abuse potential but they can be prescribed in a very very controlled environment and close monitoring of the physician but it
was never approved in the U.S and I suspect that had to do something with patents and finances doesn’t matter but nevertheless it made it into this illicit well into this not elicit but legal Market of dietary supplements and they have been pushing it whether it’s online or now we’re hearing about gas station over the counter dietary supplement that people started to take
and abuse okay we know that intoxication as it has presented to a lot of the poison centers poison control centers has intoxication is with lethargy and sort of anxiety and dysphoric mood we also know that withdrawals are very similar to opiate withdrawals sweating abdominal issues GI issues anxiety muscle aches and pains myalges they call
it so where are we at with this stuff okay it just seems uh like uh every single day something new comes up the point of what I’m trying to describe is to educate and give you a formal understanding of what these things are and take sort of the magic out of it this stuff is pretty dangerous because one other thing that you should know is the average dose that’s prescribed for daily it’s something like 12.5 milligrams twice a day it could be up to
50 milligrams total a day the people that are abusing it are taking 50 to 100 times more of that in a day the withdrawals are horrendous and have been using it for a long time keep in mind this stuff is not just hitting the opiate receptors we’re dealing with many other receptors and neurotransmitters and we already know a lot of people that are on any kind of psychotropic whether
it’s benzodiazepines or antidepressants or some of the other ones are having significant withdrawal issues now you’re throwing this in the mix and it’s not regulated and people are putting themselves at incredible risk and when they say that it has less overdose potential I disagree because I think we’re going to start to see that as people combine this stuff with alcohol with opiates with benzodiazepines or
even with methamphetamines and this kind of acid or cardiotoxicity of the methan amphetamines so this stuff is pretty dangerous and I think some of the states are going to start to really come down on this stuff one last thought I want to leave you with is the issue or the point that here we have an anti-depressant and before they even knew it eventually they found out this stuff hits the MU receptor and increases dopamine and
oftentimes I believe it has been used for treatment resistant anti-depression that being said what a lot of people don’t know is that there’s been quite a bit of small studies I haven’t looked lately but traditionally in the past there was multiple small studies where they used low-dose buprenorphine for treatment resistant depression and they got significantly reduced symptoms
and statistically meaningful results even though they were small studies and this is a little bit of a side step but think about the complexity the intermingling of a lot of these issues including opiate abuse substance abuse anxiety depression which came first what’s the person’s clinical history where they ended up nevertheless
sometimes you can’t teach through that as you’re treating a patient dealing with substance abuse but to know that buprenorphine product can also be used to treat the depression after stopping the use of opiates is very important significant and somehow it ties into this whole issue of why gas station heroin may be a substance of significant
misuse abuse and illicit consumption at times thank you very much hope this helps and see you next time