On August 25, 2020, the Center for Science in the Public Interest (CSPI) sent a letter urging FDA to take further enforcement against manufacturers, distributors, and retailers that sell products with tianeptine.  Tianeptine, approved as a prescription antidepressant in other countries, is being marketed as a dietary supplement in the Southeastern U.S.

FDA has issued warnings to consumers and companies on the dangers of tianeptine in the past. In 2018, FDA issued warning letters to two companies for the illegal marketing of products labeled as dietary supplements that contained tianeptine, which companies illegally claimed to treat opioid use disorder, pain, and anxiety.  CSPI noted that one online retailer that received an FDA warning letter in 2018, jackbgoods.com, continued to sell tianeptine supplements into late July.  Tianeptine products continue to be commonly available in gas stations, vape stores, and other retail outlets in Alabama and online.

CSPI believes that enforcement against supplements containing tianeptine should be prioritized, as they target a vulnerable population of recovering or active drug users during a nationwide opioid epidemic.  The letter notes that the popularity of tianeptine increased in the state after Alabama prohibited the sale of kratom, a substance that provides similar effects.  A bill has been introduced in Alabama to ban the sale of tianeptine in the state.