Synthetic Cannabinoids Found Hidden in Tianeptine Products Sold at Gas Stations
An outbreak of 34 severe poisonings in New Jersey was traced to tianeptine products sold at gas stations that were secretly laced with potent synthetic cannabinoids.
Quick Facts
What This Study Found
Products marketed as containing tianeptine were found to contain the synthetic cannabinoids MDMB-4en-PINACA and ADB-4en-PINACA. Of 37 acute exposures, 43% required intubation and 65% were admitted to the ICU.
Key Numbers
34 unique patients over about 8 months, compared to a background rate of 0.5 tianeptine cases per year. 43% (16 patients) required intubation. 65% (24 patients) admitted to ICU.
How They Did This
Retrospective and prospective surveillance through New Jersey Poison Control. Six product samples were analyzed by gas chromatography and mass spectrometry.
Why This Research Matters
Unregulated products sold openly at gas stations and online can contain dangerous adulterants with no labeling to warn users.
The Bigger Picture
This outbreak illustrates a broader pattern in unregulated markets: products sold as one substance may contain entirely different and more dangerous compounds.
What This Study Doesn't Tell Us
Case series without controls. Product composition varied across samples. Only two patient blood samples were tested.
Questions This Raises
- ?How widespread is synthetic cannabinoid adulteration in unregulated consumer products?
- ?Would regulation of tianeptine reduce these incidents?
Trust & Context
- Key Stat:
- 43% of patients required intubation; 65% admitted to ICU
- Evidence Grade:
- Case series documenting an outbreak; provides clinical and toxicological evidence but no controlled comparison.
- Study Age:
- 2025 publication covering June 2023 to February 2024 cases
- Original Title:
- An Outbreak of Synthetic Cannabinoid-Adulterated Tianeptine Products in New Jersey - Case Series.
- Published In:
- Journal of medical toxicology : official journal of the American College of Medical Toxicology, 21(2), 253-259 (2025)
- Authors:
- Counts, Christopher J, Spadaro, Anthony V, Cerbini, Trevor A, Krotulski, Alex J, Walton, Sara E, Greller, Howard A, Nelson, Lewis S, Ruck, Bruce E, Hung, Oliver, Logan, Barry, Calello, Diane P
- Database ID:
- RTHC-06267
Evidence Hierarchy
Describes what happened to one person or a small group.
What do these levels mean? →Frequently Asked Questions
What is tianeptine?
Tianeptine is an atypical antidepressant approved in some countries but not in the United States. It is sold in unregulated markets as a supplement, often at gas stations and online, under brand names like Neptune's Fix.
What made these cases so severe?
The products contained potent synthetic cannabinoids (MDMB-4en-PINACA and ADB-4en-PINACA) that are far more powerful than natural cannabis compounds.
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Cite This Study
https://rethinkthc.com/research/RTHC-06267APA
Counts, Christopher J; Spadaro, Anthony V; Cerbini, Trevor A; Krotulski, Alex J; Walton, Sara E; Greller, Howard A; Nelson, Lewis S; Ruck, Bruce E; Hung, Oliver; Logan, Barry; Calello, Diane P. (2025). An Outbreak of Synthetic Cannabinoid-Adulterated Tianeptine Products in New Jersey - Case Series.. Journal of medical toxicology : official journal of the American College of Medical Toxicology, 21(2), 253-259. https://doi.org/10.1007/s13181-025-01068-7
MLA
Counts, Christopher J, et al. "An Outbreak of Synthetic Cannabinoid-Adulterated Tianeptine Products in New Jersey - Case Series.." Journal of medical toxicology : official journal of the American College of Medical Toxicology, 2025. https://doi.org/10.1007/s13181-025-01068-7
RethinkTHC
RethinkTHC Research Database. "An Outbreak of Synthetic Cannabinoid-Adulterated Tianeptine ..." RTHC-06267. Retrieved from https://rethinkthc.com/research/counts-2025-an-outbreak-of-synthetic
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.