Fourteen states had already acted before Connecticut joined the list. And the federal government is now raising its own alarm. Earlier this month, FDA Commissioner Martin Makary penned a letter warning about what he called a "dangerous and growing health trend."

The core problem is straightforward: a substance that acts on opioid receptors and can kill in high doses has been sitting on shelves next to energy drinks and rolling papers, marketed with candy-like flavors and packaging that suggests it is harmless. That it took this long for even fifteen states to act tells you something about how slowly government responds when a drug slips through regulatory gaps.

What tianeptine does, and why it kills

Robert Schwaner, M.D., vice chair of system clinical affairs at Stony Brook Emergency Medicine, told Fox News Digital that the FDA has never approved tianeptine as a dietary supplement. He explained the pharmacology in blunt terms:

"The euphoria at low doses is primarily due to increased serotonergic activity from its serotonin reuptake effects. With increasing doses, the mu-opioid receptor stimulation may become lethal."

Schwaner went further, drawing a direct line between tianeptine and the drugs fueling America's overdose crisis:

"As with heroin and other opioids, significant mu-opioid receptor stimulation ultimately results in a loss of respiratory drive and subsequent cardiac arrest."

The Drug Enforcement Administration has stated that misuse of tianeptine can cause severe adverse health effects, including respiratory depression, severe sedation, and death. The FDA has said the substance can produce euphoria in higher doses and can be more potent than morphine and addictive opioids.

That combination, euphoria, opioid-receptor activation, and lethality at higher doses, is the textbook profile of a substance that hooks users fast and punishes them hard. Schwaner cautioned that tianeptine carries the potential for tolerance, dependence, and withdrawal, the same grim cycle that has defined America's opioid epidemic for two decades.

Connecticut's broader crackdown

Connecticut did not stop at tianeptine. The state also added Mitragyna speciosa, commonly known as kratom, along with 7-hydroxymitragynine, Bromazolam, Flubromazolam, Nitazenes, and Phenibut to the schedule classification. That is a significant sweep of substances that have proliferated in the gray market, often sold as supplements or research chemicals to sidestep existing drug laws.

Connecticut Lt. Gov. Susan Bysiewicz framed the action as a public safety imperative. In a press release, she said the schedule change is "a necessary step to combat addiction."

"With false marketing that led consumers to believe these are safe products, and with candy-like flavor options, these substances posed a clear threat to those battling substance-use disorder and our youngest residents."

That phrase, "our youngest residents", matters. These products were not hidden in back alleys. They sat in retail environments that teenagers walk through every day, packaged to look benign. The marketing was the mask. The pharmacology was the trap. In a landscape where states are increasingly willing to restrict what Americans can buy at the point of sale, from unhealthy food to dangerous supplements, Connecticut's move fits a pattern of governments belatedly catching up to products that should never have been on shelves in the first place.

FDA Commissioner sounds the alarm

FDA Commissioner Martin Makary did not mince words. In a letter penned earlier this month, he warned the public directly about the risks.

"I am very concerned. I want the public to be especially aware of this dangerous product and the serious and continuing risk it poses to America's youth."

Makary called it a "dangerous and growing health trend." That language from the head of the nation's food and drug regulatory body carries weight. It also raises an obvious question: if the FDA is this alarmed, why hasn't the federal government moved faster to schedule tianeptine nationally? Fox News Digital reached out to the FDA for comment, but the article did not report a response.

The gap between federal concern and federal action is the story within the story. Fifteen states have now acted on their own. That means thirty-five have not. In those states, tianeptine remains available to anyone who walks into a gas station or clicks through an online retailer.

Kratom and the wider 'addiction epidemic'

Connecticut's decision to schedule kratom alongside tianeptine reflects a broader concern about substances that operate in a regulatory no-man's-land. Dr. Marc Siegel, Fox News senior medical analyst, told Fox News Digital that kratom is part of what he called a "burgeoning addiction epidemic" in the United States, with millions of Americans using the substance each year.

Siegel warned that kratom's active compound, 7-hydroxymitragynine, is significantly more potent than morphine at the opioid receptor and carries a high risk of addiction and overdose. He said there is no FDA-approved medical use and emphasized the need for stricter oversight.

"Despite how common these products have become, they are not routinely tested for, even in overdose cases."

That last point deserves emphasis. If hospitals and coroners are not routinely testing for these substances, the true scope of harm is almost certainly undercounted. People may be dying from tianeptine or kratom-related overdoses without those drugs ever appearing on a toxicology report. The data gap makes the policy gap worse. And both gaps leave families in the dark.

A patchwork response to a national problem

The state-by-state approach has a familiar feel. It mirrors how legislatures have handled everything from fentanyl analogs to election integrity measures that courts later uphold, individual states stepping into vacuums that federal regulators leave open. Sometimes that patchwork works. Often it means the problem simply migrates to the next state over, where the substance remains legal and the shelves stay stocked.

Schwaner, the Stony Brook emergency physician, said he believes tianeptine requires national regulation due to its addictive qualities. That is not an ideological position. It is a clinical one. A drug that mimics heroin at the opioid receptor and kills through respiratory arrest does not become safer because a user buys it in a state that has not gotten around to banning it yet.

The products themselves tell the story of the failure. Names like Neptune's Fix and Pegasus. Candy-like flavors. Retail packaging designed to look like supplements. None of this happened by accident. Manufacturers built a consumer pipeline that exploited the gap between what the substance does and what regulators were willing to call it. Every month that gap stayed open, more people got hooked, and some of them died.

Connecticut acted. Fourteen states acted before it. The FDA commissioner has written a letter expressing grave concern. The DEA has catalogued the lethal effects. The medical experts are on the record.

Thirty-five states have still done nothing. And the gas stations are still open.