Whether you prefer Wawa, 7-Eleven,  Buc-ee’s, Chevron, Townpump,   or Casey’s, gas stations have a  fix for a lot of your problems.

Hungry? Grab a snack.

Thirsty? Pick from the 10 slightly  different options of water. Dragging on a road trip?

How about an energy drink to keep you going? But between the Chex Mix  and the bottled cold brew,   you can also find a different kind of  fix: the so-called “gas station drugs.” You may have heard of “spice” or “bath  salts,” which were some of the early versions. Generally, these compounds mimic  the effects of other drugs… Including how deadly they can be.

But in their early days, they’re  available because they haven’t   reached the level of popularity, or  documented danger, to be regulated yet. Bath salts and spice have  now achieved that notoriety,   but in their wake you can find products with  names like Neptune’s Fix or X-rated Honey. Fun names aside, these can contain  some pretty strong active ingredients.

So let’s talk about what exactly is  in some of those gas station drugs. [♪ INTRO] The first drug on our list might be new to your  gas station, but it has a long history of use. Kratom comes from the leaves  of a Southeast Asian tree. People in that part of the world have used  it for centuries, to help boost energy,   enjoy at social gatherings, or for  medicinal or religious purposes.

It’s still popular in Southeast Asia, and it’s  booming in popularity in the United States,   with more than 1.7 million  reported US users in 2021. Those users smoke it, steep  it, swallow it in capsules,   or drink it as a liquid extract from the plant. So you could see it in quite  a few forms at the store.

And kratom doesn’t just come in many formats,  it also comes with a wide range of effects. At lower doses, people say  it’s more of a stimulant. But at higher doses, it flips, acting more like  a sedative pain reliever, similar to an opioid.

Some people even use it as an alternative to  stronger opioids to get through withdrawal. It has those effects thanks to compounds in  the leaves that bind to mu-opioid receptors. …Which are the same receptors  targeted by morphine or heroin,   so it makes sense that kratom  can produce similar effects. The difference is that kratom’s  compounds don’t bind quite as well,   which is why the effects tend to be weaker.

People often take kratom as an alternative  to substances we already know are risky. And compared to heroin or morphine, kratom does  appear to come with a lower mortality risk. But “lower risk” is not the same thing as “safe”.

Potential side effects range from  relatively mild, like nausea and dizziness,   to much more severe complications like liver  toxicity, slowed breathing, or seizures. People have died after taking kratom. But most of those deaths involved  other substances as well,   making it difficult to tease apart how  much the kratom itself contributed.

All in all, kratom acts a  lot like a weaker opioid. But its compounds also interact with  serotonin receptors, dopamine receptors,   and other targets in the brain. That multi-tasking helps explain  why kratom can feel stimulating,   sedating, euphoric or focusing  depending on the circumstances.

With all of those targets, kratom may  have legitimate medical potential. And researchers are looking into that possibility. But many countries aren’t waiting for the answers.

Kratom is illegal in at least 33 countries  and regulated in some way in at least 11 more. Meanwhile, in the US, it’s for sale  next to snacks and supplements. Which may make you think again  before choosing it as a casual   gas station pick-me-up to  grab with your trail mix.

And it’s not the only opioid-like  substance hiding there. This next gas station drug has a nickname that   does not inspire confidence  as an unregulated substance. Officially, it’s called tianeptine.

Unofficially, people call it “gas station heroin”. It wasn’t intended to be something that  people buy on a whim and become addicted to. Tianeptine was originally developed  in Europe as an antidepressant,   and in some countries it’s still  prescribed and used that way today.

Chemically, tianeptine looks similar  to some tricyclic antidepressants,   which helps explain why it was  developed for that purpose initially. But instead of targeting serotonin and  noradrenaline like most tricyclics,   tianeptine acts on glutamate  to reduce depressive symptoms. …And, to a lesser extent, it also  activates mu-opioid receptors. You probably saw that coming  when you heard its nickname.

But, yeah, this new kind of antidepressant  can also act like an opioid. At therapeutic doses, it  can help treat depression. But when you have free access to self-prescribe  however much of this gas station drug feels good,   some people take up to 120 times those  doses to get opioid-like effects.

Unsurprisingly, acting on the opioid  receptors comes with opioid-like risks,   like dependence, tolerance,  withdrawal, and overdose. And tianeptine doesn’t stick  around in your body for very   long, which can cause withdrawal  symptoms to kick in fast and hard. So while prescription tianeptine can  act as an antidepressant, gas-station   tianeptine use often results in opioid-like  effects, with opioid-like risks to match.

But the people who make it have a  more positive outlook on that story. They market it as a potential  stopgap to ease opioid withdrawal. Like, if you’re addicted to  heroin, try this instead!

Setting a really high bar, making a drug  that is… slightly better for you than heroin. And there is some data to support that claim. One study conducted in rodents  found that tianeptine was less   likely than heroin to cause dependence.

But case reports and anecdotes paint  a much less reassuring picture. Which might be why some countries keep it  a controlled prescription antidepressant. In the US, it has never been approved for  medical use and sits in a regulatory grey zone.

It’s not regulated at a federal  level, but it is illegal in 13 states. So it might not be long before this gas  station drug goes the way of bath salts. Before we get to the next gas station  drug, it’s time for a quick ad break.

I’m assuming it’ll be a bit of a tone shift. Thanks to our Presidents of  Science, binorthedrunkdwarf,   Charlie Stanley, and Harry Plumley  for supporting this SciShow video! Last year, SciShow made hundreds  of videos about everything from the   weird ways people have tried to live  forever to the science of urinals.

Each of these videos is written, fact  checked, hosted, and animated by real people. And we couldn’t have done that without the   help of our incredible Presidents of  Science, who support us on patreon. We’re proud to be a nonprofit supported   by a community that believes  good information is worth it.

And we’re thankful to have you in that community, too. Every time you watch a SciShow video,  comment, share it with your friends,   or support us on patreon, you  help make SciShow what it is. You can learn more at patreon.com/SciShow.

Despite how it may seem  from the first two examples,   not every gas station drug  wants to cosplay as an opioid. Case in point: phenibut. Phenibut was initially developed in the  Soviet Union to help cosmonauts stay calm,   cool, and collected in stressful situations.

It has since been used for things like anxiety,   alcohol withdrawal, PTSD, and some motor  control issues like restless leg syndrome. Unlike the previous opioid-like drugs, this  gas station drug acts like GABA, an inhibitory   neurotransmitter that basically tells your  brain and body to slow things down a bit. By binding to the same receptors as GABA,   phenibut can elicit a wide range of  effects, from reduced anxiety to euphoria.

It also blocks other receptors linked to  anxiety, giving an extra layer of chill. But a 2019 review suggests that  this is just the tip of the iceberg. That paper summarized that too much  phenibut can cause a whole host of   symptoms including sedation, agitation,  combativeness, delirium, and psychosis.

It’s like - kinda - really like  all over the spectrum there. Plus, phenibut can cause withdrawal  symptoms similar to benzodiazepines,   since they target some of the same pathways. So you could end up with agitation, tremors,   heart palpitations, decreased appetite,  insomnia, and increased anxiety.

Basically, the opposite effects from what many  people are taking it for in the first place! Phenibut may promise a calming fix, but  can easily turn stressful, or worse. Which is why in Russia, you  still need a prescription for it.

And in the US, the FDA is cracking down on  companies that sell it as a dietary supplement. It’s hard to know how common  use is, though poison control   centers in the US receive hundreds of  calls related to phenibut every year. But that’s nothing compared to the number of  calls they get about this next gas station drug.

Now we get to talk about a familiar  friend…but with a twist: synthetic THC. For a quick botany refresher, THC  comes from marijuana and hemp. Legally, they are differentiated  by their THC content.

Anything at or below 0.3% THC  by weight is considered hemp. This is important because hemp is legal to  grow, sell, and make products from in the US,   while marijuana is not, at least at the federal  level, and at least as we film this video. You can make lots of things  from hemp, including CBD.

And that’s where things get interesting. It is possible to chemically convert this  hemp-derived CBD into delta-8 and delta-10 THC. These are chemical cousins to the  delta-9 THC found in marijuana,   the one most people think of  when they think of getting high.

Because these synthetic forms of THC come from  hemp CBD, they exist in a legal grey area. They aren’t technically the illegal  delta-9 form…but they are pretty close. People use these synthetic THCs for many  of the same reasons they use marijuana:   to get high, reduce stress, spark appetite,  or manage nausea, pain, or inflammation.

Like natural THC, synthetic versions of THCs also  bind to your cannabinoid receptors in your brain. And where those receptors are in the brain  matters for what kind of effects you might feel. Hitting the memory center can  impair your short-term memory.

And binding in your emotional center  can lead to panic and paranoia. These synthetic THCs have been described  as being a bit weaker than delta-9,   so both the desired effects and  inadvertent side effects can be milder. But milder doesn’t mean there are no side effects.

Studies on delta 8 and delta 10 THC are sparse,   but we do know that they can cause the  same types of side effects as delta-9,   including changes in heart rate, low blood  pressure, lethargy, and impaired coordination. And that’s enough to raise a red  flag for some consenting adults. But there’s also concern for children  accidentally taking these drugs.

After all, if you like THC gummies  because they are sweet and tasty,   six year olds are also going to  like them for that very reason. And poison control center calls back that up. Now think about the fact that the  conversion process from CBD to   synthetic THC is sometimes referred  to as “kitchen chemistry” because,   well, just about anyone can do it  with some fairly common chemicals.

The lack of regulations in making these products   mean that some nasty stuff might be  in there without anyone’s knowledge. So even if you’re a big fan of THC  and know how it works in your body,   there’s no real way of knowing  what else is in these products. …unless you were the “chemist.” And the number of people in that synthetic  THC fan club is tricky to pin down. But we know that global internet  searches for delta-8 THC went up   by 257% in 2020 compared to 2019, and  by 705% in just eight months of 2021.

This doesn’t necessarily mean usage  exploded, but curiosity certainly did. And if you’re curious to try this next drug,   well, please just listen to our  explanation of the science first. The last gas station drug on our list is really…. getting a rise out of some people.

Honey packets, sometimes sold  as X-Rated Honey for Men,   contain tadalafil, the  active ingredient in Cialis. In case the innuendo didn’t give it away,  this is a drug for erectile dysfunction. Tadalafil works by inhibiting  an enzyme called PDE5, which   breaks down a molecule that helps  dilate blood vessels in the penis.

So when you block PDE5, more  of that molecule is around,   more blood flows in, and…well,  you know what happens next. But tadalafil doesn’t just go to your penis. It affects all blood vessels, including the  ones in your lungs, prostate, and bladder,   making it a helpful prescription to  treat other conditions related to blood   vessel function, like pulmonary arterial  hypertension or certain prostate issues.

With all that power over your blood  vessels, side effects are inevitable. You could end up with headaches, indigestion,   back pain, hearing loss, or a  whole list of other symptoms. One unlucky guy learned firsthand  that messing with blood flow can   have unexpected consequences for your vision.

He showed up at the doctor complaining of blurry   vision in one eye after taking  some X Rated Honey for Men. The seemingly innocent little  honey packets swole up his retina! Fortunately for him, his eye went back  to normal after a month without honey.

But the big danger is how  it mixes with other stuff. For example, nitrates are often  taken for certain heart conditions. And when you take tadalafil  and nitrates at the same time,   your blood pressure can drop  to life-threatening levels.

And yes, tadalafil can cause prolonged  erections that can permanently damage tissue. Funny in movies, not so  funny if it happens to you. Like the other drugs in this video,  tadalafil isn’t inherently bad.

It’s the unregulated, casual  availability that makes it dangerous. Many gas station drugs contain real,  pharmacologically active ingredients,   like those that might benefit from a  prescription and regular check-ins with a doctor. But without regulation, dosing  guidance, or quality control,   these products can pose serious risks.

So if you’re feeling like a  daredevil at the gas station,   maybe stick to something a bit less extreme. …Like a new flavor of Takis. [♪ OUTRO]