A brightly colored box at a smoke shop should not hit like an opioid, yet that’s the business model behind “gas station heroin.” We dive into how tianeptine—a foreign antidepressant with mu‑opioid activity—landed on American countertops as a “dietary supplement,” and why that mirrors a broader playbook: repackage potent psychoactives, exploit loopholes, pivot fast when bans arrive, and let consumers pay the price. Joined by Matthew Lowe, executive director of the Global Kratom Coalition, we trace the supply chain from warehouses to wallets and separate leaf kratom from the synthetic isolates hijacking its name.

We break down the risk gradient inside the kratom category: natural leaf with fiber and mixed pharmacology, concentrated extracts that raise potency, and seven‑hydroxymitragynine products that function like a novel opioid. Matthew explains why the FDA’s percentage‑based scheduling of 7‑OH is a smart, surgical fix that preserves traditional use while ejecting synthetic opioids from the “supplement” aisle. We also tackle hemp’s loophole economy—Delta‑8 and Delta‑10 THC derived from hemp yet delivering marijuana‑like effects with far less oversight—plus contamination, cross‑stocking, and the handful of distributors fueling multiple “legal high” trends at once.

Beyond policy, we talk people. When regulators finally pull a dangerous product, dependent users are often left stranded. We outline a practical path: better labeling that discloses opioid activity and dependence risk, age gates, potency caps, and targeted enforcement against unapproved drugs sold as supplements. Just as crucial, clinicians need straightforward guidance to assess what patients took, why they took it, and how to transition them to safer, evidence‑based care without stigma.

Curious how these products keep showing up, what “novel synthetic opioid” really means, and how we can protect choice where risk is low while acting decisively where harm is high? Press play, share this episode with a friend, and leave a review with the one reform you think would make the biggest difference. If this helped you learn something new, subscribe so you never miss an update.

To contact Dr. Grover: [email protected]