It is not breaking news that we are currently in the midst of a mental health and substance use disorder crisis. We saw a record number of overdose deaths in a 12-month period from May 2022 to May 2023. According to the CDC, overdose deaths totaled more than 112,000 during that period. There has been an all-hands-on-deck effort to curb these deaths with efforts aimed at decreasing supply, educating the public, and increasing harm reduction availability. And while the country is desperately and urgently putting measures into place to reduce deaths, these efforts are largely aimed at substances such as fentanyl and xylazine. This has provided a great distraction from another crisis brewing in the background. A crisis in which many know nothing about. This insidious crisis is weaving its way through our country, and it is taking aim at our youth. It is a crisis of convenience, if you will.
Convenience stores have become a culprit in multiple new addictions. They have become a breeding ground for unregulated substances of abuse. With flashy packaging eerily similar to brand-name candy, mouth-watering flavors, and placement front and center on the counters, convenience stores have made addiction awfully convenient. We’ve seen this with vaping, which has become a public health emergency in our youth, but also in OTC CBD products that are found to have more than the legally accepted amount of THC in them. But there are even more substances of great concern reaching the shelves that the public knows nothing about.
Convenience stores are taking full advantage of this lack of education and the fact that there is little to no oversight over what they put on their shelves. As a psychiatrist, I incorporate education in all of my patient visits. I have found that a large part of that education is now directed at these products on convenience store shelves. The largest offender in the state of Mississippi appears to be kratom. Touted as “an all-natural, safe solution for pain and ADHD,” kratom is highly addictive and has contributed to numerous deaths in our country. Kratom is essentially an opioid as it works on the same receptors and carries the same risk of addiction and death that other opioids do. The American Kratom Association does a great job of fooling the public into thinking kratom is a safe alternative to traditional medications. A quick Google search of kratom deaths shows otherwise.
Another substance of concern is tianeptine, also known as “gas station heroin,” because of its opioid-like properties. Companies are making dangerous claims that it is a safe treatment for depression, anxiety, and pain. However, it has zero FDA approval for any medical use and is contributing to addiction and death. Inpatient treatment facilities are seeing a sharp increase in patients being admitted for tianeptine addiction and in need of a medical detox. Luckily, physicians have alerted lawmakers to the growing concerns, and multiple states have adopted legislation to ban the sale of tianeptine in convenience stores.
And though there are multiple substances of concern snaking their way into convenience stores and onto the counters, a newer one of growing concern is gummy mushrooms. Shrooms, similar to kratom and tianeptine, cause a high, are addictive, and come in attractive packaging very similar to candy gummies, which children can easily confuse.
Once these substances get onto the counters, it is exceedingly difficult if not impossible to get them off the counters. It usually takes legislation to ban these substances, and large companies are heavily invested in and profit from the sale of these substances in convenience stores, so they put much effort and money into fighting any legislation that would require legitimate regulation or banning of these substances.
Physicians feel like getting these substances off the counter is like playing an aggressive game of “whack-a-mole.” As soon as you knock one off the counter, a new one pops up. States need to begin looking at ways to prevent these substances from ever reaching convenience stores, as opposed to having to clean up the mess that these unregulated substances cause. Mississippi physicians have proposed ways to designate a gatekeeper to look into substances before they reach the shelves, yet thus far, legislators have not supported this effort. But it is becoming abundantly clear that something must be done because convenience stores are making addiction way too convenient.
Katherine Pannel is a psychiatrist.
