Salvia: Dangerous Hallucinogen or Beneficial Herb?

Salvia divinorum has become increasingly popular as a recreational drug for its hallucinogenic effects. Although adolescents and college students are just beginning to experiment with this powerful herb, it’s no newbie to the list of psychedelics. Historically, salvia was used by the Mazatecs for divination and shamanism, and it’s been suggested that the herb’s use may even date back to the Aztecs. (1)

In recent years, especially after a video of teen pop star Miley Cyrus using the drug surfaced in 2010, the rising popularity of recreational salvia in the U.S. has been reported. Research published in Drug and Alcohol Dependence in 2008 indicates that salvia is becoming a significant member of the list of drugs that are used by college students. For the study, a sample of college students were randomly drawn from a large public university in the southwestern U.S. and invited to participate in an online survey.

Researchers found that 4.4 percent of just over 1,500 students reported using salvia at least once within the past 12 months. And reports by the National Institute on Drug Abuse for Teens indicate that 1.5 percent of 12th graders have recently used salvia. (2, 3)

The long-term impact of using salvia is still unclear, and there are concerns that it may effect your mental health. Although the herb’s use as a recreational and medicinal drug is becoming more popular, the scientific literature documenting the benefits and negative consequences of salvia is scarce.

What Is Salvia Divinorum?

Salvia is a naturally occurring hallucinogenic plant that belongs to the sage family. Street names for salvia include Magic Mint, Sally D, Diviners Sage, Seer’s Sage, Shepherdess’s Herb and Purple Sticky™, which is a popular brand name that’s sold in smoke shops. For centuries, salvia has been used in religious rituals in South America for its psycho-mimetic effects, but today it’s often used by young adults who are looking to experience a short-term trip.

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So are there any health benefits to ingesting or smoking salvia leaves, or is it just another dangerous drug that should be banned in the U.S.? Studies do suggest that the sage species can be considered for drug development because of their therapeutic and pharmacology activities in many countries of Asia and the Middle East, especially China and India, but there’s varying opinions about whether or not the risks outweigh the benefits when it comes to using salvia divinorum. (4)

The active ingredient in salvia is called salvinorin A — a dopamine-reducing kappa-opioid receptor that’s responsible for the hallucinogenic effect of the salvia plant. Recently, salvinorin A has been researched for its potential beneficial effects for a variety of central nervous system illnesses, but reports suggest that its this ingredient that makes the salvia experience so unique, and usually uncomfortable or even terrifying. Drugs like morphine and other opioids increase dopamine levels, creating euphoric and analgesic effects, but salvia reduces dopamine levels, causing what’s been described as a state of dysphoria instead. (5)

Today, salvia is popular mainly among adolescents and young adults, who use it for the “short-lived relatively pleasant experiences many consider a ‘legal high’ and its ready availability through internet purchases,” according to researchers at the National University Hospital in Singapore. (6)

The salvia plant is consumed by chewing the fresh leaves, drinking the juices of the freshly crushed leaves or smoking the dried leaves. The dried leaves can also be inhaled through water pipes or by using a vaporizer. The effects of salvia when used this way depend on the absorption of salvinorin A through the oral mucosa, or mouth lining, before the herb is swallowed or inhaled. Extractions of salvinorin A can also be produced and are sold on the internet as a tincture that can be taken orally or as an enhanced dried leaf product. (7, 8)

The hallucinatory effects of salvia are said to be highly dose dependent, with larger doses causing significant hallucinations. Research suggests that doses as small as 4.5 micrograms per kilogram of body weight as well as relatively large doses of 8 milligrams both result in hallucinogenic experiences.

It’s the short duration of the herb’s effects that may be what makes it more attractive to users than other hallucinogens, like LSD. After smoking or ingesting salvia, the effects are usually felt within two minutes and last for 20 minutes or less. But reports indicate that the effects of salvia, however short-lived, can be intense and even frightening.

Effects and Potential Benefits

There’s no doubt that more clinical and pharmacologic research is needed to determine the potential benefits and health risks of using salvia. When Mazatec Indians used salvia for their healing rituals, the plant provided an altered state of consciousness.

But it was also used medicinally for the management of issues like headaches, diarrhea, upset stomach, rheumatism and anemia. These potential benefits of salvia have not been tested on humans yet, so there’s no clear answer about its effects and proper dosage.

There are three areas that have been tested on animals — analyzing salvia’s effects on depression, anxiety, pain and perceptual disorders like schizophrenia. The research suggests that salvia may have the ability to:

1. Reduce Depression and Anxiety

There’s some evidence that salvia divinorum has mood-enhancing, antidepressant and anxiolytic (anti-anxiety) effects. It’s said to increase feelings of relaxation and self awareness, and may work as a potential natural remedy for depression.

This is due to the herbs primary active ingredient, salvinorin A, which is a kappa opioid receptor that produces profound mood alternations. Animal studies show that kappa opioid agonists induce an emotional response that helps animals to overcome stress, like when mice are subjected to a forced swim test or tail suspension. (9)

And researchers of the Department of Psychological Sciences at the University of Missouri found that salvinorin A has unique neurophysiological effects that make it an ideal candidate for major depressive disorder treatment research. However, more studies are needed to determine the differences between doses and their varying behavioral and neurophysiological outcomes. (10)

2. Relieve Chronic Pain

Some research suggests that salvia may work as a natural painkiller for people who are dealing with chronic pain. An animal study conducted in 2017 by researchers in Mexico found that salvia divinorum is capable of reducing pain responses that are associated with neuropathic and inflammatory pain.

This is, again, due to the herb’s primary active ingredient, salvinorin A, which acts as a kappa opioid receptor antagonist. Researchers conclude that this study supports using salvia as a therapeutic alternative for a disabling health problem that’s due to long-term pain. (11)

And another animal study, this one conducted in 2018, also shows that salvia works as an effective agent for the treatment of neuropathic pain. When salvinorin A was injected into the sciatic nerve ligature of rats, researchers found a potent “antinociceptive effect,” which means that it blocked the detection of pain. (12)

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3. Improve Schizophrenia

In 2003, researchers at Case Western Reserve University Medical School in Ohio suggested that salvinorin A, the only known non-nitrogenous kappa opioid receptor, represents a potential molecular target for the development of drugs to treat disorders that are characterized by alterations in perception, including schizophrenia.

Because salvinorin A is able to effect the mind and human perception, and alter the symptoms of diseases that are manifested by perceptual disorders, it may serve as an effective tool for people with schizophrenia symptoms. (13, 14)

Again, although the research isn’t totally clear at this point, reports suggest that when it comes to the addictive qualities of salvia, and salvinorin A, it doesn’t appear to be a threat. In fact, because salvinorin A actually suppresses dopamine activity in the brain, it may even have anti-addictive effects, which is why it’s been researched for its ability to treat cocaine addiction.

Risks and Side Effects

There are no national controls on salvia divinorum, and although the Drug Enforcement Administration (DEA) has placed the herb on a watch list and some U.S. states have banned salvia, it’s still relatively easy to obtain because there are no federal laws that apply to the herb. Because salvia isn’t controlled by the Controlled Substances Act, individual states have to decide whether or not salvia use is allowed. While some states have outlawed selling, buying or possessing salvia, it’s still considered a legal drug in many areas of the U.S.

According to the 2013 report published by the DEA, some of the states that have enacted legislation placing regulatory controls on salvia divinorum include California, Delaware, Floria, Kentucky, Louisiana, Tennessee, Virginia, North Carolina and Missouri. (15)

There are certainly concerns with using salvia, mostly due to the intense hallucinations that occur as a result of eating, drinking or smoking the herb. People who have used salvia report emotional swings, anxiety and paranoia, changes in vision, feelings of detachment and losing contact with reality — being unable to distinguish the difference between what’s real and what’s not. This can be a frightening, disorienting and dangerous experience, especially if you are driving under the influence of salvia, and it may even cause panic attacks.

Using salvia may also cause a loss of coordination, slurred speech, dizziness and memory impairment. A 2011 animal study published in the International Journal of Toxicology found that salvinorin A, the active ingredient in salvia, has deleterious effects on learning and memory, through a kappa-opioid receptor mechanism. The study results showed that salvia use caused impairment of cognitive behavior in rats. (16)

And a poison-center-based review published in The Journal of Emergency Medicine indicates that intentional use of salvia divinorum, whether alone or in combination with alcoholic beverages and other drugs, causes cardiovascular, gastrointestinal and neurologic effects. (17)

Here’s the bottom line: If you are interested in trying salvia for its potential medicinal benefits, including its ability to reduce symptoms of depression, anxiety, chronic pain and schizophrenia, talk to your healthcare provider about a proper dose beforehand. If you have a heart condition or mental health disorder, avoid using salvia, and if you are using prescription medications, check with your doctor to make sure there aren’t any concerns about interactions.

Final Thoughts

• Salvia is a naturally occurring hallucinogenic plant that belongs to the sage family. For centuries, it has been used in religious rituals in South America for its psycho-mimetic effects, but today it’s often used by young adults who are looking to experience a short-term trip.
• The active ingredient in salvia is called salvinorin A — a dopamine-reducing kappa-opioid receptor that’s responsible for the plant’s hallucinogenic effects. Salvinorin A has been researched for its potential beneficial effects for a variety of conditions, including depression, anxiety, chronic pain and schizophrenia.
• But aside from its potential health benefits, salvia is gaining popularity among young adults who use it for the short-lived, “legal high.”
• People who have used salvia report a number of side effects, including emotional swings, anxiety and paranoia, changes in vision, feelings of detachment and losing contact with reality. It has also been described as a frightening, disorienting and even dangerous experience, especially for those with a pre-existing mental health condition. For these reasons, before using salvia, people should be aware of the seemingly inevitable negative consequences.

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