Salvia Divinorum

Salvia divinorum is a plant-based hallucinogen that has come under increasing regulatory scrutiny and control during the beginning of the 21st century. It is a mint plant that has been used in traditional spiritual practices by the Mazatec Indians of Oaxaca, Mexico. Although the use of Salvia divinorum by these indigenous people dates back hundreds of years, an understanding of the psychoactive effects of this plant by American users dates only to the mid-1990s. Users commonly refer to the substance as “salvia.”

The major psychoactive constituent of Salvia divinorum is salvinorin A, which is chemically unusual as a psychoactive drug because it does not contain nitrogen, and is therefore not an alkaloid. Salvinorin A is a highly selective agonist at the kappa opioid receptor in the brain, and is structurally unique from previous synthetic drugs found to activate this receptor. This mechanism is different than the mechanisms of other classes of hallucinogenic drugs. Because of its unique structure and effects at the kappa opioid site, some researchers believe that salvinorin A or an analog of it may hold promise as a medication for a variety of disorders with which the kappa opioid system has been implicated, such as Alzheimer's disease and other forms of dementia, chronic pain, and cocaine dependence. Scientists interested in such research have suggested that scheduling the drug would create bureaucratic obstacles to such research, and decrease financial incentives for pharmaceutical companies to invest in research on analogs of salvinorin A for therapeutic purposes.

Although in traditional Mexican use, the leaves of Salvia divinorum were chewed or made into an [Page 710]infusion and swallowed, contemporary use typically involves smoking either the dried leaves, or more commonly, dried leaves to which additional extract of the plant has been added. The latter method is used because many users report difficulty in achieving effects by smoking unenhanced leaves, and those who do achieve effects that way report that multiple rapid and large inhalations are required. When smoked, effects are achieved nearly instantly, sometimes before the individual exhales, and major effects last 20 minutes or less. Typical effects include motor impairment, sensory alteration, vivid hallucinations, “out-of-body” experiences, and feelings merging with inanimate objects. Users report the effects to be distinct from those caused by classical hallucinogens such as LSD and psilocybin, with Salvia divinorum effect being characterized by more derealization and depersonalization than these drugs.

The Salvia Divinorum plant in bloom. By 2006 an estimated 1.8 million people in the United States had tried the drug.

In 2006 approximately 1.8 million people 12 years old or older in the United States had reported using Salvia divinorum in their lifetime. Surveys and anecdotal reports suggest that often people use the drug once or a few times and are deterred from using the drug further by its often intense and bizarre effects. Animal research suggests the drug is relatively safe physiologically. Furthermore, animal research, survey research, and knowledge of its neuropharmacological mechanism suggest addiction or compulsive drug seeking is not likely. However, the substantial behavioral impairment caused by the drug is a relevant domain of danger, and accidents may be likely if users engage in behavior such as driving while using the drug. Although the drug's short duration likely lessens the opportunity for such injuries, in comparison to long-acting impairing drug such as alcohol, there have been calls to poison control centers concerning behavioral impairment resulting from Salvia divinorum use.

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