View source for Salvia divinorum

== Also known as ==

Mexican magic mint, holy sage, eclipse, diviner's sage, lady salvia, magic mint, purple sticky, sally d, sage of the seers, Maria Pastora, Shepherdess's Herb, Seer's Sage

== Classification ==

Hallucinogen 
[[Category:Hallucinogenics]]

== Overview ==

''Salvia divinorum'', a relative of the herb sage, grows wild in parts of Mexico but is also cultivated around the world. The plant's leaves have traditionally been used by Mazatec shamans for medicinal purposes and healing rituals. The chemical thought to be responsible for the psychoactive effects is salvinorin A. To the surprise of scientists, this molecule has no nitrogen atoms, which is very peculiar for a drug with powerful psychoactive effects <ref name="1a">'''Salvia''', 2016, http://www.drugscience.org.uk/drugs/psychedelics/salvia/</ref>.

== What does it look like? ==

Dried and crushed leaves fortified with extracts from other leaves are dark green, brownish or even blackish green, due to concentrated pigments.

Pure salvinorin A forms colourless crystals with a melting point of 242'c - 244'c <ref name="2a">'''Salvia divinorum drug profile''', 2015, http://www.emcdda.europa.eu/publications/drug-profiles/salvia</ref>
.

It looks like green plant leaves or a liquid extract <ref name="3a">'''Salvia divinorum''', 2017, http://www.drugfree.org/drug-guide/salvia-divinorum/</ref>.

== Source ==

Salvia divinorum is a 0.5 to 1.5 metre high perennial shrublike herb. It can be easily recognised from its square-shaped and hollow stem and opposite pairs of ovate-lanceolate, jagged-edged leaves, which are usually velvety or hairy. The characteristic flower of the plant has a white corolla surrounded by a violet blue calyx. Salvia divinorum hardly ever sets seeds, and even when produced, they are rarely viable. The propagation of the plant is thus exclusively vegetative and most of the Salvia divinorum plants now cultivated worldwide are clones of a few early Oaxaca collections <ref name="2a"/>.

The plant has spade-shaped variegated green leaves that look similar to mint. The plants themselves grow to more than three feet high, have large green leaves, hollow square stems, with white and purple flowers that typically grow in large clusters to more than 3 feet in height <ref name="99a">DEA, '''Drugs of Abuse''', 2015, Drug Enforcement Administration, https://www.dea.gov/pr/multimedia-library/publications/drug_of_abuse.pdf</ref>.

== Prevalence ==

There is limited information on the extent of use of Salvia divinorum and its preparations in European countries.

In Romania, a 2008 survey amongst Bucharest-based young people aged 15 - 34 who attend recreational settings, showed that 0.3% had tried Salvia divinorum at least once in their life.

In an online survey of UK club-goers carried-out late 2009, 3.2% of respondents admit to a last month consumption of Salvia divinorum, making it the fifteenth most commonly used drug with this frequency. Lifetime prevalence reaches 29.2%. These findings cannot, however, be considered as representative of the wider population of club-goers, due to the methodological limitations of online surveys.

In the US, the annual National Survey on Drug Use and Health conducted in 2006 indicates that the last 12 month use of Salvia divinorum was 0.3% among persons aged 12 or older; overall, about 1.8 million persons admit to using the drug in their lifetime.

According to the more recent 'Monitoring the Future' report of the National Institute on Drug Abuse, last year prevalence of Salvia divinorum in 2009 was 6.0% among high school seniors (this percentage is higher than the previous year prevalence for ecstasy). It appears that the use is restricted and experimental, rather than as a social or party drug.

According to a 2006 study conducted by Khey et al. among students in a US college (average age 19.8 years), the lifetime, last year and last month prevalences were 6.7, 3.0 and 0.5% respectively, with half of the sample expressing no desire to use the drug again <ref name="4a">Khey, D. N. and Miller, B. L. and Griffin, O. H., '''Salvia divinorum use among a college student sample''', ''Journal of Drug Education'', 2008, 38, 3, 297-306, https://doi.org/10.2190/DE.38.3.g, http://journals.sagepub.com/doi/abs/10.2190/DE.38.3.g</ref>, this suggests that Salvia divinorum use may have a low continuation rate <ref name="2a"/>.

== Street price ==

Prices vary between countries and depend on the type and amount of product concerned. In early 2011, an 'EMCDDA snapshot' of online shops found that the European market prices for Salvia divinorum dried leaves ranged from EUR 0.27 (1 kilogram package) to EUR 1.5 per gram (one-gram package).

A '2011 EMCDDA snapshot' also showed that 'Salvia 5X' extracts are sold in small amounts such as ½ gram for around EUR 11–12. 'Salvia 40X' costs around EUR 30 for ½ gram <ref name="2a"/>.

Salvia is sold in dried leaf form and costs on average £12 for 1oz.

Salvia is available as a refined extract in different concentrations, ranging from '5x' to '50x'. The costs range from £10 for '5x' concentration to £40 for '50x' concentration <ref name="5a">'''Salvia divinorum''', 2016, http://www.talktofrank.com/drug/salvia</ref>.

== Why take it? ==

=== Sought after effects ===

* [[hallucinations]],
* giggling,
* reminiscence (bringing back happy memories) <ref name="6a">'''Salvia''', 2017, http://www.release.org.uk/drugs/salvia</ref>.
* can cause powerful hallucinations where you perceive other dimensions or experience alternate realities,
* some people report a loss of physical coordination with trouble walking or standing,
* uncontrollable laughter, usually at the beginning of the trip,
* headaches can come on as salvia starts to wear off <ref name="7a">'''Salvia''', 2015, http://www.themix.org.uk/drink-and-drugs/legal-highs/salvia-9854.html</ref>.

=== Undesired effects ===

* sometimes scary distortions to senses <ref name="6a"/>.

== How long do its effects last? ==

=== Onset of effects ===

* smoked - 15 - 60 seconds <ref name="8a">'''Salvinorin A''', 2017, https://psychonautwiki.org/w/index.php?title=Salvinorin_A&_=</ref>, 0 - 2 minutes <ref name="9a">'''Salvia''', 2017, http://drugs.tripsit.me/salvia</ref>.
* sublingual - 10 - 20 minutes <ref name="8a"/>.
* chewing - circa 15 minutes <ref name="10a">'''Salvia''', 2017, https://teens.drugabuse.gov/drug-facts/salvia</ref>.  
* all [[ROA]]'s - 20 - 60 seconds <ref name="11a">'''Salvia''', 2017, https://wiki.tripsit.me/wiki/Salvia</ref>.

=== Peak ===

* chewing - circa 30 minutes <ref name="10a"/>.

=== Duration of effects ===

* smoked - 15 - 90 minutes <ref name="8a"/>, 5 - 30 minutes <ref name="9a"/>.
* sublingual - 30 - 90 minutes <ref name="8a"/>, 30 - 60 minutes <ref name="9a"/>.
* all [[ROA]]'s - 5 - 15 minutes <ref name="11a"/>.

=== After-effects ===

* smoked - 15 - 60 minutes <ref name="8a"/>, 15 - 20 minutes <ref name="9a"/>.
* sublingual - 30 - 120 minutes <ref name="8a"/>, 15 - 20 minutes <ref name="9a"/>.
* all [[ROA]]'s - 20 - 40 minutes <ref name="11a"/>.
   
== Pharmacology ==

Salvia is a very unusual dissociative hallucinogen which does not have the same action in the brain as [[LSD]] and other classical psychedelics, or dissociative drugs like [[ketamine]]. Its effects are probably due to its action on the κ-opioid receptor, but how this produces the experience of salvia is unknown <ref name="1a"/>.

Salvinorin A has a unique mode of action and pharmacology. The potent and selective full agonist activity at κ-opioid receptor (KOR) subtypes is primarily responsible for the hallucinogenic effect of the drug. Whereas, 'classical' hallucinogens such as [[psilocybin]], [[LSD]] or DOB, all alkaloidal in nature, interact with specific serotonin receptor subtypes. Salvinorin A shows no significant binding to over 50 other (psycho)pharmacologically important receptors, transporter proteins and ion channels.

In humans, salvinorin A induces short-lived, profound [[hallucinations]]. Inhalation of doses equivalent to 200 - 500 micrograms of salvinorin A leads to loss of control over physical movements (incapacitation); uncontrollable laughter; vivid, colourful and often bizarre, dream- or film-like hallucinations. Temporal boundaries among past, present and future disappear and the user is transported to alternative time and places ('spatiotemporal dislocation') with perceptions of being in several locations simultaneously. The 'trip', especially at higher doses, can be frightening and can cause serious psychotic disturbances. It has been reported that this can last for hours after the hallucinations have disappeared. Common after-effects include tiredness, dizziness and amnesia. Emergency reports have described lasting psychosis in vulnerable individuals.

Although preliminary experiments by Mowry et al, <ref name="12a">Mowry, M. and Mosher, M. and Briner, W., '''Acute physiologic and chronic histologic changes in rats and mice exposed to the unique hallucinogen salvinorin A''', ''Journal of Psychoactive Drugs'', 2003, 35, 3, 379-382, https://doi.org/10.1080/02791072.2003.10400021, https://www.ncbi.nlm.nih.gov/pubmed/14621136</ref> indicated that salvinorin A has relatively low toxicity to rodents, no other study has examined the acute or chronic physiological toxic effect of Salvia divinorum leaves or of the various extracts <ref name="2a"/>.

The main active chemical component of Salvia Divinorum, salvinorin A elicits its strong hallucinogenic effect by binding to and activating a specific receptor in the brain - the kappa opioid receptor (KOR).

Once ingested, salvinorin A causes intense but short hallucinations that may be particularly vivid, unexplainable, colourful or dream-like. The user may also experience uncontrollable laughter, while perception of time and location may alter while users may become completely incapacitated depending on the dose taken.

Once the effects have ended, it is common for users to feel tired, dizzy and not remember the details of their experience.

Although the duration of effect is short, vulnerable individuals have been known to experience psychotic symptoms for some time after the effects have ended - particularly with higher doses.

Ordinarily, the kappa opioid receptor is a binding site for naturally-occurring opium-like chemicals (called alkaloids) and to date, salvinorin A is the only non-alkaloid found to bind to this receptor.

Uniquely, salvinorin A does not bind to or act on the specific serotonin receptor system associated with the actions of other hallucinogenic drugs such as LSD and psilocybin. The original assumption that it did led to delays in understanding salvinorin A's mode of action.

Extensive testing has shown that salvinorin A does not bind to over 50 other receptors considered to be important from a psychopharmacology viewpoint.

More recent research has found that Salvinorin A binds to the dopamine receptor 2 (D2 receptor) with a greater affinity than it has for the kappa opioid receptor. As this receptor is associated with treatments for brain disorders (for example schizophrenia and Parkinson's disease) it is possible that Salvinorin A could have a role in the development of new treatments <ref name="6a"/>.

Salvinorin A is a potent kappa-opioid receptor agonist. It does not have any effect on the 5-HT2A receptor, the receptor targeted by most psychedelic drugs, nor does it function as an NMDA receptor antagonist as most dissociatives do. Its unique structure lacks features commonly associated with opioid ligand binding, namely it doesn't contain a quaternary carbon atom linked to a tertiary amine group by two other carbon atoms. Unlike traditional opioid agonists, salvinorin A targets the kappa-opioid receptor rather than the mu-opioid receptor. Salvinorin A is currently being researched in relation to its properties as an anti-addiction drug, and several analogs with improved pharmacokinetic profiles have been shown to have anti-addictive effects as well <ref name="13a">Kivell, B. M. and Ewald, A. W. M. and Prisinzano, T. E., '''Salvinorin A analogs and other κ-opioid receptor compounds as treatments for cocaine abuse''', ''Advances in Pharmacology'', 2014, 69, 481-511, https://doi.org/10.1016/B978-0-12-420118-7.00012-3, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4128345/</ref>.

However, the role of these interactions and how they result in a hallucinogenic experience continues to remain elusive <ref name="8a"/>.

=== Pharmacodynamics ===

Researchers are studying salvia to learn exactly how it acts in the brain to produce its effects. What is currently known is that salvinorin A, the main active ingredient in salvia, attaches to parts of nerve cells called kappa opioid receptors. (Note: These receptors are different from the ones involved with opioid drugs, such as heroin and morphine) <ref name="10a"/>.

=== Toxicity ===

The toxicity and toxic dose are both unknown <ref name="8a"/>.

== Mode of use ==

Usually, people chew fresh leaves or drink their extracted juices. The dried leaves can also can be smoked in rolled cigarettes, inhaled through water pipes (hookahs), or vaporised and inhaled <ref name="10a"/>.

=== Chewing ===

Fresh leaves can be chewed. A salvia 'quid' (lump of leaves) is crushed slowly with the teeth and held in the mouth for about half an hour. Dried leaves are soaked in water first before chewing. The salvinorin A is absorbed through the lining of the mouth, so chewing fast and swallowing is ineffective. Some brush the inside of their mouth with mouthwash, or eat chillies before chewing, in order to increase blood flow and so boost the absorption of the chemical. Just 10 strong leaves have given some people realistic visions of being in another place, so users should be cautious with quantity, and start with a small amount the first time. With this precaution, chewing is likely to be the lowest risk way of using salvia. The effects take about 15 minutes to kick in and last an hour or so before fading, peaking in about 30 minutes.

A variety of tinctures made to be taken by mouth have also been observed, these are concentrated and require even more care to prevent a stronger-than-desired experience <ref name="1a"/>.

=== Smoking ===

Some people smoke dried salvia leaves in order to get a stronger experience of the drug. Using a [[water-pipe]] ([[bongs|bong]]) and a cigarette lighter is a popular method. Using matches is risky, as you are likely to drop it as soon as the drug kicks in. The problem with smoking dried salvia leaf is that you need to inhale a great deal of thick smoke over 2 or 3 minutes to get an effective dose as the leaves naturally contain so little of the drug. This is unpleasant, probably unhealthy, and difficult to achieve for most people.

However, salvia for smoking is now mostly purchased in the form of dried, ground-up salvia leaf which frequently has had a concentrated salvia extract added. This allows the entire dose of Salvinorin A to be consumed in just a few puffs or even just one inhalation. This gives a large risk of having an unpleasantly overwhelming experience. Extreme caution must be taken with these products. If you intend to use them, start small and work your way up, rather than jumping in at the deep end.

Concentrated salvia leaf looks a bit like dark dried herbs. This product is usually described by how many times the potency of the original dried salvia leaf has been fortified (e.g. 5x extract, 20x, or even 60x). Quality control for products like these is virtually non-existent. This means that if you buy salvia you cannot rely on the claimed strength of the extract being trustworthy and there is the possibility that salvinorin A may be replaced by another substance. Experience reports on websites like Erowid.org suggest that people have gone through very powerful experiences from products labelled as being any of the available strengths <ref name="1a"/>.

Sold on the internet and in 'headshops' as 'herbal ecstasy', salvia is one of a number of substances marketed as 'herbal highs'.

Depending on dosage, experiences can vary from the fairly mild to full blown with psychedelic hallucinations. At higher doses users can experience dramatic time distortion, vivid imagery and scary hallucinations <ref name="5a"/>.

Traditionally, the Mazatec Indians roll the fresh leaves of the plant into a cigar-like 'quid', which is then sucked or chewed while retaining the juice in the mouth to increase absorption of the active ingredient.

Alternatively, the fresh foliage is crushed by hand or ground on a milling stone which can be used for making a drinkable infusion. At least six fresh leaves are needed to achieve noticeable effects, which manifest after about 10 minutes and lasts for 45 minutes or longer.

For recreational use, the most common way of administration is smoking the crushed dried leaves from a [[water-pipe]] or [[bongs|bong]], providing short-lasting (15 - 20 minute) hallucinations within a minute. Typically, 0.25 - 0.75 gram leaf material is smoked.

Chewing the bitter leaves as a quid gives a longer lasting effect and the typical dosages to produce mild to medium effects are 10 - 30 grams of fresh leaves or 2 - 5 grams of dried leaves.

Sublingual application of aqueous ethanol tinctures made from leaves results in an onset taking 5 - 10 minutes and lasting up to 2 hours.

Drinking tea made by steeping the leaves in hot water is relatively ineffective because salvinorin A is readily degraded in the gastrointestinal tract. Vaporisation of the dried leaves or extracts without burning requires special devices and rather high temperatures (>200 'C) and is not a typical method of use.

Health risks of inhaling the vapours of pure salvinorin A are high because the inhaled amount cannot be controlled. This can lead to an 'overdose', in the form of psychotic disturbances <ref name="2a"/>.

Only when enough of Salvia's highly active compound, Salvinorin A, is absorbed through the oral mucosa and into the blood stream can a psychoactive effect be produced <ref name="14a">Siebert, D. J., '''Salvia divinorum and Salvinorin A: new pharmacological findings''', ''Journal of Ethnopharmacology'', 1994, 43, 1, 53-56, https://www.ncbi.nlm.nih.gov/pubmed/7526076</ref>. There are several methods of ingesting Salvia with varying durations of hallucinogenic effects <ref name="15a">'''Salvia Divinorum''', 2013, http://www.cesar.umd.edu/cesar/drugs/salvia.asp</ref>.

* Dried leaves of Saliva can be smoked like marijuana, in a [[bongs|bong]], pipe, or as a [[joint]], with effects lasting up to 15 minutes. Fresh leaves of Salvia can be chewed and swallowed or chewed as a quid <ref name="16a">Halpern, J. H., '''Hallucinogens and dissociative agents naturally growing in the United States''', ''Pharmacology & Therapeutics'', 2004, 102, 2, 131-138, https://doi.org/10.1016/j.pharmthera.2004.03.003, https://www.ncbi.nlm.nih.gov/pubmed/15163594</ref>.
* When chewed as a quid, the leaves of Salvia produce extractions of Salvinorin A before the leaves are removed from the mouth. The extractions are absorbed through the oral mucosa and produce visual hallucinations, lasting 1 to 2 hours; the longer the herb remains in the mouth, the stronger the effect will be.
* Salvinorin A extracts can be mixed in a drink or vaporised and inhaled.
* When Salvia's leaves are crushed and the extracted Salvinorin A can be mixed with water to make a drink. Since Salvinorin A is deactivated by the gastrointestinal system before entering the blood stream this method may produce a more moderate effect than other methods.
* Salvinorin A can also be vaporised and inhaled - Salvinorin A is heated on a piece of tin foil and the vapors are inhaled through a glass pipe <ref name="15a"/>.

It can be chewed, smoked, or vaporised, depending on the form it is in <ref name="3a"/>.

== Effects ==

Although salvia has been around for hundreds of years, there has been very little research carried out into its effects. Depending on dosage, experiences can vary from the fairly mild to full blown with psychedelic hallucinations <ref name="5a"/>.

* It can provide enjoyable hallucinations.
* At higher doses users have reported experiencing dramatic time distortion, vivid imagery and scary hallucinations <ref name="5a"/>.

Salvia is not a drug that reliably makes users feel 'good'. People often take it out of curiosity and interest in exploring weird mental states, rather than for pleasure or fun. A few use it for personal spiritual reasons but it appears that most users do not tend to repeat these powerful experiences very often.

Salvia combines hallucinogenic and dissociative effects. At higher doses it can scramble current perceptions, memory and imagination so you can lose all sense of who and where you are and what is going on. Alternatively, you might find the trip meaningful, for example revisiting places from your past, which may appear to be as clear and real as normal experience. This means that, unlike most hallucinogens, when a salvia trip is intense, it is quite possible to be unable to determine what is real and what is not, and even forget you have taken a drug, which cause intensely disturbing 'derealisation' and fragmentation of identity.

When smoked, the effects of salvia come on in seconds, peak in the first 5 or 10 minutes and then decrease over the next half hour. The experience can be very unusual and for a minority of people taking salvia feels enlightening and has elements of beauty. However many find that it very difficult to make any sense of. Most people do not regret trying salvia, but plenty find it unpleasant and sometimes terrifying. Small doses of Salvia, for example when the plant is chewed, or smoked in an ineffective way, may make you feel odd and giggly.

If a large dose is taken, which can be with just one lungful of smoke, the user will have a very intense experience, in which no aspect of normal conscious reality stays the same, and it is common to forget that you have taken a drug, or even who or what you are. Every person will experience something different on salvia, and no two trips will be alike. Salvia can make your perception of time and the place you are in different. People can find themselves laughing hysterically. It can bring about [http://www.ncbi.nlm.nih.gov/pubmed/21131142 cartoonish hallucinations], and even a total immersion in a dream reality outside of the normal universe. You can even experience encounters with [http://www.ncbi.nlm.nih.gov/pubmed/21131142 other beings]. Your whole body feels involved in a salvia trip, and sensations of falling, being pulled around, or floating are common. Some salvia effects are perhaps most comparable to other controlled psychedelic hallucinogens like [[LSD]] and [[DMT]], although salvia works very differently in the brain. Salvia is more often scary and confusing, with the experience imposing itself on you whilst you have little control. The classic psychedelics more frequently give trips which feel meaningful and uplifting, where you often feel involved with the experience rather than the experience just happening to you, although salvia has the safety advantage of being very short-acting <ref name="1a"/>.

=== Short-term effects ===

This drug is a psychoactive hallucinogen that can cause dramatic and sometimes frightening mind-states. Depending on dosage, a user's reaction can vary from a subtle, just-off-baseline state to a full-blown psychedelic experience. It has been reported to induce an intense hallucinatory experience in humans (particularly when smoked) which typically persists from several minutes to an hour. It has been described as a '20-minute acid trip'. Physical effects include dizziness, slurred speech, and loss of coordination <ref name="3a"/>.

=== Physical effects ===

* dizziness,
* nausea,
* lack of coordination,
* slurred speech,
* awkward sentence patterns,
* decreased heart rate,
* chills <ref name="15a"/>,
* changes in felt bodily form,
* changes in gravity,
* spatial disorientation,
* spontaneous tactile sensations <ref name="8a"/>.

=== Long-term effects ===

Since not much is known, it can only be said that harm from Salvia divinorum most likely occurs from inadequate preparation or from using the drug in a setting in which it is dangerous to be intoxicated from any drug at all (i.e. driving) <ref name="3a"/>.

=== Cognitive effects ===

* anxiety, - general paranoia, anxiety and panic are very common for the unprepared and this can be accounted for by the fact that k-opioid agonists have been shown to cause such feelings in people.
* amnesia,
* cognitive dysphoria,
* confusion,
* delusions,
* depersonalisation,
* ego replacement - this effect differs qualitatively from psychedelics in that it usually comes about in the form of another human being, animal or even plant.
* feelings of impending doom,
* increased music appreciation,
* information processing suppression,
* language suppression,
* laughter - the average first time salvia user generally experiences a mixture of extreme giggles and confusion.
* memory suppression - this substance is particularly intense in its cognitive effects due to the near instant transition from sobriety into ego death (complete memory failure) which can occur very suddenly at moderate to high doses. Throughout the experience, this feels as if the user is receiving the sensory input of their trip but are not fully conscious enough to process the implications of it until the offset.
* thought deceleration,
* time distortion,
* unity and interconnectedness <ref name="8a"/>.

=== Visual effects ===

* depth perception distortions - this effect is usually characterized by a total loss of depth perception and a complete flattening of the visual field into a 2-dimensional image. it can also make objects seem further away or closer in distance than they actually are, 
* drifting,
* perspective distortions - this effect can be described as specific objects with the external environment or the surroundings as a whole changing in physical size and becoming impossibly huge or small in size, 
* environmental cubism,
* scenery slicing <ref name="8a"/>.

=== Hallucinatory states ===

* internal hallucinations,
* transformations <ref name="8a"/>.

=== Auditory effects ===

* distortions,
* hallucinations <ref name="8a"/>.

=== Positive effects ===

* radical shift in perspective and perception,
* increase in sensual activity,
* introspective insight,
* powerful open/closed eye visuals,
* change in consciousness <ref name="11a"/>.

=== Neutral effects ===

* dissociation,
* perspiration <ref name="11a"/>.

=== Negative effects ===

* [[dysphoria]],
* [[ataxia]],
* dizziness,
* amnesia,
* nausea <ref name="11a"/>.

=== Overdose ===

* loss of coordination,
* dizziness,
* slurred speech <ref name="99a"/>.

== Risks ==

Taking salvia does involve risks. Here's what it could do to you.

* There is some concern that salvia could trigger psychotic episodes particularly in young people and people with previous history of, or a family history of, mental health problems.
* Throat and lung irritation, headaches and mild irritability have been reported after using salvia.
* Most physical harms resulting from using salvia occur as a result of people injuring themselves when under the influence of salvia, rather than salvia directly causing harm <ref name="5a"/>.

There is no evidence that salvia is toxic to the body or brain but there has not been detailed scientific investigation on the potential of salvia to be harmful. Some people feel headachy or foggy-minded for a while afterwards.

In some countries, salvia is controlled, so make sure you investigate this first <ref name="1a"/>.

* the effect can be extremely overwhelming and somewhat terrifying. Users have experienced upsetting hallucinations where time seems to go on indefinitely, or they believe themselves to be inanimate objects,
* people going through emotional upheaval have found salvia exacerbates their problems,
* personal injury can be caused by trying to stand or move around while under the influence of salvia,
* the herb is very strong and can cause throat and lung irritation,
* users with a family history of mental illness should be careful as strong psychedelics can trigger psychological problems, 
* there is no evidence to suggest salvia is addictive, but frequent users can find they become more sensitive to the drug and feel the effects more strongly with regular use <ref name="7a"/>.

=== Traumatic experiences (bad trips and lasting symptoms) ===

Not enjoying salvia is common, but a truly traumatic experience seems very rare. The chance of it happening to you can probably never be ruled out, but is much more likely on very high doses, especially if you have never taken salvia before and if you are unprepared for its potentially powerful effects. If you are feeling negative emotions like anxiety, self-doubt or depression before you take the drug, bad feelings may become amplified.

People have believed they were dead or dying, that the walls were closing in, or that they were going permanently mad. Salvia often causes sensations of [[depersonalisation]] and [[derealisation]], where users lose track of their identity and question reality. For some, this is a profound and valuable experience, but for some it causes extreme fear and distress.

Although the salvia experience does not last long, some people report feeling like it lasts for hours, or even forgetting that another sort of existence exists outside of the bad trip. During the trip, people can have panic attacks, become agitated, and try to escape. This risks injury to themselves and anyone who tries to restrain them.

There have also been cases, not formally reported in medical journals, of people who have found that a single salvia experience left them with [[derealisation]] that lasted many days or more. They felt spaced out, miserable, and disconnected from reality. Others claim to have suffered lasting alterations of perception that echo the [[hallucinations]] during their trip. It is important to repeat that these effects have not been scientifically documented, but they are serious enough to be aware of. There may be millions of people who have taken salvia without harm, and very few have suffered these serious lasting problems <ref name="1a"/>.

=== Injuries ===

When you are tripping on salvia, you may be totally unaware of your real surroundings, but will often want to move around, which makes you vulnerable to dangerous accidents. Dangerous objects (car keys, knives) should be made inaccessible. Someone tripping strongly is less likely to suffer harm if they have constant supervision by a 'trip sitter'. Unless it is unavoidable, the sitter should not try to physically restrain someone who is tripping so much that they are unaware of their surroundings, as the user may become frightened and lash out violently. If an appropriate setting is chosen, restraint should not be needed <ref name="1a"/>.

== Addiction ==

=== Can you get addicted ===

Salvia is not known to be either physically addictive or to cause psychological dependence <ref name="5a"/>.

== Harm Reduction ==

If you have had problems with your mental health, such as bipolar disorder or any psychotic illness, salvia could perhaps [http://informahealthcare.com/doi/abs/10.3109/14659890903060167 provoke bad reactions]. In one almost unique case where a man [http://ajp.psychiatryonline.org/article.aspx?articleid=100983 developed a lasting psychotic illness] after smoking salvia, it was thought that he may have been predisposed to schizophrenia, and the salvia brought on the appearance of symptoms <ref name="1a"/>.

* due to the [[ataxia]] and loss of body control, it is recommended to position yourself in a way that you will not aspirate during the experience (though vomiting from salvia is not a common occurrence),
* it is generally recommended to use a sitter while ingesting salvia, due to the mental intensity of the experience or potential for injury while in dysphoric state <ref name="11a"/>.

== Legality ==

Although salvia has been legal in the past, since the Psychoactive Substances Act came into effect on 26 May 2016, it is now illegal to supply or import salvia for human consumption <ref name="5a"/>.

=== Did you know? ===

Like drinking and driving, it's illegal to drive if your driving has been impaired by taking drugs. With some drugs, you can even remain unfit to drive the next day.

As well as this drug-impaired-driving offence, it's now illegal in England and Wales to drive over set levels for any of 17 named drugs (legal and illegal) in your body, whether or not you are impaired. Very low limits have been set for some common illegal drugs such as [[cannabis]], [[cocaine]] and [[MDMA]]. You can get a heavy fine, be disqualified from driving or even go to prison <ref name="5a"/>.

== Harm reduction advice ==

Salvia is legally available in many European countries, but this should not be taken as a reflection of its power. It can be distressing and even harmful, [http://www.ncbi.nlm.nih.gov/pubmed/19193352 especially when used by people] who are not prepared. There will always be a risk that you will have a horrible experience with salvia, but thoughtful preparation can help reduce the risks <ref name="1a"/>.

Because the drug comes on so quickly and with such force, many users find the experience daunting and scary. Accompanying this can be a racing heart and increased breathing.

Some users also report nausea and loss of balance. Users should have a safe, comfortable place to sit or lay when using the drug. If you want to experience a dose of Salvia it is advisable to have a 'sitter' because some users attempt to get up and walk about while intoxicated. This can happen even to people aware of the effects of hallucinogens.

It is not advisable to use this drug for the first time in a club or at a festival because of its differing and sometimes disturbing effects on different people.

Lobelia, a red flowering plant that grows up to six feet high is often recommended as a moderating influence on more powerful or uncontrollable trips. Its extract is contained in some of the Salvia x40 preparations. It does not possess any hallucinogenic qualities in itself.

Salvia is also sometimes used in a dark and quiet room because users believe this brings out the disassociative effect. However, first time users should not attempt this alone because the results can be disturbing. The higher concentrations (x10, 15,40) should be avoided by inexperienced users.

Read any information you can before you embark on a 'trip'. This may be a very intense experience <ref name="6a"/>.

=== Chewing or smoking salvia ===

Considering what type of experience you want is important, For many people chewing leaves will give a sufficient experience with less of the risk of going too far than smoking might give. Even if you think you want a powerful experience, working your way up through lower doses will reduce the chance of getting more intensity than you wished for. This is true of most drugs <ref name="1a"/>.

=== Having a sitter ===

A sober and trusted friend, a 'trip sitter', can help look out for you, prevent accidents and may be able to reassure you if you are having an unpleasant or frightening experience. Getting comfortable in a safe place such as on a carpet, with cushions around and dangerous objects removed, reduces the risk of injury <ref name="1a"/>.

== History ==

The first recorded mention of Salvia was made in 1938 by Jean B. Johnson, who heard of Mazatecs making a tea from the leaves of ''hierba Maria'', which induced visions in users. In 1952, Roberto G. Weitlaner, Johnson's father-in-law, reported the preparation of ''yerba de Maria''. R. Gordon Wasson and Albert Hofmann acquired the first specimen of Salvia divinorum from the Mazatecs in 1962; they described it as "a less desirable substitute" for hallucinogenic mushrooms <ref name="17a">Rovinsky, S. A. and Cizadlo, G. R., '''Salvia divinorum Epling et Jativa-M. (Labiatae): An Ethnopharmacological Investigation''', ''The McNair Scholarly Review'', 1998, 3, 145-159, http://www.sagewisdom.org/rovinsky.html</ref>.

It was not until August 2002 that researchers discovered that Salvia divinorum acts at the kappa opiate receptor (KOR) site, where much of human perception is regulated. This puts Salvia divinorum in a class of drugs known as KOR agonists, which are thought to play psychotherapeutic roles in perception altering diseases such as schizophrenia and Alzheimer's disease <ref name="18a">Roth, B. L. and  Baner, K. and Westkaemper, R. and Siebert, D. and Rice, K. C. and Steinberg, S. and Ernsberger, P. and Rothman, R. B., '''Salvinorin A: A potent naturally occurring nonnitrogenous kappa opioid selective agonist''', ''Proceedings of the National Academy of Sciences'', 2002, 99, 18, 11934-11939, https://doi.org/10.1073/pnas.182234399, http://www.pnas.org/content/99/18/11934.full</ref>, <ref name="15a"/>.

Salvia divinorum is believed to have a long history of use in traditional Central American rituals, particularly for divination and healing. However, unlike many plants known to indigenous peoples, salvia was not recognised by early European explorers, and was only ethnobotanically described in 1938 by the American anthropologist Jean B. Johnson.

Despite several decades of investigation, the precise mechanisms of action of the active ingredients of the plant (divinorin A and B) remained unknown until 2002. Salvia began to be available commercially in the late-1990's, often marketed as an 'exotic' legal alternative to cannabis, although smoking has never been noted as a traditional form of consumption. Extracts of the plant in various forms and strengths have become widespread on the internet and in head shops in recent years <ref name="6a"/>.

== Salvia myths and misunderstandings ==

=== Is salvia like cannabis? ===

No. Salvia is sometimes described as or compared with cannabis in the media, for example being referred to as a legal cannabis alternative because it is a smokeable herb and often not controlled. Most users do not find the drugs similar and they do very different things to the brain <ref name="1a"/>.

----

== References ==

<references />