From Our 2008 Archives

Salvia Becoming 'Drug du Jour' for Some Teens

Hallucinogenic Herb Salvia divinorum Causes Concern as Young Adults Use It to Get a Cheap High

By By Don Fernandez
WebMD Health News

Reviewed By Brunilda Nazario, MD

June 27, 2008 — Salvia has been smoked for centuries by Mazatec Indians as a healing and divining tool.

Now, the hallucinogenic herb properly known as Salvia divinorum is becoming the "drug du jour" among some young adults, causing concern among parents, medical professionals, and lawmakers.

Adding to their worries: It's cheap, easy to get, and in most states, perfectly legal.

Salvia's crushed leaves are typically smoked or, less frequently, chewed to provide a 5- to 20-minute hallucinogenic high.

The cultural cachet of the "purple drug" has been increased through videos posted to YouTube featuring teen users as they experiment with the mind-altering plant. Experts describe salvia's power in the same breath as LSD, PCP, and hallucinogenic mushrooms.

Its emerging popularity has led several states to ban its sale and purchase, with more likely to follow. Doctors and drug recovery experts, still learning about salvia's effects, are wary about its long- and short-term effects on young adults.

But is salvia, a member of the sage family also known as "Magic Mint" and "Sally-D," a dangerous substance?

"It's dangerous in the sense that kids are using it," says Harris B. Stratyner, PhD, co-chairman of the board of the National Council for Alcoholism and Drug Dependence. "It has hallucinogenic properties. The scary part is the potential for abuse and using it like an LSD substance."

"It frightens me," Stratyner says.

This fear is partly rooted in the uncertainty of salvia's long-term effects, along with the question of whether salvia is addictive.

Deidre Houtmeyers, executive director of Caritas St. Elizabeth's Medical Center's Comprehensive Addictions Program (SECAP) in Boston, says addiction is unlikely. But general abuse by people who smoke salvia is possible. And the effects could be devastating.

"We see people who do LSD and ecstasy for years and there are some horrendous long-term effects," she says. "Brain dysfunction; brain damage. An inability to learn new information. Any hallucinogenic, used repeatedly, will have some kind of damaging effect to the brain."

The mind-altering power of salvia derives from salvinorin A, a unique compound that is responsible for the hallucinogenic reaction. "To my knowledge, salvia is the most potent natural substance with these hallucinogenic properties," says Nick Votolato, professor of psychiatry at Ohio State University, who is also certified in psychopharmacology.

Salvia is most often smoked, but its leaves can also be chewed, inhaled, or crushed and mixed in a drink. The high from smoking salvia can be both odd and unsettling.

Houtmeyers has interviewed several teens who have experimented with salvia. Some describe the experience as almost innocent and quaint, with one teen relating tales of floating Ferris wheels, flying pigs, and a fairy wearing a green dress.

Others aren't so charmed. Another young man described his experience as "frightening and nauseating," as he felt his body was moving down a conveyor belt.

In addition to the hallucinogenic effects, salvia can cause dizziness, nausea, lack of coordination, slurred speech, a decreased heart rate, and chills.

Salvia is easily purchased in most states and is available for sale through Internet sites, sometimes for as little as $12 an ounce, and at head shops and convenience stores.

The National Survey on Drug Use and Health (NSDUH) recently released a report sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). Based on data complied in 2006, about 1.8 million people aged 12 or older had used Salvia divinorum once in their lifetime. Of those, nearly 750,000 tried it in the previous year.

"When you look at the data, it is now used more often than LSD or more often than PCP," H. Westley Clark, MD, director of the Center for Substance Abuse Treatment at SAMHSA, says. "It may be the drug du jour, if you will."

Its usage still pales compared to well known psychedelics.

The 1.8 million people who have used salvia in their lifetime trails far behind the 23 million who have tried LSD, or the 6.6 million that have experimented with PCP, according to the study. Still, more people tried salvia during the survey's time frame in the past year than LSD or PCP.

Another recent survey of college students found that 4.4% had used it at least once in the previous 12 months. Users were more likely to be white, male, and fraternity members.

There have been no reported cases of death or any other permanent injury from smoking salvia, although one recent incident has been linked to salvia use. In 2006, Brett Chidester, 17, of Wilmington, Del., reportedly committed suicide after using salvia. His suicide note mentioned learning the secrets of life and the chaos this knowledge could cause.

The teenager had recently purchased salvia on a web site, and his mother blamed it for his death. This incident led to legislation banning salvia in Delaware. Other local governments are now pushing to curb or criminalize the purchase of salvia. North Dakota, Missouri, and Illinois have enacted legislation making it a Schedule I substance, essentially declaring it illegal. Florida and South Carolina are among several states that have also taken measures to ban salvia, the former aiming to place it in the same category as marijuana and psychedelics. The city of West Bridgewater, Mass., has forbidden its sale, and countries including Italy, Australia, and Belgium have also banned it.

One safety concern that stands out: teens and young adults driving under salvia's influence.

Still, for all the fears about it, salvia may have characteristics that can treat depression, sleep disorders, heart disease, and possibly cocaine addiction, Stratyner and Votolato say. In China, salvia has been used for 30 years to treat renal failure in patients suffering from diabetes. Much more research is required, though, to know whether salvia can be beneficial.

For many medical professionals, the basic question is why anyone — with the limited knowledge and research that exists about the herb — would take the risk.

"It always disturbs me when people see a need for people to get high," Stratyner says. "And I'm a jazz musician."

SOURCES: Harris B. Stratyner, PhD, co-chairman of the board of the National Council For Alcoholism and Drug Dependence; vice president, Caron Treatment Centers, New York City. Nick Votolato, professor of psychiatry, Ohio State University. Deidre Houtmeyers, executive director of Caritas St. Elizabeth's Medical Center's Comprehensive Addictions Program (SECAP), Boston. H. Westley Clark, MD, director of the Center for Substance Abuse Treatment at the Substance Abuse and Mental Health Services Administration, Rockville, Md.

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