Salvia Divinorum Health Concerns

Q. Does Salvia use cause any after effects?
A. Some users report a positive mood "afterglow" that lasts between a few hours to a a couple of days. Minor, if any, negative after effects are noticed. A few users report a mild headache, bronchial irritation, insomnia or irritability. These symptoms seem to be reported more often by smokers than by quid chewers, and perhaps might be due to some combustion products, such as carbon monoxide rather than salvinorin.

Q. How long is a person's ability to drive impaired after using Salvia?
A. Most people feel they can drive safely by 3 hours after smoking Salvia, or 4 hours after chewing it. Many believe they can safely drive even sooner than this. The duration of impairment after drinking the infusion might be up to 8 hours. But studies of the duration of impairment, after taking Salvia by any route, have never been done.

Q. Is Salvia addicting?
A. Although Salvia is not believed to be addicting, bare in mind that some habit forming drugs including tobacco, heroin, cocaine and benzodiazepines also were initially thought not to be addicting. No physical dependence on Salvia or salvinorin has been reported. Withdrawal symptoms have not been reported. It is quite unlikely that anyone using Salvia in the traditional fashion (by chewing quids of leaves occasionally) will become 'addicted'. Whether this freedom from addictive risk also holds for smoking leaves, smoking extract enriched leaves, vaporizing powdered leaves or vaporizing salvinorin is something only time will tell. Prudence and general health concerns would advise not to inhale Salvia smoke (or vapor) into your lungs often.

Q. Does Salvia cause any physical damage?
A. There are no known health problems from oral Salvia use. However, it is known that smoking tobacco is damaging to your lungs and may cause cancer, emphysema, bronchitis, stroke and cardiovascular disease. These toxic side-effects of tobacco smoking are not due mainly to nicotine but rather to combustion products (tars and carbon monoxide), which are present whenever any type of plant material (e.g. Salvia) is smoked. Common sense will tell you that smoking Salvia, or any material, can be bad for your health. It is not known if Salvia can cause birth defects, but it is prudent to assume that it could.

Q. Can you take a fatal overdose?
A. Fatal poisoning from Salvia divinorum appears to be very unlikely to occur. No case of fatal salvinorin poisoning has been reported. The human oral lethal dose is not known but is believed to be extremely high. Swallowed salvinorin is not well absorbed. The chances of inadvertently swallowing a lethal overdose of an oral preparation of leaves, tinctures/elixirs, or soft/hard extracts are extremely low.

If salvinorin is inhaled as multiple inhalations of leaf smoke or vapor one could reasonably expect to pass out before he/she could take a lethal overdose. But significantly, nothing is known about the toxic effects of smoking truly massive "single bolus" doses of pure salvinorin, such a practice might be quite dangerous, and should certainly be avoided.

Q. Does Salvia cause brain damage?
A. Not so far as is known. However salvinorin has some phenomenological similarities to dissociatives such as PCP and ketamine, and these dissociatives can cause brain damage (Olney's Lesions) if taken in very high dose. Therefore the possibility that salvinorin might cause brain damage if taken in excessive dosage cannot be completely discounted. However, there have been no reports of any brain damage from salvinorin in man or animals. For those chewing quids of Salvia leaves there would seem to be no danger of brain damage at all. Chewing leaves is the very safe traditional mode of use. For those vaporizing pure salvinorin in high doses... who knows? Vaporizing pure salvinorin makes possible dosages far in excess of that any traditional user has encountered, so the safety of traditional usage patterns cannot guarantee the safety of using pure salvinorin.

Q. How does salvinorin-A work in the brain?
A. Nobody knows as of yet.

Q. In what parts of the brain does it act?
A. This is not known for sure but from the subjective and behavioral effects it can be surmised that salvinorin is almost certainly affecting the limbic system, and may be affecting somatosensory (parietal lobe), cerebellar and vestibular function as well.

Q. Does it act at any receptors where other drugs act?
A. As of now, the mechanism of action for salvinorin-A is still unknown. Discovering which receptor site(s) it binds to will be an important step toward developing an understanding of how this substance works in the brain. Once this is know, it will be possible to look for endogenous ligands for these receptors, so that we can understand in what way salvinorin-A may relate to naturally occurring human biochemistry. It is possible that salvinorin-A does not act directly on any receptor site, but rather acts to release some endogenous neurotransmitter from synaptic storage vesicles.

Q. Are there psychiatric dangers associated with Salvia use?
A. Probably there are for some individuals. Acutely, salvinorin-A induces what could be termed a "toxic psychosis," in other words one may see visions, hear voices, have bizarre thought patterns etc. This is normal when tripping. The acute effects of Salvia (both desirable and undesirable) wear off very quickly. However for some people the overwhelming strangeness of the Salvia experience (or perhaps some direct effect of salvinorin in the brain) can trigger panic attacks. Some individuals with schizophrenia or other psychotic disorders (even if in remission) might experience a Salvia induced relapse, or exacerbation of their condition. People with Borderline Personality Disorder even when not on any drug often depersonalize, self mutilate, make suicide gestures or attempts, commit antisocial acts, and get into fights. Individuals with Borderline Personality Disorder might become even more unstable when under the influence of Salvia. Although some individuals with depression have reported that Salvia has lifted their depression, for others it could make a pre-existing depression acutely worse. For such an individual there may be risk of suicide. However, no Salvia related suicides have been reported. If you have a psychological condition and want to use Salvia, please use discretion and first consult your doctor.

Q. Are there medical or psychiatric uses of Salvia?
A. There are no accepted uses for Salvia divinorum in standard medical practice at this time. Some areas for exploration include Salvia aided psychotherapy (there is anecdotal material supporting its usefulness in resolving pathological grief), use of salvinorin as a brief acting general or dissociative anesthetic agent, use to provide pain relief, use in easing both the physical and mental suffering of terminal patients as part of hospice care, and a possible antidepressant effect. If a specific salvinorin receptor were discovered this would be of great interest to psychopharmacology and neuroscience.