Salvia Addiction

Salvia Addiction

Salvia Addiction

Salvia AddictionBefore she got famous for twerking at MTV’s Music Video Awards, Miley Cyrus had another video that went viral on the Internet.  In the one made in 2006, she was filmed smoking a strange but legal drug called salvia through a water pipe.  She acted silly and made no sense, but many of her fans loved it. Later she told Billboard Magazine, “I made a mistake. It was a bad decision because of what I stand for.”  Luckily, she made her bad decision five days after her eighteenth birthday when she was no longer a minor.[i]

A favorite teenage pastime is to do just what Cyrus did – film yourself or your friends high on salvia. The popular drug has been tried by literally millions of people around the world, even though not much is really known about it and it has been liked to suicides.

Some experts are troubled not only by the salvia phenomenon but by the huge public demand for all kinds of legal drugs being sold on the Internet and through legitimate tobacco stores.  As one writer put it, “The recent proliferation of unregulated psychoactive substances is unprecedented in the annals of drug abuse.”[ii]

The movements to keep drugs like salvia and spice available and to legalize marijuana and similar substances may be unstoppable, and yet some worry that the drugs do have negative consequences. Some of these negative effects are with us already, such as an increase in car accidents because of drivers under the influence of safe drugs. And other consequences — such as permanent memory loss and brain damage from using unregulated drugs like salvia—are still not completely understood.

What is Salvia?

Salvia divinorum is a plant in the mint or Lamiaceae family that grows naturally in the Sierra Mazateco region of Oaxaca, Mexico. It is a sage plant, but not the same as common garden or scarlet sage. Mazatecs, the natives in the region, use salvia in their religious ceremonies, and their shamans use to induce visions. Mazatecs call salvia “divining sage” and use it as a herbal remedy for anemia, headache, rheumatism, diarrhea, and water retention. The first Westerner to try salvia was probably botanist Daniel Siebert in the 1980s.[iii]

The plant has large green leaves, hollow square stems, and white flowers, and grows about three feet high.

The active ingredient in salvia divinorum is salvinorin, which is an entheogen or psychoactive substance, technically known as a neoclerodane diterpene. Salvinorin is found mostly in the leaves of the plant, and you need between 200 and 600 micrograms to induce an altered state of consciousness.[iv]

No one is exactly sure how salvia produces hallucinations and out-of-body experiences. Morphine, heroin and other narcotic drugs operate on the mu, kappa and delta opioid receptors in the central nervous system.[v] LSD and PCP, which can produce states of altered consciousness similar to the ones caused by salvia, affect more than 50 kinds of receptors.[vi] In contrast, salvia affects only the kappa opioid receptors in the central nervous system.[vii] This leads some scientists such as Tom Prisinzano, a chemist at the University of Kansas, to conclude that salvia is probably non-addictive, because addiction is associated with the alteration of the mu-receptors.[viii]

What are the Medical Uses of Salvia?

The United States Food and Drug Administration has not approved salvia for any medical uses.[ix]

Chemist Tom Prisinzano and others believe that if the U.S. government classifies salvia as a Schedule I Controlled Substance, “It would make it virtually impossible for the medical community to obtain for research. It seems that sober thinking is needed on both sides of the debate.” Prisinzano believes salvia may have benefits in the treatment of pain, depression and substance abuse.[x]

Other researchers, including Dr. Bryan Roth of the University of North Carolina believe that salvia could help treat depression and schizophrenia, especially if science is could figure out how to block the effects of the drug on the kappa opioid receptors.[xi] Dr. Roth has said that the effects of salvia can be similar to “late stage Alzheimer’s,” and therefore the drug could hold a clue to a cure for it.[xii] Others believe that research into salvia could help people in chronic pain or addicted to cocaine.[xiii]

Despite the fact that millions of people have experimented with salvia, it is a drug that has only been known in the United States and Europe for a few decades, which means there is not much research pertaining to it.

How Is Salvia Used Recreationally?

When you buy salvia, you buy dried leaves, fresh leaves, extract from leaves, seeds or plant cuttings.[xiv]

You can put the leaves in your mouth as a quid, like chewing tobacco, but the smell is like sewer water and the taste can make you vomit, according to anecdotal evidence.  Taken by mouth and chewing salvia probably delivers the greatest effects.[xv]

Nevertheless, the most common way to ingest salvia is to use a bong, a water pipe commonly used to smoke marijuana, and to inhale the vapors of crystallized salvia through a glass tube.[xvi]

Other people roll either the fresh or dried leaves or dried stems into tobacco paper and smoke it like a cigarette, but more slowly. They typically hold the smoke inside their lungs for ten to 30 seconds to induce a trance.[xvii]

Salvia leaves can be boiled and then drunk as a tea. The drug can also be purchased in liquid form, as an extract from the leaves, which is also made into a tea.[xviii]

What are the Effects of Salvia?

“…Suddenly I lost all physical awareness. I felt as if I were completely conscious and yet I had no body. I wondered if I were dead.” That is the way Daniel Siebert describes his first experience with it. Considered the foremost expert on salvia, he takes the drug very seriously, calling it “a philosopher’s tool, and not a party drug. It makes people more introverted.”[xix] Siebert maintains an extensive website about the drug and finances his research by selling salvia.[xx]

Another person who uses salvia frequently is Neal Pollack, who says he once saw “visions of great thick green vines,” “an Aztec god spewing fire,” and “a stone warrior from Mesoamerica.  A large hole opened and I flew to it.”  Pollack met a “woman in a white robe,” who is a fairly common figure in salvia visions and who often serves as a guide. Pollack notes that most of his experiences last fewer than ten minutes.[xxi]

For the majority of people who try salvia, the experience is extremely intense but very short.  People hear colors and smell sounds –a phenomenon called synesthesia,” and they go into trances, visual distortions and out-of-body experiences.[xxii] They sometimes hallucinate, feel dissociated from their egos, and travel through time. Outwardly they might appear silly, uncoordinated, and have slurred speech.[xxiii]

About 5,000 videos of people using salvia have been posted on YouTube, and some of them have had 500,000 views.[xxiv] Researchers at San Diego State University decided that the videos offered a unique opportunity to study the effects of salvia, and screened a large sample of them, only using the ones that recorded the entire “drug trip.”  They found that the onset of the effect of salvia took only a minute or two, and in some cases, just a few seconds. The effects were similar to other hallucinogens, but the duration was usually less than eight minutes. The dose and potency of the drug varied from one individual to the next, and the duration of the experience may depend partly on the amount taken.[xxv]

One of the few controlled studies of salvia was done by Dr. Matthew Johnson, and published in the journal Drug and Alcohol Dependence.  He and his team recruited four people to take the drug five times over a three-month period, and concluded that the drug was probably “physiologically but not behaviorally safe.”[xxvi] Subjects reported seeing cartoon characters and images from their childhoods, and some made contact with the entity described by Pollack.

Most people who try it once do not want to try salvia a second time – in fact, Siebert says only 10% of his customers re-order the drug.[xxvii]  Nevertheless, salvia has its fans and its repeat users within that minority.[xxviii]

Neal Pollack has written that salvia is weaker than Ecstasy, and “too intense to be addictive … Anyone who does it more than once a month needs his head examined.”[xxix]

What Drugs Interact with Salvia?

Very little research has been done on this topic, but it is known that alcohol can increase the effects of salvia.[xxx] 

Which People Should not Take Salvia? 

People with undiagnosed mental illnesses should not experiment with salvia because of the danger of persistent psychosis or other severe reactions. People who have built up a tolerance to drugs like LSD and PCP should probably not take salvia because they may be more likely to develop flashbacks and other problems. The problem is that people with undiagnosed mental illnesses and those who abuse other hallucinogens are among those most likely to experiment with salvia.

What are the Risks of Taking Salvia 

The main risk of taking salvia is that you are ingesting a substance into your body that has not been sufficiently researched and studied for its long-term harmful effects.  No one really knows much about the risks of taking salvia.[xxxi]

While some people have wonderful experiences with salvia, many others experience adverse effects such as anxiety, confusion, language impairment, headache, and drowsiness.[xxxii]  One teenaged girl who took it while she was dressed as Minnie Mouse for Halloween had a terrifying experience. Believing that giant mouse ears were melting into her head, she became hysterical.[xxxiii]

In a case study by researchers at Brown University, a 21-year-old with no personal or family history of psychiatric problems had to be hospitalized after taking salvia. He tried to jump out of the car, barricade himself in a room, and experienced strange muscle movements similar to symptoms of Parkinson’s disease. Doctors in the psych unit treated him with risperidone, but when this drug was withdrawn, the patient experienced agitation, paranoia, and aggression, believing that he was able to project and receive thoughts. He recovered within four months.

Salvia is linked to at least two suicides. In March 2008 42-year-old Mario Arsenziano of Yonkers, New York, shot himself in what relatives said was a confused state caused by salvia. In 2006, a 17-year-old Delaware student named Brett Chidester had been experimenting with salvia and believed the drug had revealed “the secret of life” to him.  He left a suicide note that said, “Once you know the secret of life, life is not worth living.”[xxxiv]

One risk of salvia is that you more likely to injure yourself or get into an accident under its influence. Some people get “hangovers” the day after taking salvia.

A 2011 study of laboratory rats found that their long-term memories and ability to learn was adversely affected by salvia.[xxxv]

Some experts believe that salvia used on a long-term basis could cause memory loss and flashbacks similar to those of LSD.[xxxvi]  Harvard University Professor Bertha Madras believes that salvia may be particularly dangerous to adolescents because their brains are not fully developed.

“We don’t know salvia affects the developing brain,” she wrote. “We are in uncharted territory.  Science has not caught up with this drug.”[xxxvii]

Does Salvia Show up on Urine Tests?

The Armed Forces Institute of Pathology developed the first urine test to detect salvia.[xxxviii]  The problem is the drug has a very short half-life, only between 24 and 54 minutes in laboratory primates, which means it clears the body very quickly and is therefore hard to detect in any test.[xxxix]

What is a Salvia Overdose?

People rarely show up in the emergency treatment centers with salvia overdoses because the effects of the drug are so short in duration. If someone is overdosing, salvia is usually just one of several drugs he or she has ingested. Doctors have no antidotes for salvia overdoses, but they do sedate these patients with benzodiazepines.[xl]

One research team purchased a variety of salvia products over the Internet and then did chemical analyses on them.  They found that each product had a different degree of potency of the drug, and concluded that this could make the drug dangerous in terms of overdoses.  They also referenced the suicide of Chidester and speculated as that it could have been a salvia overdose.[xli]

At very high doses salvia can induce unconsciousness.[xlii]

What is Salvia Withdrawal?

Only a few recorded cases of salvia withdrawal syndrome have been documented.  One 51 year-old Caucasian woman developed nausea, vomiting, diarrhea and other gastrointestinal symptoms after stopping salvia. She had been smoking several salvia cigarettes every day for three months, and her withdrawal symptoms appeared 48 hours after stopping her substance abuse. She needed to be hospitalized for three days.[xliii]

One study of 500 self-reported users of salvia found that the majority (80%) would use the drug again because it causes feelings of well-being.  The bad news is that drugs that induce positive states are associated usually are addictive drugs, according to the research team, which could mean that salvia has potential for addiction.[xliv]

What is the Legal Status of Salvia?

The United States Food and Drug Administration has not approved salvia for any medical uses. The United States Department of Justice through the U.S. Drug Enforcement Agency lists salvia as “a drug of concern.” Although government researchers have studied salvia extensively since 1998 with some expressing concerns about its safety, the DEA has not classified salvia as a controlled substance. It is therefore legal to buy and sell without government regulation.[xlv]

Most drugs listed as “drugs of concern” eventually become controlled substances under the Comprehensive Drug Abuse Prevention and Control Act of 1970.

Salvia is listed as a controlled substances in many states, but laws are different for each state.  For example, possession of salvia is a felony in Florida but selling it to a minor is only a misdemeanor in California.[xlvi] Salvia is illegal under state laws of Missouri, Delaware, Hawaii, Illinois, Arkansas, Kentucky, Louisiana, Kansas, Maryland, Minnesota, Wisconsin, Oklahoma, Tennessee, Virginia, and Wisconsin.[xlvii] In some of these, salvia is a Schedule I Controlled Substance or one that is considered the most dangerous. Possession or dealing in Schedule I Controlled Substances puts you at risk for the most severe fines and prison terms in drug law.

Salvia is illegal in certain European and Asian countries, including Australia, Belgium, Denmark, Estonia, Finland, Italy, Spain, Sweden, and Japan.[xlviii]

What is Salvia Abuse?

Salvia has been a teenage fad for several years, especially taking the drug while you are being filmed, and then posting the results on YouTube. As Christopher Letizini told the New York Times, “It’s just fun to see a friend act like a total idiot. Everybody loves it.”[xlix]

According to the National Survey on Drug Use and Health, 1.8 million people over the age of 12 years old tried salvia in 2008, and 750,000 used it for the first time. The most likely group to use salvia are males ages 18 to 25, with salvia being about as popular as Ecstasy among that group.  College students use it at the highest rate – about seven percent try it every year,[l] compared to six percent of high school seniors.[li]

Salvia can be easily purchased at tobacco stores and “head shops” or over the Internet. One gram costs about $10. A package that includes an ounce of dried salvia and a vial of extract sells for $66 on one website, including shipping. Street names for salvia are diviner’s sage, magic mint, shepherdess’ herb, seer’s sage, and Sally D.

In the past, parents of children who suffered adverse effects from salvia have sued suppliers.[lii]

What Treatments are Available for Salvia and other Drug Addictions?

Salvia is classified as a non-addictive drug, even though there have been case studies of people going through withdrawal syndromes when they try to stop using it.  People can become psychologically dependent on mind-altering substances such as salvia and LSD, in that their drug-induced states become more compelling than their everyday lives and they cannot stop using their drugs.  Their drug experiences can become a way to escape from personal problems or to medicate untreated psychiatric conditions.

The majority of drug addicts have untreated comorbidities such as depression, bipolar disorder, attention deficit disorder, childhood traumas, post-traumatic stress syndrome and many others.  They will not be successful in quitting drugs unless they address their other problems within a medical protocol of counseling and medications.

The state of the art treatment for substance abuse and alcoholism is to enter a residential treatment center where you can get help on a 24/7 basis.  The first step is to undergo a physical and psychological examination, and then to work with professionals to devise an individualized treatment program that addresses all your issues as a whole person.  The next step is chemical detoxification or the process in which you allow all substances to completely clear your body.

After detox, you enter the residential unit and work through your program with others facing similar challenges. The keystone of any good program is individual psychotherapy, supplemented with group, family and sometimes couples counseling.  A good program will include achieving physical fitness, developing an understanding of drug addiction, learning to cope with stress without using substances, and planning a life for yourself that does not include drugs.  Once you return home, you remain in psychotherapy and attend self-help meetings in your community.

How Can I Tell if I am Addicted to Salvia and Other Drugs?

If you can answer yes to any of the following questions, it is time to consult your family physician or a drug addiction specialist about your problem with salvia.

  • Are you using salvia alone?
  • Do you use salvia more than once a month?
  • Have you tried unsuccessfully to quit using salvia?
  • Have you tried unsuccessfully to cut down on your salvia use?
  • Do you experiment with illegal psychoactive substances, such as marijuana, ecstasy or PCP?
  • Do your friends or family members criticize you for using salvia and other drugs?
  • Do you feel guilty or ashamed about your drug abuse?
  • Do you have trouble going for any short length of time without using drugs?
  • Do you think your life may improve if you did not use drugs?
  • Do you think you suffer from depression, loneliness, childhood traumas, post-traumatic stress syndrome or other psychological problems?

[i] Mapes, Julian. “Miley Cyrus Opens Up About Salvia Bong Hit,” February 9, 2011, Billboard, see http://www.billboard.com/articles/news/473147/miley-cyrus-opens-up-about-salvia-bong-hit

[ii] Rosenbaum, Christopher et al. “Here Today and Gone Tomorrow.” The Journal of Medical Toxicology, January 2012, 8:211-215.

[iii] Vince, Gaia. “Legally high.” New Scientist, 9/30/2006, Vol. 191, Issue 2571

[iv] “Salvia,” The United States Department of Justice, the Drug Enforcement Agency, see http://www.deadiversion.usdoj.gov/drug_chem_info/salvia_d.pdf

[v] “How Does the Opiate System Control Pain, Reward and Addictive Behavior?” Science daily, October 7, 2007.

[vi] Sack, Kevin and Brent McDonald. “Popular hallucinogen faces growing legal opposition in U.S.,” The New York Times, September 9, 2008.

[vii] “Salvia,” A pamphlet from the National Institute of Drug Abuse, see http://www.drugabuse.gov/publications/drugfacts/salvia

[viii] Braiker B. Old Herb, New Controversy. Newsweek [serial online]. May 19, 2008; 151(20):41. Available from: Academic Search Premier, Ipswich, MA. Accessed September 4, 2013.

[ix] “Salvia,” The United States Department of Justice, the Drug Enforcement Agency, see http://www.deadiversion.usdoj.gov/drug_chem_info/salvia_d.pdf

[x] Braiker B. Old Herb, New Controversy. Newsweek [serial online]. May 19, 2008; 151(20):41. Available from: Academic Search Premier, Ipswich, MA. Accessed September 4, 2013.

[xi] Sack, Kevin and Brent McDonald. “Popularity of a Hallucinogen May Thwart Its Medical Uses,” The New York Times, September 9, 2008.

[xii]Vince, Gaia. “Legally high.” New Scientist, 9/30/2006, Vol. 191, Issue 2571

[xiii] Detrick, Ben. “Salvia Takes a Starring Role,” The New York Times, December 23, 2010.

[xiv] “Salvia,” The United States Department of Justice, the Drug Enforcement Agency, see http://www.deadiversion.usdoj.gov/drug_chem_info/salvia_d.pdf

[xv] Jones, Richard. “New Cautions Over a Plant with a Buzz,” The New York Times, July 9, 2001.

[xvi] Leander, J. et al “Not your usual cup of tea.” Brown University Psychopharmacology Update. Volume 26(3) JulSept 1994.

[xvii] Rosenbaum, Christopher et al. “Here Today and Gone Tomorrow.” The Journal of Medical Toxicology, January 2012, 8:211-215.

[xviii] Jones, Richard. “New Cautions Over a Plant with a Buzz,” The New York Times, July 9, 2001.

[xix] Ibid.

[xx] “Sage Wisdom by Daniel Siebert,” see www.sagewisdom.org

[xxi] Pollack, Neal. “Confessions of a Salvia Eater,” June 18, 2008, Salon.com, see http://www.salon.com/2008/06/18/salvia/

[xxii] Rosenbaum, Christopher et al. “Here Today and Gone Tomorrow.” The Journal of Medical Toxicology, January 2012, 8:211-215.

[xxiii] “Salvia: Facts and Questions,” The Web MD, see http://www.webmd.com/parenting/features/salvia-faq

[xxiv] Sack, Kevin and Brent McDonald. “Popularity of a Hallucinogen May Thwart Its Medical Uses,” The New York Times, September 9, 2008.

[xxv] Lange, James et al. “Salvia Divorium, Effects on You-Tube Users,” Drug and Alcohol Dependence, Volume 8, Issue l, April 2010, pg.138-140.

[xxvi] Baskin, Roberta. “Exclusive Investigation of a Hallucinogenic Drug That Has Begun to Sweep the Nation,” ABC-TV, WJLA-TV, July 7, 2007.

[xxvii] Jones, Richard. “New Cautions Over a Plant with a Buzz,” The New York Times, July 9, 2001.

[xxviii] Baggott M, Erowid E, Erowid F, Galloway G, Mendelson J. Use patterns and self-reported effects of Salvia divinorum: An internet-based survey. Drug & Alcohol Dependence [serial online]. October 2010; 111(3):250-256.

[xxix] Pollack, Neal. “Confessions of a Salvia Eater,” June 18, 2008, Salon.com, see http://www.salon.com/2008/06/18/salvia/

[xxx] Jones, Richard. “New Cautions Over a Plant with a Buzz,” The New York Times, July 9, 2001.

[xxxi] Elder, Lee Erica. “SALVIA: A look at the unknown risks of this powerful drug.” Current Health 2. Dec2009, Vol. 36 Issue 4, p26-29. 4p.

[xxxii]Rosenbaum, Christopher et al. “Here Today and Gone Tomorrow.” The Journal of Medical Toxicology, January 2012, 8:211-215.

[xxxiii] DiConsiglio, John. “Bad Trip.” Scholastic Choices, 0883475X, Feb/Mar2009, Vol. 24, Issue 5

[xxxiv] Chalmers, Mike. “Parents Sue over Dead Son’s Salvia Use,” The Delaware News Journal, August 3, 2007. See also Wolowich W, Perkins A, Cienki J. Analysis of the Psychoactive Terpenoid Salvinorin A Content in Five Salvia divinorum Herbal Products. Pharmacotherapy [serial online]. September 2006; 26(9):1268-1272.

[xxxv] Braida D, Donzelli A, Martucci R, Capurro V, Sala M. Learning and Memory Impairment Induced by Salvinorin A, the Principal Ingredient of Salvia divinorum, in Wistar Rats. International Journal of Toxicology (Sage) [serial online]. November 2011; 30(6):650-661.

[xxxvi] Jones, Richard. “New Cautions Over a Plant with a Buzz,” The New York Times, July 9, 2001.

[xxxvii] DiConsiglio, John. “Bad Trip.” Scholastic Choices, 0883475X, Feb/Mar2009, Vol. 24, Issue 5

[xxxviii] Sack, Kevin and Brent McDonald. “Popularity of a Hallucinogen May Thwart Its Medical Uses,” The New York Times, September 9, 2008.

[xxxix] Rosenbaum, Christopher et al. “Here Today and Gone Tomorrow.” The Journal of Medical Toxicology, January 2012, 8:211-215.

[xl]Ibid.

[xli] Wolowich W, Perkins A, Cienki J. Analysis of the Psychoactive Terpenoid Salvinorin A Content in Five Salvia divinorum Herbal Products. Pharmacotherapy [serial online]. September 2006; 26(9):1268-1272.

[xlii] Jones, Richard. “New Cautions Over a Plant With a Buzz,” The New York Times, July 9, 2001.

[xliii] Travis C, Ray G, Marlowe K. A Report of Nausea and Vomiting with Discontinuation of Chronic Use of Salvia divinorum. Case Reports In Medicine [serial online]. January 2012;:1-4. Available from: Academic Search Premier, Ipswich, MA. Accessed September 4, 2013.

[xliv] Baggott M, Erowid E, Erowid F, Galloway G, Mendelson J. Use patterns and self-reported effects of Salvia divinorum: An internet-based survey. Drug & Alcohol Dependence [serial online]. October 2010;111(3):250-256.

[xlv] “Salvia,” The United States Department of Justice, the Drug Enforcement Agency, see http://www.deadiversion.usdoj.gov/drug_chem_info/salvia_d.pdf

[xlvi] Sack, Kevin and Brent McDonald. “Popularity of a Hallucinogen May Thwart Its Medical Uses,” The New York Times, September 9, 2008.

[xlvii] “Salvia,” The United States Department of Justice, the Drug Enforcement Agency, see http://www.deadiversion.usdoj.gov/drug_chem_info/salvia_d.pdf

[xlviii] Ibid.

[xlix] Sack, Kevin and Brent McDonald. “Popular hallucinogen faces growing legal opposition in U.S.,” The New York Times, September 9, 2008.

[l] Ibid.

[li] “Salvia,” The United States Department of Justice, the Drug Enforcement Agency, see http://www.deadiversion.usdoj.gov/drug_chem_info/salvia_d.pdf

[lii] Chalmers, Mike. “Parents Sue over Dead Son’s Salvia Use,” The Delaware News Journal, August 3, 2007.

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