Elsevier

Drug and Alcohol Dependence

Volume 85, Issue 2, 8 November 2006, Pages 157-162
Drug and Alcohol Dependence

Pattern of use and subjective effects of Salvia divinorum among recreational users

https://doi.org/10.1016/j.drugalcdep.2006.04.001Get rights and content

Abstract

Backgroud

Salvia divinorum is a member of the Lamiaceae family and contains the psychotropic diterpene and kappa-opioid receptor agonist salvinorin-A. Originally a shamanic inebriant used by the Mexican Mazatec Indians, the plant and its preparations are becoming increasingly popular among non-traditional users.

Methods

Demographic data and information on pattern of use and subjective effects were obtained by means of self-report questionnaires from a sample of 32 recreational users of salvia and other psychedelics.

Results

Involvement with salvia appeared to be a recent phenomenon. Smoking the extract was the preferred form of administration. Subjective effects were described as intense but short-lived, appearing in less than 1 min and lasting 15 min or less. They included psychedelic-like changes in visual perception, mood and somatic sensations, and importantly, a highly modified perception of external reality and the self, leading to a decreased ability to interact with oneself or with one's surroundings.

Conclusions

Although some aspects of the subjective effects reported were similar to high doses of classical psychedelics with serotonin-2A receptor agonist activity, the intense derealization and impairment reported appear to be a characteristic of salvia. The observed simultaneous high scores on the LSD and PCAG subscales of the Addiction Research Center Inventory (ARCI) have been previously reported for other kappa-opioid agonists, and support kappa receptor activation as the probable pharmacologic mechanism underlying the modified state of awareness induced by salvia.

Introduction

Salvia divinorum (Lamiaceae) is a psychotropic mint whose leaves are used for medicinal and religious purposes by Mazatec shamans in the Mexican state of Oaxaca (Wasson, 1962, Valdes et al., 1983). The Mazatecs, who call the plant “ska pastora” or “ska Maria pastora”, meaning “leaves of the shepherdess” or “leaves of Mary the shepherdess”, traditionally ingest the plant as a water infusion or by eating the fresh leaves (Wasson, 1962, Valdes et al., 1983). Early ethnological research found that the Mazatecs regard the psychotropic effects elicited by the plant as weak and use it only in substitution of the psilocybin-containing mushrooms when these are scarce (Wasson, 1962). However, the plant's apparently weak potency could be due to limited absorption of the active principle when ingested orally (Ott, 1995).

Despite its initial reputation as a lesser drug, interest for salvia has greatly increased in recent years among recreational users for the modified state of awareness it can elicit. The use of salvia has spread to Europe and North America in a similar fashion to other natural drugs, as the DMT-containing ayahuasca did a decade ago (Riba and Barbanoj, 2005). However, unlike many ayahuasca users, current non-traditional users of salvia have accessed the plant and its preparations outside a religious context, mainly through “smart shops” and internet websites selling psychotropic plants and extracts, paraphernalia and dietary supplements (Dennehy et al., 2005). The term “smart shop” originated in The Netherlands and describes stores where natural psychoactive drugs such as ephedra, mescaline-containing cacti, psilocybian mushrooms and salvia extracts are sold. Such stores can also be found in Spain but their activities have been restricted since a decree was issued prohibiting the sale of a large number of plants, including salvia (see http://www.boe.es, number 32, 6 February 2004).

S. divinorum owes its psychoactive properties to salvinorin-A, its main active principle. This compound is a neoclerodane diterpene which was first isolated and identified by Ortega et al. (1982), and shortly after by Valdes et al. (1984). Recent pharmacological research has found it to be a highly selective full agonist of the kappa-opioid receptor (Roth et al., 2002, Butelman et al., 2004, Chavkin et al., 2004). Salvinorin-A is the only non-nitrogenous natural compound known to date to exert agonistic activity at these sites. Furthermore, in contrast with the classical psychedelics, salvinorin-A does not interact with the serotonin-2A receptor, but presumably induces its psychotropic effects through activation of the kappa-opioid receptor.

Contrary to what was initially assumed, salvinorin-A can be quite powerful. Inhalation of the vaporized active principle has been found to be active in doses as low as 200 μg (Siebert, 1994), in the same range as LSD. Recreational users have developed methods of administration that appear to lead to intense psychoactivity. These include chewing the leaves and retaining the juices in the mouth to allow absorption through the mucosa and obtaining concentrated extracts that can be administered either sublingually, applied to the buccal mucosa, or smoked (Siebert, 1994, Ott, 1995). The subjective effects described in self-experiments and case reports range widely, from increased relaxation, to laughter, colored visions, out-of-body experiences and loss of consciousness (Siebert, 1994, Bücheler et al., 2005, Dennehy et al., 2005).

In the present study we aimed to obtain systematic information on the pattern of use and the nature of the subjective effects elicited by salvia in recreational users. Self-report questionnaires were administered to the participants to obtain demographic and subjective effect data.

Section snippets

Sample

The sample was recruited by direct approach by the first author, who also conducted the interviews. Potential participants had to have used salvia at least once in their lifetime. Given the infrequent nature of the behavior under study, adaptive sampling was used with participants referring to acquaintances who had also had experience with the drug (Thompson and Collins, 2002). Several leads were followed, so participants did not belong to a single social network. After initial contact with the

Demographic characteristics of the sample

A total of 32 salvia users were recruited, 18 (56%) of whom were male and 14 (44%) were female. The mean age of the sample was 25 years (S.D.: 4.32; range: 18–40 years). Education level was high with 23 (72%) of the sample having completed high school and 7 (22%) having obtained a university degree. At the time of the survey, 22 (69%) were attending university. Seventeen participants (53%) were full-time students, 6 (19%) combined studies with part-time jobs, 7 (22%) worked exclusively, and 2

Discussion

Results from the present study show that awareness and involvement with salvia appears to be a recent phenomenon. Most participants had had their first contact with salvia during the last year, and had consumed it on average only on two occasions, mainly smoking the extract, which almost all participants had acquired in “smart shops”. It is worth mentioning here that the survey was conducted during the second half of 2003 and the first-half of 2004. In February 2004 a decree from the Spanish

Acknowledgements

The authors wish to thank Araceli Cabrero for her help in questionnaire scoring and elaboration of the data bases. This research was supported by internal funds.

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