By Anthony McDaniel, M.D.
Salvia divinorum (also known as Diviner's Sage, Ska María Pastora, Seer's Sage, and by its genus name Salvia) is a psychoactive plant which can induce dissociative effects and is a potent producer of "visions" and other hallucinatory experiences. Its native habitat is within cloud forest in the isolated Sierra Mazateca of Oaxaca, Mexico, growing in shady and moist locations. The plant grows to over a meter high, has hollow square stems, large leaves, and occasional white flowers with violet calyx. Botanists have not determined whether Salvia divinorum is a cultigen or a hybrid; native plants reproduce vegetatively, rarely producing viable seed.
Salvia divinorum has a long and continuous tradition of religious use by Mazatec shamans, who use it to facilitate visionary states of consciousness during spiritual healing sessions. Most of the plant's local common names allude to the Mazatec belief that the plant is an incarnation of the Virgin Mary, with its ritual use also invoking that relationship. Its active psychoactive constituent is a structurally unique diterpenoid called salvinorin A, a potent κ-opioid and D2 receptor agonist. Salvia divinorum is generally understood to be of low toxicity (high LD50) and low addictive potential; as a κ-opioid agonist. Media stories generally raise alarms over Salvia divinorum's legal status and are sometimes headlined with generally ill-supported comparisons to LSD or other psychoactive substances. Parental concerns are raised by focusing on salvia's usage by younger teens—the emergence of YouTube videos purporting to depict its use being an area of particular concern in this respect. The isolated and controversial suicide of Brett Chidester received much media attention. Salvia divinorum remains legal in most countries and, within the United States, is legal in the majority of states. However, some have called for its prohibition. While not currently regulated by US federal drug laws, several states have passed laws criminalizing the substance. Some proposed state bills have failed to progress and have not been made into law (with motions having been voted down or otherwise dying in committee stages). There have not been many publicized prosecutions of individuals violating anti-salvia laws in the few countries and states in which it has been made illegal.
After the peak effects, normal awareness-of-self and the immediate surroundings return but lingering effects may be felt. These short-term lingering effects have a completely different character than the peak experience. About half of users report a pleasing 'afterglow', or pleasant state of mind following the main effects. Researchers from the University of California and California Pacific Medical Center Research Institute conducted a survey of 500 salvia users which identified that they 'sometimes or often' experience certain effects, including. Differing studies suggest no overall consensus so far with regard to the long-term effects of Salvia divinorum on mood. It is well-established that some k-opioid agonists can cause dysphoria in humans, and research using rats in forced-swim tests has been used to suggest that Salvia divinorum may have "depressive-like" effects. However, a report has been published detailing an individual case of Salvia divinorum use as self-medicated treatment for depression, and Baggott's survey of 500 people with firsthand experience of salvia found that 25.8% of respondents reported improved mood and "antidepressant-like effects" lasting 24 hours or longer. Only 4.4% reported persisting (24 hours or more) negative effects (most often anxiety) on at least one occasion.
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