The hallucinogenic mint Salvia divinorum is traditionally consumed by indigenous tribes in Mexico as a medicine and for spiritual purposes. While many states and countries have criminalized salvia, science shows that its active ingredient, salvinorin A, has several potential uses. It may help relieve pain, decrease inflammation, and improve depression. Read on to learn more about the benefits, mechanisms, and risks associated with the use of this herb.
Note: By writing this post, we are not recommending this drug. Some of our readers who were already taking the drug requested that we commission a post on it, and we are simply providing information that is available in the scientific literature. Please discuss your medications with your doctor.
What is Salvia divinorum?
Salvia divinorum (Sage of the Diviners, Seer’s Sage, Yerba de la Pastora, Ska Maria) is one of more than 1,000 species of sage (Salvia) known worldwide. It is a member of the mint family (Lamiaceae).
The name “salvia” is derived from the Latin salvare, meaning “to heal” or “to save.”
Street names for this plant include Magic Mint, Purple Sticky, Lady Salvia, and Sally D [R].
The plant is native to the sierras of Oaxaca, Mexico. The Mazatec tribe who are native to the region use the plant in religious ceremonies and as a medicine for conditions including headaches, joint pain, and arthritis pain [R, R].
In the 1970s, it was reported that young people from cities in Mexico were traveling to the Sierra Mazateca to purchase Salvia divinorum from the native tribes to make into cigarettes and smoke as a substitute for marijuana [R].
Use in the United States appears to have grown steadily during the 1990s. From 2006 to 2008, the National Survey on Drug Use and Health recorded an 83% increase (from 0.7% to 1.3%) in lifetime prevalence of Salvia divinorum use [R].
Salvia divinorum is sold over the internet and in some shops as a ‘legal high,’ or alternative to illegal drugs. While laws have been passed in many parts of the world regulating or prohibiting the sale of salvia, including many places in the United States, it still remains a legal alternative to controlled substances in others [R, R].
In 2008, a study of 1,571 college students found that 4.4% had used the plant at least once within the past year [R].
Researchers have shown an interest in using the active ingredient in Salvia divinorum (salvinorin A), and synthetic analogues (with similar structure) designed to achieve similar outcomes with fewer side effects, to study brain disorders (such as Alzheimer’s disease), psychiatric disorders (such as schizophrenia and bipolar disorder), pain, and drug dependence [R, R, R, R, R, R].
Mechanism of Action
Salvia is the most potent of all natural hallucinogens.
The main component responsible for Salvia divinorum‘s hallucinogenic effects is a unique compound known as salvinorin A [R].
The hallucinogenic dose of salvinorin A in humans is estimated at 250 to 500 μg, which makes it only slightly inferior to LSD, a synthetic hallucinogen that is known for its extremely high potency [R].
The primary mechanism of salvinorin A is activation of kappa-opioid receptors (OPRK1). These are receptors that increase or reduce pain, cause hallucinations, modify bodily perception, motor control, mood, and are involved in depression and addiction [R, R, R].
Compared to other opioid receptor activators, salvinorin A causes fewer of the opioid receptors it activates to either desensitize or shut down [R].
Salvia also has indirect effects on the same receptor types that are activated by cannabis (CB1 and CB2) and may inhibit release of serotonin and dopamine while causing the release of adrenaline (by bonding to presynaptic kappa-opioid receptors) [R, R, R].
Technical: Salvia divinorum is unique both among opioid-receptor activators and among hallucinogens. As an opioid receptor activator, it is the only known example that is not an alkaloid (or is non-nitrogenous). As a hallucinogen, it is the only known example that is composed of two types of molecules (or is a diterpene) [R, R].
Potential Uses of Salvia divinorum
1) Salvia divinorum May Relieve Pain and Aches
The Mazatec people have traditionally used salvia to treat headaches, joint, and arthritis-related pain [R].
However, the painkilling effects of salvia appear to be relatively short-lived [R].
2) Salvia divinorum May Decrease Inflammation and Allergies
In mice and rats, salvia reduces lung inflammation. One study found it reduced TNF-a, IL-10, and iNOS. Another found it reduced leukotrienes LTB4 and LTC4. These are involved in a number of autoimmune/inflammatory disorders including asthma, allergic rhinitis, and heart diseases. Salvia also reduced myeloperoxidase (MPO) activity [R, R].
Salvia could also help allergies by inhibiting the ability of mast cells to produce Th2 cytokines IL-4 and IL-13. However, researchers speculate that this inhibition could cause the number of mast cells in the lungs to increase to compensate [R].
Another rat study found that salvia slowed the movement of intestines, but it was only effective when gut inflammation was present [R].
In mice, salvia inhibited the contractions of the stomach and colon (by inhibiting ion transport in the epithelium) and also slowed movement of the upper digestive tract [R].
Also in mice, salvia prevented and reversed damage to the digestive tract caused by endotoxins (found in bacteria) [R].
Technical: Salvia’s ability to reduce inflammation is shared with other drugs in the same class (kappa-opioid receptor activators); however, another biological system that is involved in processes such as appetite and pain (the endocannabinoid system) appears to be involved in salvia’s ability to slow the movement of inflamed intestines [R].
4) Salvia divinorum May Protect The Brain Against Oxygen Deprivation
5) Salvia divinorum May Treat Depression and Anxiety
A 26-year old woman with a history of depression since childhood experienced complete relief from depressive symptoms after chewing 2 to 3 leaves of Salvia divinorum three times per week [R].
However, another rat study found that with smaller doses, salvia had antidepressant and anti-anxiety effects. Another study found that depression could be reversed in rats with a 3-week treatment with salvia [R, R].
6) Salvia divinorum May Help with Drug Addiction (Or May Make It Worse)
The active ingredient in salvia (salvinorin A) decreases activity in the parts of the brain that cause drug use to be rewarding [R].
Also when monkeys were given salvinorin A in combination with either an opioid (remifentanil) or cocaine, they developed less desire for either substance [R].
In animal studies, short-term use of kappa-opioid receptor activators reduced the desire for cocaine. However, long-term use of kappa-opioid receptor activators can also increase the desire for cocaine [R, R, R].
Researchers have debated a variety of speculated mechanisms to explain this. Repeated exposure to kappa-opioid receptor activators may impair the ability of dopamine receptors (DRD2) in the nucleus accumbens to reduce excess dopamine activity. Alternatively, the dysphoria caused by activating the kappa-opioid receptor could make cocaine use more enjoyable [R, R].
These results hold true for salvia as well. While salvia reduces the reward from cocaine immediately, it also increases the reward from cocaine 24 hours later [R].
This may help explain why a significant percentage of former salvia users continue abusing cocaine, among other drugs [R].
Potential Negative Effects
1) Salvia divinorum May Cause Short-Term or Long-Term Psychosis
A 21-year-old man with no previous history of mental illness was hospitalized for severe psychosis and paranoia shortly after smoking salvia. After symptoms continued for 3 days, an antipsychotic (risperidone) helped stabilize the man’s condition. After discontinuing the antipsychotic, however, his symptoms reappeared. At a 4-month follow-up, there had been no improvement in his condition [R].
An 18-year-old female was admitted to a psychiatric emergency room and then legally committed for involuntary treatment after escalating attempts at self-harm, disorientation, and other psychotic behaviors. These symptoms appear to have been triggered by a boyfriend putting salvia into her marijuana cigarette without her awareness [R].
In another case, a 15-year-old man was admitted to psychiatric emergency services after experiencing 3 days of paranoia, déjà vu, and other psychotic symptoms after consuming salvia [R].
2) Salvia divinorum Could Cause Recurring Visual “Flashbacks”
A small percentage of users of all hallucinogenic drugs (usually the most frequent users) report experiencing constant or near-constant visual distortions similar to what they experienced during the ‘trip’ that continue long after having taken the drug (this is known as Hallucinogen Persisting Perception Disorder or HPPD).
A much larger percentage of users report having experiences like these for a shorter period of time after the trip, with symptoms either happening only occasionally or eventually going away.
In one study, 60% of 2,455 participants reported having had this kind of drug-free visual experience. However, only a small number of those individuals reported finding the symptoms distressing or impairing enough to consider seeking treatment (104, or 4%). As studies in subjects who have never used other hallucinogenic drugs are extremely rare, it is uncertain whether salvia alone is capable of causing more than brief lingering visual after-effects [R].
3) Salvia divinorum May Impair Learning, Memory, and Attention
A study in 8 otherwise healthy hallucinogen-using adults found that using salvia once impaired two types of memory (recall and recognition of words), but at a 1-month follow-up, there was no evidence this effect had persisted [R].
In rats, salvia (salvinorin A) had no impact on short-term memory but did impair other forms of memory (spatial long-term, episodic, and aversive memories) [R].
Another rat study found a negative effect of salvia on attention and reaction time [R].
4) Withdrawal from Regular Salvia divinorum Use May Be Unpleasant
One woman who quit salvia after consuming it regularly for 3 to 4 months was referred to a hospital after experiencing 3 days of nausea, vomiting, diarrhea, and gut pain during her withdrawal. However, cases of users consuming salvia regularly enough for withdrawal to occur are extremely rare [R].
5) Salvia divinorum Could Possibly Worsen Depression
While some studies suggest that salvia could improve depression, at least one small study in rats shows that salvia use can worsen motivation. As low motivation is a key symptom of depression, this suggests that salvia could also make depression worse [R].
Researchers have speculated that salvia could worsen depression by decreasing the bioavailability of adrenaline in the brain [R].
Salvia divinorum Is Not Likely to Be Useful for Cancer
One widely misinterpreted study claimed to show that salvia is beneficial for cancer treatment. What this study actually shows is that while salvia is capable of killing cells, liver cancer (Hep G2) and colon cancer (Caco-2) cells are particularly resistant to this effect [R].
Salvia divinorum Is Likely Non-Toxic
A small study in rats failed to find evidence that salvia was toxic to any organ or organ system, even at doses much higher than any human user would ordinarily consume [R].
A review of the California Poison Control System found only 37 cases over a 10-year period where CPCS had been contacted over-consumption of Salvia divinorum, and only 18 cases where salvia was the only substance of concern the individual had been exposed to [R].
Salvia divinorum Is Not Addictive
Salvia does not appear to be addictive. Rat studies suggest that salvia may even have an “aversive” effect that makes frequent or long-term use especially unlikely [R].
This coincides with what is usually found in surveys: For instance, in a college sample, a majority of those who had tried the drug reported that they would not do so again [R].
However, a survey conducted online that included many experienced and ongoing hallucinogen users found that a majority “probably” or “definitely would” use salvia again. Therefore, whether a user is tempted to use salvia more than once may simply depend on whether or not they consider hallucinogenic effects enjoyable [R].
Limitations and Caveats
In general, much about the impact of salvia consumption is still unknown. There are no studies on the long-term effects of repeated use of salvia on depression, memory, or learning in humans.
Studies are limited either by using animal subjects, by looking only at the short-term effects of salvia, or by observing the outcomes of only a single dose of salvia.
There are 3 primary methods of consuming salvia: Smoking, chewing (to absorb the active ingredient through mucous membranes in the mouth without swallowing), and brewing tea.
There are significant differences in the timing of the experience and the amount of salvia required to produce effects depending on the method chosen. The doses required for chewing or brewing tea vastly exceed doses used for smoking. The effects of chewing or brewing are milder than smoking but take longer to set in and also last much longer. The effects of smoking are significantly more intense, but set in very quickly and are over much faster [R, R].
The standard dose recommended for chewing (in online forums) is between 8 and 28 leaves (20 to 70g), which contains an estimated 49 to 69 mcg (micrograms) of salvinorin A.
The tea brewed by Mazatec shamans typically requires between 20 to 80 leaves (50 to 200g) and may contain 122 to 490 mcg salvinorin A.
The estimated dose of salvinorin A from a single cigarette made of dried salvia leaf is 133 mcg [R].
Two hundred micrograms of salvinorin A has been described as the threshold dose for hallucinations after inhalation [R].
When salvia is sold in smart shops or over the internet for purposes of smoking, it is typically sold dried and powdered with concentrated salvia extract added to the leaf, along with labels that state anywhere from “5x” to “60x” potency. While these labels are very unreliable, the most potent products were found to contain up to 521mg salvinorin A per gram [R].
The temperature required to release the active ingredient from salvia is very high (about 238 to 244° Celsius, or 460 to 464° Fahrenheit). Thus, to achieve the most intense subjective effects of salvia, the ground leaves are sometimes smoked in a manner similar to freebase cocaine (or crack) [R, R].
Consuming salvia by placing it under the tongue (sublingually) is typically not recommended because of the large doses required and because of the alcohol present in liquid extracts.
At least one controlled study has found that salvia is almost totally ineffective when consumed by placing it under the tongue, so it is possible that people discussing the mild effects of sublingual salvia tinctures are just experiencing a placebo effect. However, the study suggesting this included only 8 subjects [R].
Onset and Duration
When chewing salvia leaves, the effects take approximately 20 minutes to begin and usually last between 1 to 2 hours [R].
In the case of infused tea, the experience can last up to 3 hours. However, since the active ingredient in salvia is deactivated by the digestive system before reaching the bloodstream, teas usually produce far milder effects than either chewing or smoking, both of which allow the active ingredient to enter the bloodstream directly [R, R].
A study of salvia trips posted to YouTube found that more intense effects (as measured by difficulty speaking) were experienced the longer the hits were held in the lungs. Also, 44% of water pipe users had unusual speech after smoking salvia, compared to only 13% of regular pipe users, indicating a more intense experience among waterpipe users [R].
A study of 34 salvia users found that the majority of them described salvia as either “intense” or “extremely intense” [R].
In a study of 100 YouTube videos recording smoked salvia trips, 65% of these experiences were classified as ‘positive,’ 23% as ‘neutral’ and 13% as ‘negative’ [R].
- Revisiting places from the past, and childhood memories
- Loss of the body and/or identity
- Sensations of motion, spinning, stretching, or of being pulled or twisted by forces of some kind
- Uncontrollable hysterical laughter
- Overlapping realities; the perception that one is in several locations at once
- Communication and interaction with entities or beings
- Cartoon-like visual imagery and auditory experiences (often associated with childhood)
- Recurring content across sessions
In a small experiment conducted by the Multidisciplinary Association for Psychedelic Studies, 1 gram of chewed dried leaf was an optimal dose that made it easier for subjects to concentrate in meditation without experiencing distracting thoughts or hallucinogenic effects.
Some people experience very little or nothing [R].
- Intense anxiety, paranoia, or fear
- Confusion with a frightening sense of a “fractured reality”
- Temporary speech impairment
- Heaviness of head
- Physical exhaustion
- Slowed mental function
With sufficiently high doses, a salvia user may be entirely unresponsive for the duration of the ‘trip,’ with no awareness of their environment for the duration of the experience, and no memory of what they did or what happened to them during the experience afterward. Salvia also impairs motor coordination more as the dose is increased, which could make salvia use dangerous without someone watching, or in an environment full of sharp objects, fires, etc [R, R].
Salvia Compared To Other Drugs
A systematic review of drug-induced sensory crossing found that where most drugs tend to cause a crossing of the experiences of sound and sight, salvia rather uniquely tends to cause a crossing of the experiences of sight and touch (visual-tactile synesthesia) [R].
In a study of 30 adult participants, half described their experiences as unique and strange, with statements like “It’s a very unique psychedelic, and I’ve never had anything else that induces that same [or] even somewhat similar state” [R].
However, the perceived similarity of salvia to other psychedelics sometimes prompts users to increase the dosage [R].
Users of salvia tend to report that after-effects, which are usually positive and/or mild, last up to 24 hours or more after smoking. In a study of 30 participants, 16 out of 23 who successfully followed up after 8 weeks reported that these after-effects had lasted for more than 24 hours [R].
An online survey of 500 individuals, including many experienced and ongoing hallucinogen users, asked about the after-effects from a salvia trip. It found high response rates for “increased insight” (47%), “improved mood” (45%), and “calmness” (42%). However, it also found high response rates for “weird thoughts” (36%), “things seeming unreal” (32%), and “mind racing” (23%) [R].
The information provided here is based on government websites and media reports. Laws are complex and constantly changing, and may also vary from one jurisdiction to another (including the county level in the United States). Please be sure to verify the current legal status of Salvia divinorum in your local area before attempting to purchase, sell, grow, or use it.
As of December 2017, Salvia divinorum is legal for sale in 18 states: Alaska, Arizona, California, Idaho, Maine, Maryland, Massachusetts, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, Oregon, South Carolina, Utah, Washington, and West Virginia.
It is decriminalized for personal possession but not legal for purchase or sale in Wisconsin and Tennessee, and Salvia divinorum extracts are illegal although the plant itself is legal in Rhode Island.
It is illegal in the remaining 29 states.
Salvia divinorum is legal to possess, but not to sell in Chile, Russia, Spain, and the UK. It is legal to possess or sell with a license in New Zealand. It is legal for medical purposes only in Estonia, Finland, Iceland, Norway, and Denmark. Salvia is fully legal to possess or sell in France (when labeled not for human consumption), Indonesia, Malaysia, Myanmar, the Netherlands, and Thailand.