Salvia Addiction & Abuse

What Is Salvia?

Salvia, scientifically known as Salvia divinorum, is the largest genus of plants in the mint family and consists of more than 900 species in the family Lamiaceae. For over a century, it has been used for religious rituals in Central America, but the substance is now being abused for non-medical and non-religious reasons by adolescents and young adults in the United Kingdom. (1)

In some communities, the plant may be used for medicinal purposes like curing mouth inflammations. Currently, Salvia is abused in the UK as a recreational drug because of its highly psychoactive nature. (1)

The drug offers users short-lived pleasant experiences that many consider a ‘legal high’. It is also widely believed to have low addictive potential and low toxicity with no long-term effects, hence its popularity. (1)

Salvia’s active ingredient is salvinorin A, a kappa opioid receptor (KOR) agonist that has been known to produce visual hallucinogenic effects similar to narcotics such as LSD. Some users claim they have experienced mystical and spiritual experiences after taking it. People usually feel the initial effects within two minutes after smoking, with the whole experience lasting than 20 minutes. (1)

Other Terms for Salvia

Routes of Administration

Absorption of salvinorin A into the bloodstream through the oral mucosa produces a psychoactive effect. There are several methods used to ingest Salvia, and each has a varying duration of hallucinogenic effects. (2)

The first way is by smoking dried Salvia leaves like marijuana using a bong, pipe or rolling paper, which produces effects that last up to 15 minutes. Fresh Salvia leaves can also be chewed and swallowed or chewed as a quid. (2)

Some users prefer to nibble Salvia leaves in a quid form for a long-term effect. An adequate amount of salvinorin A is thus sucked up via the salivary glands to the bloodstream, producing the psychoactive effect. (2)

Another way is to mix salvinorin A extracted from crushed Salvia leaves with water to produce a drink. Since salvinorin A has to be deactivated by the gastrointestinal system before entering the bloodstream, this method produces a weaker effect than other methods and is not commonly used. (2)

Salvia can also be vaporised and inhaled once it’s is heated on a piece of tin foil. The vapours are usually inhaled through a glass pipe. (2)

History of Salvia

Salvia species (sage) belong to the family Lamiaceae. The Latin genus name Salvia means ‘to heal’ or ‘to be safe and unharmed’, referring to the medicinal properties of some of the species. It has been used for centuries, especially by the Chinese as a herb for longevity, in Roman ceremonies as a sacred herb and in Mexican communities for religious and ritual functions. (1)

In the West, the first recorded mention ofSalvia was in 1938 after Jean B. Johnson heard rumours about a tribe in Mexico that induced visions by preparing tea from the leaves of a plant known as ‘hierba Maria’.

In 1962, Gordon Wasson and Albert Hofmann obtained the original form of the Salvia divinorum from the Mexican community and considered it to be a replacement for the psilocybin mushroom. (1)

In 2002, a group of scientists discovered that Salvia divinorum affects human perception when consumed because it reacts with the KOR location, leading to its categorisation as a KOR agonist. KOR agonists are used in hypnotherapy or behaviour therapy, especially for people with diseases like Alzheimer’s and schizophrenia. (2)

Legal status

Salvia divinorum was legal in the United Kingdom until 28 January 2016, when the Psychoactive Substances Act was passed into law. However, implementation was only until 26 May 2016. An Early Day Motion had been raised in the year 2005, but it received only eleven signatures and did not pass. Three years later, a second Early Day Motion was raised on the same issue. It received 18 signatures, which was a positive indication of the matter.

Upon approval eight years later, the Psychoactive Substances Act made it illegal to possess the substance with the intent to supply. It also prohibited possession on custodial premises, importation for human consumption and ownership for the intent of legal highs. Currently, anyone caught with Salvia faces up to two years in prison. (3)

Active Constituents of Salvia Divinorum

The main ingredient responsible for the psychoactive effect of Salvia divinorum is neoclerodane diterpene, commonly called salvinorin A. The IUPAC systematic name is (2S,4aR,6aR,7R,9S,10aS,10bR)-9-(acetyloxy)-2-(3-furanyl)dodecahydro-6a,10b-dimethyl-4,10-dioxo-2H-naphtho[2,1-c]pyran-7-carboxylic acid methyl ester (CAS number: 83729-01-5).

What distinguishes salvinorin A from other synthetic and classical natural hallucinogens is the fact that it is not an alkaloid since it does not contain any nitrogen atoms. (3)

Salvia divinorum leaves have two diterpenes, salvinorin or divinorin A and salvinorin or divinorin B. There are, however, some still-unidentified substances in the leaves. Among the naturally occurring substances, salvinorin A has been identified as extremely powerful and 10 times stronger than psilocybin. It is about 10 times more potent, hence its popularity among drug users. (3)

The empirical formula of salvinorin A is C23H28O8. This makes it different from other psychedelic compounds that mostly operate on the serotonergic system, specifically binding to the 5HT2A receptors. Salvinorin A functions as a critical agonist for kappa opioid receptors, making the compound quite unique from a pharmacological point of view. (4)

One study conducted in the UK found out that a large number of Salvia users who also consumed alcohol are likely to abuse alcohol compared to non-users. Abuse of various substances is frequent among users who mix Salvia intake with alcoholism. Salvia is mostly combined with alcohol, and some users have claimed that the mixture slightly enhances the effects of Salvia, while others claimed that there was no difference experienced. (6)

It is not recommended to mix Salvia divinorum with LSD because both are potent hallucinogenics and can be unpredictable. The conclusion is that there are no known side effects to using Salvia in combination with other drugs besides the obvious fact that you may end up abusing more drugs and harming yourself or the public in general. (2)

Chemistry and Pharmacological Mechanisms

Scientists have managed to extract compounds that are primarily diterpenes from Salvia divinorum. Diterpenoids are derived from the condensation of four isoprene units which, in Salvia species, leads to the formation of bicyclic, tricyclic and tetracyclic compounds. (5)

The compound responsible for the bioactivity in Salvia divinorum is the diterpene salvinorin, which is also considered to be present in lead compounds used in pharmaceutical research.

The KOR is among the five related receptors that bind opioid-type compounds in the brain and is involved in pain perception, mood and motor control. It is encoded by the OPRK1 gene and is present in the brain, spinal cord and pain neurons.

Scientists agree that the primary endogenous agonists of this receptor are the dynorphin peptide. In addition to binding to this endogenous ligand, KOR also binds to naturally occurring alkaloids, synthetic ligands and salvinorin A. (5)

C23H28O8

C23H28O8 is the molecular formula of salvinorin A, an organic heterotricyclic compound and an organ oxygen compound that plays the role of a metabolite. The former compound contains more than one heteroatoms in more than one ring of the tricyclic skeleton. (6)

The unique molecular composition of salvinorin A makes it capable of inducing hallucinations, ideations, delusions, paranoia and illusions in the user. The drug also makes users unpredictable by altering their moods and way of thinking. This may lead to spontaneous dangerous acts with harmful physical results to the user and those around them.

The capacity to induce altered states of emotional and mental perception is what distinguishes Salvia from other classes of drugs. This sort of ‘high’ is exactly what is most sought after by users, thus making the drug prone to misuse. (6)

Salvia Abuse Risk Factor

Epigenetic markers are crucial because they affect the person’s well-being and, to an extent, determine the traits that an individual passes on to their offspring. For example, a cocaine user may have the cocaine marker in his DNA that raises the manufacture of addiction proteins; hence, high levels of altered proteins in the DNA may be evident in their child. (10)

Addiction Potential of Salvia

There has been a minimal spread of Salvia compared to other drugs. Despite scant research on its use and withdrawal effects, users have described the drug as so powerful that most first users do not try it again. UK medical professionals have noted that it’s easy for users with mental and behavioural health conditions to become addicted to it. (7)

Salvia works differently from other stimulants when consumed. Unlike other narcotics that activate the opioid receptors in the brain, Salvia activates a different opioid receptor and doesn’t trigger the receptors responsible for bliss or euphoria. Due to this difference in targeted opioid receptors, Salvia may not be as addictive as other potent hallucinogenic drugs.

However, Salvia is a hallucinogen just like others that contain chemical compounds that alter perception, thought processes and awareness of a person’s surroundings, making the user unpredictable. This makes Salvia potentially addictive, even though not enough research is available to justify this claim.

Salvia users are likely to be extremely unpredictable and violent and can be a constant potential danger to those around them. Such individuals are commonly described as being in a ‘zombie-like’ state without any idea of what is happening to their bodies and minds. One of the insidious risks of Salvia use is that, unlike well-known drugs like cocaine or heroin, there is not enough research available to pinpoint a timeline for withdrawal or the long-term consequences of its use. (8)

Salvia abuse in teens

Teenage years are the most turbulent years for most people. Adolescence is a period when teenagers are growing fast and going through a lot of social, psychological and physical changes. Most start experimenting with alcohol and substances during this time.

According to a survey by the European Monitoring Centre for Drugs and Drug Addiction, two in five 15-year-olds in the UK have tried cannabis. The UK also has the highest number of young cocaine users alongside Spain. (9)

Salvia divinorum is commonly referred to as the ‘YouTube’ drug by teenagers and was popular for recreational purposes by UK teenagers and young adults before it was banned.

It has the ability to affect an adolescent’s sensory perception and interpretation. The drug is popular among teens as they consider hallucinations to be fun and an enhancement to the ultimate party experience. (9)

The abuse of Salvia has caused many teenagers to depend on the drug, with many of them missing school, scoring poor grades, losing interest in activities they previously used to enjoy, losing friends, experiencing decreased appetite and even committing suicide in extreme cases. Unfortunately, most teenagers may easily access the drug online, even though it is illegal.

Physical, Emotional and Social Effects of Salvia Abuse

Psychological

• Hallucinations
• Changes in vision, mood and sensations
• Extreme emotional swings
• Detachment from self, reality and surroundings, causing loss of perception between what’s real and what’s not

How Long Does Salvia Withdrawal Last?

A person may experience withdrawal symptoms like emotional swings, sleep disorder, cravings, headaches and dizziness among many others when they stop using the drug. Medical research has revealed that individuals are likely to start experiencing withdrawal symptoms a few hours after their last intake, which last for several days unless the person takes another dose of Salvia. (7)

Most users abuse the drug to relax and unwind; hence, a sudden withdrawal may lead to psychological effects. The most commonly diagnosed withdrawal symptoms of Salvia include nausea, sleep disturbance, loss of physical coordination, slurred speech, panic attacks and paranoia. (7)

Individuals may also experience long-term withdrawal symptoms like visions, flashbacks and the initial effects of the drug. According to users, most of these symptoms persist even after clients undergo a detoxification programme and may be difficult to control at first.

To effectively manage the effects of the drug’s withdrawals like sleep disruptions, hallucinations and mood swings, clients may need to seek therapy to prevent relapse. Treatment providers encourage clients to perform regular exercises, eat a properly balanced diet and stick to professional patterns in order to cope with the withdrawal symptoms. (7)

Treatment and Therapies for Salvia Abuse

Salvia is highly addictive, and clients under the influence of this psychoactive drug may be at a high risk of injury. Medical research shows that dependence on Salvia and other drugs has an effect on parts of the brain responsible for body coordination, thinking, mood regulation, decision making and many other important functions.

Salvia substance dependence may make it difficult for most clients to control their daily consumption, leading to irresponsible behaviours that may result in family breakups, dwindling finances and even poor physical health. (7)

Clients may seek drug rehabilitation services in rehab centres to address their Salvia addiction problems. Apart from the comprehensive treatment offered, clients can access services like detoxification, aftercare and drug counselling that will speed up their recovery and prevent relapse. (7)

Treatment offered to clients includes both therapy and counselling sessions that are specifically tailored to a client’s situation to enable them to achieve optimum levels of care and support during and after the programme. Furthermore, treatment providers involve families and loved ones to help them develop a treatment plan for the client.

Salvia treatment can be done on either an outpatient basis or in a residential setting, depending on the clients’ needs. The residential setting treatment enables health care providers to monitor the client in a comfortable and secure environment, while outpatient care allows the client to live at home with their loved ones. It is difficult to overcome substance abuse without professional help. Thus, clients looking for the best treatment centre in the UK may call to get help in finding a good rehab facility. (7)

Sources

(2) http://www.cesar.umd.edu/cesar/drugs/Salvia.asp

(4) https://www.psycheplants.org

(5) https://epubs.scu.edu.au/theses/502/

(6) https://pubchem.ncbi.nlm.nih.gov/

(7) https://www.medicalnewstoday.com/articles/309735.php

(8) https://ascert.biz/drug-and-alcohol-information/a-z-drugs/Salvia-divorum

(9) http://www.bbc.co.uk/worldservice/learningenglish/newsenglish/britain/teenagers_drugs.shtml

(10) https://www.drugabuse.gov/publications/drugfacts/genetics-epigenetics-addiction