Salvia: Good For Research, Bad For Recreation

Parents who keep an eye on YouTube are likely aware of a recent viral video: The young actress and singer Miley Cyrus smoking an unknown substance leading to a fit of laughter and apparently extreme disorientation -- even hallucination. Some watchers have concluded that Cyrus' bong was likely packed with salvia divinorum, a psychedelic relative of sage that has become popular with young people in recent years for its intense but short-lived high. Another reason it's popular: In many states, it's totally legal.

The issue of salvia is as important as the drug is misunderstood. So I'd like to clear up some misconceptions and at the same time give you an idea why child and adolescent psychiatrists care about this drug. There are two reasons: We want to protect against its perils, and we want to protect its promise.

Salvia is a powerful hallucinogen that frankly terrifies many who try it, can cause loss of motor coordination, and often brings on overwhelming dissociative hallucinations. You probably wouldn't be OK with your child taking LSD or heroin; and yet because salvia is a leaf and is legal, some make snap judgments. Looking around the web for reactions, I stumbled on this comment about Cyrus, "Obviously she wasn't in her right frame of mind when this was filmed. Perhaps, she had a little more than that salvia."

More than that salvia? This sort of thinking unfortunately plagues the public consciousness. That blogger appears to think that Cyrus was actually smoking marijuana, because the legal herb salvia couldn't possibly have such an effect! Here's the real deal: Just because salvia is superficially similar to marijuana doesn't make it any safer than other hard drugs. (And, like other hallucinogens, it should be off limits for any child at risk for a psychiatric disorder.)

You can watch hundreds of salvia videos on YouTube that may elicit a chuckle, but a first person account in a comment on NPR's website gets closer to the heart of the matter. "I smoked this stuff once ... and only once," the commenter begins. "It scared the hell out of me."

I did see my mom and dad looking down at me and trying to tell me something, I couldn't hear them and realized I was dead and in a coffin. I also thought I was on a giant record player. Every time the record spun I saw a window into reality that became bigger and bigger as time went on. My friend told me I was spinning around in my chair yelling that my foot was on fire for about 10 minutes.

That is not just getting stoned. And it should be mentioned that salvia has been linked, if vaguely, to a handful of suicides. Which is not to say that the reckless and dissociative behavior that can be brought on by salvia isn't worrying in and of itself.

So why, you ask, is it legal? The DEA "schedules," or regulates, drugs and medications -- in part -- based on chemical similarities with already scheduled drugs. Salvia is legal because its method of action -- how it affects the brain -- is so novel that it is unrelated to any of the drugs currently regulated or outlawed by the federal government. But this is also why it should not be outlawed entirely -- because of the possible research benefits, which often, sadly, shrivel up when the government decides to outlaw instead of regulate.

The point is that this plant is telling us things we didn't know about how drugs interact with the brain. Its psychoactive ingredient, Salvinorin A, appears to target a single specific receptor in the brain that is implicated in a variety of psychiatric disorders. Down the road, this could lead to treatments for everything from depression and schizophrenia to addiction and even diarrhea. If the hallucinogenic side effects are removed or mitigated, derivatives of salvia or related chemicals could provide a path towards new psychopharmacological treatments for mental illness, and we must protect that promise.

In no way am I calling salvia a possible "medication" -- as it naturally occurs and is used to "trip," it is what we call a drug of abuse. But there is a possibility that research can yield valid, even life-saving medical treatments.

So it's important not to make a mistake here: Salvia is a powerful hallucinogen -- it must be regulated. But we don't know enough about it to say how it should be regulated. We must balance the need to keep our children safe with the imperative to explore its potential for breakthrough medications.

We must be reasonable, as we have not always been in the past, while still being vigilant.

Harold S. Koplewicz, M.D. is a leading child and adolescent psychiatrist and the president of the Child Mind Institute. For more on adolescents, drugs, and mental health research, go to our website, which offers parenting advice and a wealth of information on childhood psychiatric and learning disorders.

 

 

 

Follow Dr. Harold Koplewicz on Twitter: www.twitter.com/DrKoplewicz

Comments

[Acert]

10:40 PM on 01/10/2011

Regulate it, but keep it legal. Ban selling/giving it to minors and driving while high, but keep recreational use for adults legal.

[NonPrawf]

07:37 PM on 01/09/2011

S@lvia rox!!!!

[chafuncta]

09:23 PM on 01/08/2011

If Miley were holding a bottle of Jack Daniels would people be calling for a ban on alcohol? Oh that's right they tried that once. How did that work out? It doesn't work, it just drives it undergroun­d where the criminal class controls it. Alcohol kills millions worldwide annually, so let's stop the hypocrisy. The US government­'s War on Drugs has only made the drug barons richer and more powerful,. We practicall­y have a narco state on our border because of the WOD. Of course that gives the gov't an excuse to increase it's police powers and control over the populace just as is happening with the War on Terror. The way to control people is to keep them afraid. What people don't understand about Salvia is that it is an incredibly unique substance unlike any other "drug". Research is being done with it that may ultimately lead to some promising therapies for treating Alzheimer'­s disease and other illnesses as the author says. Making it a controlled substance (like marijuana-­what a joke) would make it practicall­y impossible to get a hold of and most of the research would end. More education and dis-information is what we need. Daniel Siebert, a pioneer in the Salvia field has an excellent site http://www­.sagewisdo­m.org/ with a lot of informatio­n worth looking into. I personally had one of the most beautiful and enlighteni­ng experience­s of my life on Salvia and will forever be grateful to the "shepherde­ss".

[iuriggs6]

03:20 PM on 01/09/2011

If people had the self worth to not abuse drugs none of this would matter.

[OverseasVet]

06:25 AM on 01/10/2011

If people would only allow others to live out their own life without passing judgment then we could all be happy.

[OMGmoments]

06:34 PM on 01/07/2011

i doubt she was smoking salvia. she probably wouldn't have been laughing so much since it can more often than not be terrifying especially in a room full of people she didn't seem to know too well. my guess would be marijuana laced with DMT, a psychedelic which, when used, isn't typically as uncomfortable and unpredictable as a salvia trip - "This is generally smoked in a few successive breaths. The effects last for a short period of time, usually 5 to 15 minutes, dependent on the dose. The onset after inhalation is very fast (less than 45 seconds) and peak effects are reached within a minute...Some users elect to combine it with cannabis, parsley, mullein, mint, or other plants in an attempt to improve flavor and reduce harshness. Combining DMT with plant matter or depositing it upon a substrate of ash also facilitates use of an ordinary pipe, a bong, or a vaporizer."

[patman77]

03:03 PM on 01/07/2011

and pot is illegal ?

[moutonnoir]

03:49 PM on 01/06/2011

Hehe.. Anna's off the cuff description of salvia as 'being like a synthetic marijuana' is just absurdly misleading. Salvia is completely natural - and essentially unrelated to marijuana..

[OverseasVet]

06:29 AM on 01/10/2011

Does being"natural" somehow make a difference? Natural just describes the source and has no bearing on its safety or efficacy. Tetrodotoxin is as natural as anything else.

[moutonnoir]

03:46 PM on 01/10/2011

all I am saying is that she was completely and 100% wrong. that is all. you can say what you want.

[iuriggs6]

10:04 AM on 01/06/2011

You have a few screws loose if you try this product....

[HarrietM]

03:15 PM on 01/14/2011

Nah, trying it is what loosens the screws!

I still think that drug use and abuse is a matter for doctors and families to work on and should not be criminalized.

[3dtrix]

02:59 AM on 01/06/2011

I've always found saliva to be VERY useful - it keeps my tongue from sticking to my teeth and the roof of my mouth, can be used to clean smudges off of glass and silverware - and in a pinch, makes an fine, um, personal lubricant.

Wait - this isn't about SALIVA - is it?

Sorry - back to the political wars...

[SSF]

02:34 AM on 01/06/2011

I tried it at a party, the high was interesting, but that salvia smoke was very harsh on the lungs. I'm betting that repeated use would do some serious damage to the respiratory system. Once was enough.......

[k-ram]

06:58 AM on 01/06/2011

Bong hits aren’t the only way to get high with the leaves of the Mexican sage Salvia divinorum; you can also chew them as a wad or drink an infusion made from freshly crushed leaves. Salvia means “to heal” and divinorum means “divination”, reflecting its traditional uses by Mazatec folk healers or Shamans in Oxaxaca, Mexico.
http://bit.ly/hKXMqz

[AddictionWatch]

01:57 AM on 01/06/2011

People should be educated on the toxic effects of any drugs, and the least you can say about Salvia, its toxic, which means poisonous to the body. That in and of itself should enough to sway someone from doing it, but sad to say... its not. As with any drug there are going to be other more harmful effects that the desired effect, which have been creatively marketed as " side effects" when they are the overall effects, not side effects. As someone who has overcame addiction that started innocently enough, as a kid just trying to have a good time, I have since learned the end result of being exposed to any drug.

[BlackYowe]

01:39 AM on 01/06/2011

I am not at all sure why people take risks with their brains and do this shite.

[shelshock22nd]

01:11 AM on 01/06/2011

I still don't think what Miley smoked was salvia. From all I have read and heard about it, her reaction was very abnormal to salvia. To weed on the other hand.......

[Katco]

08:38 AM on 01/06/2011

You've obviously never smoked the "weed."

[Porbin]

07:04 PM on 01/06/2011

my thoughts exactly.

[mrk65]

12:26 AM on 01/06/2011

What does Salvia Brown have to do with all this? Well, she probably knows, she psychic. ;-)

[Wendy Chambers]

12:16 AM on 01/06/2011

the more press about this - the more folks will want to try it...... humans are like sheep they follow each others examples.....

[k-ram]

10:19 PM on 01/05/2011

S. divinorum is only one of about 1,000 species of Sage -- one you're probably more familiar with (and undoubtedly ingested at Thanksgiving and Christmas) is Salvia officinalis, which is a culinary seasoning for poultry and fatty meats. There is a nice figure of all of Salvia's physical and psychological effects here: http://bit.ly/e6NKxC