Salvia: Today’s Legal Salvia: Today’s Legal HallucinogenHallucinogen

2009 ACHA2009 ACHASan Francisco, CASan Francisco, CA

Dr. Lori Dewald, EdD, ATC, CHES, F-AAHEDr. Lori Dewald, EdD, ATC, CHES, F-AAHEDept. of Health and Physical EducationDept. of Health and Physical Education

Salisbury UniversitySalisbury UniversitySalisbury, MDSalisbury, MD

2009 ACHA2009 ACHA

Salvia: what is it?Salvia: what is it?• Salvia has been prominent for decades as an herb in the Sierra Salvia has been prominent for decades as an herb in the Sierra

Mazatecca area of Mexico, and Central and South America. Mazatecca area of Mexico, and Central and South America.

• It is from the sage family.It is from the sage family.

• Used in traditional spiritual and ethnopharmacological practices by Used in traditional spiritual and ethnopharmacological practices by the Mazatec Indians of the Oaxaca, Mexico.the Mazatec Indians of the Oaxaca, Mexico.

• They use it to treat headaches, diarrhea, and rheumatism.They use it to treat headaches, diarrhea, and rheumatism.

• Also use to treat “swollen belly” which is a curse from an evil Also use to treat “swollen belly” which is a curse from an evil sorcerer.sorcerer.

• In the USA, it has been used by landscapers as a ground cover. In the USA, it has been used by landscapers as a ground cover.

2009 ACHA2009 ACHA

Salvia PlantsSalvia Plants

2009 ACHA2009 ACHA

Salvia: what is it?Salvia: what is it?

• Salvia is the new LSD for today’s Salvia is the new LSD for today’s young people who are entering young people who are entering into recreational drug use. into recreational drug use.

• Why?Why?

2009 ACHA2009 ACHA

Why?Why?

• It is It is legallegal in 44 US states! in 44 US states!

• It is only illegal in:It is only illegal in:• DelawareDelaware• LouisianaLouisiana• MissouriMissouri• New JerseyNew Jersey• New YorkNew York• TennesseeTennessee

2009 ACHA2009 ACHA

A Legal HighA Legal High

• However, it has become better known in US However, it has become better known in US adolescents and teenagers as a cheap (less adolescents and teenagers as a cheap (less then $15.00) and legal hallucinogen.then $15.00) and legal hallucinogen.

• Its usage among adolescents, teenagers, Its usage among adolescents, teenagers, and college students has exploded in and college students has exploded in popularity in the USA. popularity in the USA.

““If you are into hallucinating, then ‘shrooms’ If you are into hallucinating, then ‘shrooms’ are out and Sally D is in”….stated an SU are out and Sally D is in”….stated an SU

student in my classroom on March 27, 2009.student in my classroom on March 27, 2009.

2009 ACHA2009 ACHA

Why is it so popular? Why is it so popular?

• The drug is available in stores The drug is available in stores without an age requirement for without an age requirement for purchase.purchase.

• Retail stores in many locations even Retail stores in many locations even

advertise it in the store front advertise it in the store front windows with neon signs claiming:windows with neon signs claiming:

““We have Salvia!”We have Salvia!”

2009 ACHA2009 ACHA

2009 ACHA2009 ACHA

Legally HighLegally High

2009 ACHA2009 ACHA

Controlled and Not Controlled and Not ControlledControlled

• It is It is NOTNOT a controlled substance in the USA! a controlled substance in the USA!

• It is a controlled substance in:It is a controlled substance in:• AustraliaAustralia• BelgiumBelgium• DenmarkDenmark• EstoniaEstonia• FinlandFinland• GermanyGermany• ItalyItaly• South KoreaSouth Korea• SwedenSweden

2009 ACHA2009 ACHA

Drug Enforcement Agency Drug Enforcement Agency ClassificationClassification

• The Drug Enforcement Agency lists salvia The Drug Enforcement Agency lists salvia as a Schedule I drug, just like LSD. as a Schedule I drug, just like LSD.

• It is on the DEA’s list of “drugs of concern”.It is on the DEA’s list of “drugs of concern”.

• Valdes, et al. states that “salvia is the most Valdes, et al. states that “salvia is the most potent naturally occurring hallucinogen potent naturally occurring hallucinogen thus far”.thus far”.

2009 ACHA2009 ACHA

Also Known As…Also Known As…

• Magic MintMagic Mint

• Ska Maria PastoraSka Maria Pastora

• Tripping on Sally DTripping on Sally D

2009 ACHA2009 ACHA

How usedHow used

• It is chewed, swallowed, and It is chewed, swallowed, and smoked.smoked.• Chewed as fresh leaves or in a quid Chewed as fresh leaves or in a quid

and kept in the mouth.and kept in the mouth.• Swallowed when eaten raw or in a Swallowed when eaten raw or in a

brewed liquid like tea.brewed liquid like tea.• Smoked like marijuana.Smoked like marijuana.

• Large bowled pipe, bong, or water pipe.Large bowled pipe, bong, or water pipe.• Rolled into a “Sally D” cigarette.Rolled into a “Sally D” cigarette.

2009 ACHA2009 ACHA

Salvia LeavesSalvia Leaves

2009 ACHA2009 ACHA

Sold in Various PotenciesSold in Various Potencies

• 5x5x• 10x10x• 15x15x• 20x20x• 30x30x• 40x40x

2009 ACHA2009 ACHA

Effectiveness Depends Upon Effectiveness Depends Upon UsageUsage

• Chewing or sucking or drinking results in a Chewing or sucking or drinking results in a slower onset hallucination, BUT a deeper and slower onset hallucination, BUT a deeper and more sustained experience.more sustained experience.

• Smoking or snorting results in an immediate Smoking or snorting results in an immediate effect.effect.

• Using a bong, water pipe, or bowl is a more Using a bong, water pipe, or bowl is a more effective and less wasteful method.effective and less wasteful method.

• The leaves are smoked alone and not mixed The leaves are smoked alone and not mixed with tobacco…in fact, it is not recommended with tobacco…in fact, it is not recommended that it be mixed with tobacco into a cigarette.that it be mixed with tobacco into a cigarette.

2009 ACHA2009 ACHA

HallucinationsHallucinations

• The hallucinations include: The hallucinations include: • psychedelic experiences with vision psychedelic experiences with vision

and body sensations.and body sensations.• a decreased ability to interact with a decreased ability to interact with

one’s surroundings.one’s surroundings.• a perception of overlapping realities, a perception of overlapping realities,

anxiety, discontent, and impaired anxiety, discontent, and impaired speech. speech.

2009 ACHA2009 ACHA

Length of Length of HallucinationsHallucinations

• The “high” lasts 1 minute to 2 The “high” lasts 1 minute to 2 hours depending upon the hours depending upon the potency.potency.

2009 ACHA2009 ACHA

Amount of UsageAmount of Usage

• Less than 200 grams will result in a Less than 200 grams will result in a 1 minute to 30 minute 1 minute to 30 minute hallucination.hallucination.

• 200-500 grams will result in a 30 200-500 grams will result in a 30 minute to 2 hour hallucination.minute to 2 hour hallucination.

2009 ACHA2009 ACHA

Youtube videosYoutube videos

http://www.youtube.com/watch?v=YYxkp62veWE

http://www.youtube.com/watch?v=kWeVExX3Bf4

http://www.youtube.com/watch?v=jI_e3XJ0ir8

http://www.youtube.com/watch?v=eGphHpSpPQE

2009 ACHA2009 ACHA

How Common is it’s UseHow Common is it’s Usein College Students?in College Students?

2009 ACHA2009 ACHA

Research StudiesResearch Studies• Lange, et al. April 2008Lange, et al. April 2008• LocationLocation

• Large public university in the southwestern USA.Large public university in the southwestern USA.• MethodMethod

• Online survey.Online survey.• SubjectsSubjects

• 1516 respondents.1516 respondents.• ResultsResults

• 4.4% of students reported using salvia in the past 12 months.4.4% of students reported using salvia in the past 12 months.• Subpopulations of the typical user.Subpopulations of the typical user.

• Whites.Whites.• Males.Males.• Fraternity members.Fraternity members.• Heavy episodic drinkers.Heavy episodic drinkers.• Typically most at risk for drug use within college students.Typically most at risk for drug use within college students.

2009 ACHA2009 ACHA

• Miller (in press, June 2009)Miller (in press, June 2009)• LocationLocation

• Southeastern university.Southeastern university.• MethodMethod

• Survey.Survey.• SubjectsSubjects

• 826 undergraduates.826 undergraduates.• ResultsResults

• 6.7% of those surveyed were using salvia.6.7% of those surveyed were using salvia.

Research StudiesResearch Studies

2009 ACHA2009 ACHA

Media Attention in Local Media Attention in Local Newspapers that Newspapers that

Documented Salvia Usage in Documented Salvia Usage in College Students College Students

• Ohio State UniversityOhio State University• University of KansasUniversity of Kansas• Ball State UniversityBall State University• University of OklahomaUniversity of Oklahoma• Northern Illinois UniversityNorthern Illinois University• Ohio UniversityOhio University• University of North DakotaUniversity of North Dakota• University of FloridaUniversity of Florida• Salisbury UniversitySalisbury University

2009 ACHA2009 ACHA

Ephedra’s Demise = Ephedra’s Demise = Salvia’s RiseSalvia’s Rise

• When ephedra was banned in May When ephedra was banned in May of 2004, salvia overtook ephedra of 2004, salvia overtook ephedra as the most common substance as the most common substance available over the internet.available over the internet.

2009 ACHA2009 ACHA

Treatment ProtocolsTreatment Protocols

• Short and long term effects of Short and long term effects of salvia usage are not yet known.salvia usage are not yet known.

• Overdose treatment protocols Overdose treatment protocols have not yet been developed.have not yet been developed.

2009 ACHA2009 ACHA

Drug Testing?Drug Testing?

The active compound is (The active compound is (Salvinorin ASalvinorin A) or its metabolites ) or its metabolites (the substances broken down by the body) can’t (the substances broken down by the body) can’t detect by:detect by:

Standard Drug Tests = NoStandard Drug Tests = NoExtended Drug Tests = NoExtended Drug Tests = No

Can it be tested for? Yes, but only through complicated Can it be tested for? Yes, but only through complicated and expensive lab tests.and expensive lab tests.

• by liquid chromatography-mass spectrometry in by liquid chromatography-mass spectrometry in blood and urine. blood and urine.

• by gas chromatography/mass spectrometry in blood, by gas chromatography/mass spectrometry in blood, urine, and saliva.urine, and saliva.

• by high performance liquid chromatography-by high performance liquid chromatography-atmospheric pressure chemical ionization in blood atmospheric pressure chemical ionization in blood and urine.and urine.

2009 ACHA2009 ACHA

Half LifeHalf Life

• Less than an hour after the Less than an hour after the hallucination.hallucination.

• Detection window is less than 12 Detection window is less than 12 hours.hours.

2009 ACHA2009 ACHA

Future “Legal” Drugs…Future “Legal” Drugs…

2009 ACHA2009 ACHA

Legal Herbs/DrugsLegal Herbs/Drugson the Horizonon the Horizon

Sinicuichi

Lion’s Tail

2009 ACHA2009 ACHA

More Legal Herbs/DrugsMore Legal Herbs/Drugson the Horizonon the Horizon

Sweet Flag

Blue lotus

2009 ACHA2009 ACHA

What Can We Do About What Can We Do About Salvia and these Future Salvia and these Future

Drugs?Drugs?• Collaborate with your state and regional ACHA Collaborate with your state and regional ACHA

affiliates.affiliates.• Contact your state legislator and set up a meeting with Contact your state legislator and set up a meeting with

them.them.• Ask them to develop legislation to ban it at your state Ask them to develop legislation to ban it at your state

level.level.• Contact your US senator(s) and US house of Contact your US senator(s) and US house of

representative(s) and ask them to ban it at the federal representative(s) and ask them to ban it at the federal level.level.

• Meet with your city council and ask that they ban it at Meet with your city council and ask that they ban it at the city level.the city level.

• Work with the business community to stop selling it.Work with the business community to stop selling it.• Ban it on and from your campus by working with Ban it on and from your campus by working with

student affairs and the institution’s administration.student affairs and the institution’s administration.

2009 ACHA2009 ACHA

The following legislative bill template is The following legislative bill template is provided by Dr. Greg Yeakel, PharmD from Iowa provided by Dr. Greg Yeakel, PharmD from Iowa State University’s Student Health Center. State University’s Student Health Center. Email address: gyeakel@iastate.eduEmail address: gyeakel@iastate.edu

This bill adds hallucinogenic substances to the list of schedule I controlled This bill adds hallucinogenic substances to the list of schedule I controlled substances. The bill adds “salvia divinorum” and “salvinorin A”, also known as substances. The bill adds “salvia divinorum” and “salvinorin A”, also known as “divinorum A”, to the list of schedule I controlled substances. A schedule I “divinorum A”, to the list of schedule I controlled substances. A schedule I controlled substance is considered to have a high potential for abuse and no controlled substance is considered to have a high potential for abuse and no medical purpose in treatment in the USA. The bill makes it a class “C” felony medical purpose in treatment in the USA. The bill makes it a class “C” felony pursuant to Code section ______________ for any unauthorized person to pursuant to Code section ______________ for any unauthorized person to manufacture, deliver, or possess with the intent to manufacture or deliver, salvia manufacture, deliver, or possess with the intent to manufacture or deliver, salvia divinorum or salvinorin A, including its counterfeit or a simulated form, or to act divinorum or salvinorin A, including its counterfeit or a simulated form, or to act with, enter into a common scheme or design with, or conspire with one or more with, enter into a common scheme or design with, or conspire with one or more other persons to manufacture, deliver, or possess with the intent to manufacture other persons to manufacture, deliver, or possess with the intent to manufacture or deliver salvia divinorum or salvinorin A. The bill also makes it a serious or deliver salvia divinorum or salvinorin A. The bill also makes it a serious misdemeanor pursuant to Code section _____________, for any unauthorized person misdemeanor pursuant to Code section _____________, for any unauthorized person to possess salvia divinorum or salvinorum A. A class “C felony is punishable by to possess salvia divinorum or salvinorum A. A class “C felony is punishable by confinement for no more than 10 years and a fine of at least $1,000.00 but not confinement for no more than 10 years and a fine of at least $1,000.00 but not more than $10,000.00. A serious misdemeanor is punishable by confinement for more than $10,000.00. A serious misdemeanor is punishable by confinement for no more than one year and a fine of at least $315.00 but not more than $1,875.no more than one year and a fine of at least $315.00 but not more than $1,875.

2009 ACHA2009 ACHA

ReferencesReferences 1. Dalgarno, P. June 2007. Subjective Effects of Salvia Divinorum. 1. Dalgarno, P. June 2007. Subjective Effects of Salvia Divinorum. Journal of Journal of

Psychoactive DrugsPsychoactive Drugs. 39(2): 143-149.. 39(2): 143-149. 2. Gonzalez, D., Riba, J., Bouso, J., Gomez-Jarabo, G., Barbanoj, M. 2006. 2. Gonzalez, D., Riba, J., Bouso, J., Gomez-Jarabo, G., Barbanoj, M. 2006.

Pattern of Use and Subjective Effects of Salvia Divinorum Among Pattern of Use and Subjective Effects of Salvia Divinorum Among Recreational Users. Drug and Alcohol Dependence. Recreational Users. Drug and Alcohol Dependence. Drug and Alcohol Drug and Alcohol DependenceDependence. 85:157-162.. 85:157-162.

3. Griffin, O., Miller, B., Khey, D. June 2008. Legally High? Legal 3. Griffin, O., Miller, B., Khey, D. June 2008. Legally High? Legal Considerations of Salvia Divinorum. Considerations of Salvia Divinorum. Journal of Psychoactive DrugsJournal of Psychoactive Drugs. . 40(2):183-191.40(2):183-191.

4. Hoover, V., Marlowe, D., Patapis, N., Festinger, D., Forman, R. July 2008. 4. Hoover, V., Marlowe, D., Patapis, N., Festinger, D., Forman, R. July 2008. Internet Access to Salvia Divinorum: Implications for Policy, Prevention, Internet Access to Salvia Divinorum: Implications for Policy, Prevention, and Treatment. and Treatment. Journal of Substance Abuse TreatmentJournal of Substance Abuse Treatment. 35(1):22-27.. 35(1):22-27.

5. Lange, J., Reed, M., Croff, J., Clapp, J. April 2008. College Student Use of 5. Lange, J., Reed, M., Croff, J., Clapp, J. April 2008. College Student Use of Salvia Divinorum. Salvia Divinorum. Drug and Alcohol DependenceDrug and Alcohol Dependence. 94(1-3):263-266.. 94(1-3):263-266.

6. Khey, D, Miller, B., Griffin, O. Salvia 2008. Divinorum Use Among A College 6. Khey, D, Miller, B., Griffin, O. Salvia 2008. Divinorum Use Among A College Student Sample. Student Sample. Journal of Drug Education.Journal of Drug Education. 38(3):297-306. 38(3):297-306.

7. http://www.npr.org/story/salvia/ March 20, 2006.7. http://www.npr.org/story/salvia/ March 20, 2006. 8. Prisinzano, T. 2005. Psychopharmacology of the Hallucinogenic Sage 8. Prisinzano, T. 2005. Psychopharmacology of the Hallucinogenic Sage

Salvia Divinorum. Salvia Divinorum. Life SciencesLife Sciences. 78:527-531.. 78:527-531. 9. Singh, S. 2007. Adolescent: Salvia Substance Abuse. 9. Singh, S. 2007. Adolescent: Salvia Substance Abuse. AddictionAddiction. 102:823-. 102:823-

824.824.10. Valdes, L., Seymour, R. 2008. Salvinorin A is Not Your Usual Cup of Tea. 10. Valdes, L., Seymour, R. 2008. Salvinorin A is Not Your Usual Cup of Tea.

Psychopharmacology UpdatePsychopharmacology Update. 9(7):3-4.. 9(7):3-4.

2009 ACHA2009 ACHA

Thank youThank you

2009 ACHA2009 ACHA

Questions?Questions?

Contact information:Contact information:

LoriDewald@yahoo.comLoriDewald@yahoo.com