Influence of Age on Salvia Divinorum Use: Results of an Internet Survey (Report‪)‬

Salvia divinorum is a perennial herb in the mint family native to Mexico and Central and South America (NIDA 2007; Vortherms & Roth 2006). It was traditionally used for its hallucinogenic properties by the Mazatec Indians of Oaxaca, Mexico for shamanistic purposes (NIDA 2007; Vortherms & Roth 2006). In addition, Salvia divinorum has also been used for various healing purposes including pain relief, diarrhea, and for the treatment of neurologic diseases (Weissner 2009). In the modern world, Salvia divinorum has been increasingly recognized for its abuse potential by sources that range from the general media to federal authorities. An Internet search using the term "salvia" results in hundreds of thousands of website resources providing information on its history, instructions regarding recreational use, as well as how to purchase Salvia divinorum. According to the Substance Abuse and Mental Health Services Administration's (SAMHSA) report on hallucinogen use, about 1.8 million people aged 15 years or greater used Salvia divinorum at least once in their lifetime (SAMHSA 2008). It is important to note that hundreds of salvia species exist that do not contain any psychoactive substances. Although the term "salvia" is commonly used as a colloquial term for Salvia divinorum, the hundreds of nonpsychoactive salvia species should not be confused with Salvia divinorum, the specific species that is psychoactive and the only species that is addressed in this study. To minimize repetition, the term "salvia" will refer specifically to the Salvia divinorum species throughout this article. Interestingly, Salvia divinorum is structurally different from the prototypical psychoactive substances, LSD and mescaline, which act at serotonin receptors (Roth 2002). Salvia's active component is thought to be salvinorin A, a neoclerodane diterpene (Roth 2002). Salvinorin A has been shown to be a potent kappa opioid receptor agonist (Vortherms & Roth 2006; Roth 2002). Binding at kappa opioid receptors is known to result in neurologic effects including sedation, analgesia, and perceptual disturbances (Hooker et al. 2008; Roth 2002). Its agonistic activity at kappa opioid receptors likely plays a role in the hallucinogenic effects of salvia (Roth 2002).