Salvia divinorum – Health Issues

Diviners’ Sage, Ska Pastora

Taking Cuttings

Salvia divinorum is a perennial herb from Mexico, related to Common Sage. It is native to an area known as Sierra Mazatec. It has been used by the native Mazatec for an unknown amount of time. Its use was first recorded by western science in 1938 when a young anthropologist, Jean B. Johnson wrote:

Shamans, as well as other persons, use certain narcotic plants in order to find lost objects. In some cases teonanacatl is used, while in others a seed called ‘semilla de la Virgen’ is used. ‘Hierba María’ is similarly used. The Zapotecs use a plant called ‘bador’, the little children, and the Aztecs used narcotic plants in a similar manner.

It has also been suggested that Salvia divinorum is the Pipiltzintzintli of the Aztecs, although there is scant evidence for this.

The leaves of Salvia divinorum contain Salvinorin, a novel psychoactive and the most potent naturally occurring psychoactive compound yet found. It is active in doses as low as 200 mcg (micrograms).

The traditional methods of consuming Salvia divinorum (by the Mazatec) are chewing fresh leaves and imbibing an infusion/suspension of shredded or crushed leaves in cold water. It’s use as a recreational drug in the United States and Europe usually involves the smoking of dried leaves or extracts of the leaves, although the practice of chewing fresh or re-hydrated leaves is also present.

On to the Health Issues

Unfortunately, almost nothing is known about either the long-term or short-term health issues relating to Salvia divinorum. This vacuum of information can lead to some potentially dangerous assumptions being made.

You may have heard an argument along these lines:

The Mazatec have been using Salvia divinorum for ages, and it doesn’t seem to harm them, so it must be safe.

There are a few ways to answer this.

  • Firstly, yes, the Mazatec have been using Salvia divinorum for a long time, but, no studies have ever been conducted on the Mazatec to discover what effects Salvia divinorum has on them. We know nothing of the long or short-term health risks relating to Mazatec Salvia divinorum use.
  • Secondly, there is quite a disparity between Mazatec usage practices and Western usage practices. The effects of Salvia divinorum when chewed or imbibed rise gradually to a peak and last several hours. The have been described as ‘more subtle’. Conversely, the effects of smoked Salvia divinorum (or an extract of it) begin suddenly, rise swiftly to a peak and subside again quite quickly; with lingering after-effects lasting 15-60 minutes. The rapid onset can be quite unexpected and provokes fear in some users. It should be noted that the Mazatec never smoke Salvia divinorum, considering it basically a sacrilege. This difference invalidates Mazatec usage patterns as a useful comparison for expected effects when Salvia leaves or extract are smoked.
  • Thirdly, the significance of set and setting must be considered. The set (thoughts, mood, expectations) and setting (physical and social location) of a Mazatec user and a Western user are not comparable. The influence these elements can have on an experience are highly significant. Again, the set and setting of a Mazatec user are an invalid comparison to use when discussing effects expected from a non-Mazatec user.

You may also have heard an argument along these lines:

There are no recoded cases of Salvia divinorum causing physical or psychological harm. So it must be safe.

This statement is partially true. There are no cases in the scientific literature of individuals being harmed from using Salvia divinorum. However, this statement is only provisionally true; as nobody has yet looked into whether Salvia divinorum causes harm. In the future, we may find that Salvia divinorum can cause psychosis or cancer; at present nobody knows.

So what can be said about the dangers of Salvia divinorum?

There are a couple points about the physical effects of Salvia divinorum which can be stated with reasonable confidence.

  • Salvia divinorum can sometimes affect motor co-ordination and balance. This can make it difficult to walk and perform simple tasks. The risk posed to the user can be quite significant. Even simple tasks such as walking down stairs could be dangerous if this effect is pronounced. It goes without saying that more demanding tasks, such as driving or operating machinery really should not be performed under the influence of Salvia divinorum, as the risk posed to the user in these circumstances is great. This effect can continue well after the subjective effects have subsided (perhaps up to an hour when smoked).
  • It is widely known that natural products other than tobacco can also be quite injurious to health when smoked. For example, there is much debate over whether Cannabis is itself carcinogenic when smoked. The one thing that is quite clear is that inhaling smoke of any kind is not good for your physical health. Although the effects of smoke from Salvia divinorum leaves and extracts have not been studied, it can be said with a fair amount of confidence that smoking Salvia divinorum is unlikely to be good for your lungs or general health.

What about psychological effects?

Before discussing the psychological effects Salvia divinorum may have, there is one consideration rarely touched upon when Salvia divinorum is discussed:

Many users of Salvia divinorum can act quite erratically and out of character while under the influence. It is entirely possible for a user to act in a way at odds with their usual behaviour. Although unlikely, it is possible for a user to become violent, or to perform actions which may potentially harm themselves. For this reason, the Salvia Divinorum Research and Information Center (the website of Daniel Siebert) recommends that dangerous objects, such as knives and guns are removed from the area before usage commences. It is also common to recommend a sitter (a sober person to watch over the user/users). Although this advice is basically sound, there is also the possibility that a user could become violent towards their sitter. Until research is conducted into the effects of Salvia divinorum, the likelihood of violent behaviour is an unknown quantity.

OK. So what about the other potential psychological effects of Salvia divinorum?

  • For want of a better word, Salvia divinorum is described as an hallucinogenic or visionary plant. It provokes sometimes powerful experiences broadly comparable to other substances such as LSD, Psilocybin and DMT (although the visually ‘hallucinogenic’ effects of Salvia are a lot less pronounced than these substances). Any experience with a profound effect on the psyche (whether caused by psychoactive drugs or otherwise) can have a permanent effect on an individual. Strongly negative experiences can cause psychological damage. Again, the long-term effects of Salvia divinorum on the psyche have not been studied, but it can be said with a fair amount of confidence (by comparing with similar substances), that in rare cases Salvia divinorum may cause psychosis in some users. These may be users with pre-existing mental illness, users with no history of mental illness but a latent predisposition to psychosis, or just ordinary users who go too far one day.It is impossible to say with confidence who may be susceptible to drug induced psychosis as the causes of this effect are not yet clearly understood even among more well known and well used drugs such as LSD and Cannabis.

Also, it is fairly well understood that the dangers posed by drugs are magnified when drugs are taken in combination. This may also be true with Salvia divinorum. Little is known about the effects of Salvia divinorum in combination with other drugs (other than anecdotal reports or first-hand experience reports available via websites such as This means that any user trying out Salvia divinorum in combination with other drugs is experimenting with their own body and mind, and the potential outcomes (both physical and psychological) are far from clear.

In Conclusion

Although, as has been said, little is known about the short- or long-term effects of Salvia divinorum on the body and psyche, it is important to remember that a lack of data about the dangers of Salvia do not prove it is safe. Too many websites espouse the idea that Salvia divinorum is safe when at present, so little is known about its effects, it is impossible to say either way. There is no scientific data on Western use patterns to base judgements on, and the practice has not been widely used in the West for long enough to form judgements based on large arrays of anecdotal data either.

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