Salvia: is it harmful?

I know that there was a video of Miley Cyrus smoking salvia that went viral a wile back, and since then I've been getting a bunch of emails related to salvia.  Just asking what it's all about, if its legal, if it's safe, and what it does to you?  Honestly, I didn't know all that much about it until last year, and I heard about it randomly from someone who knew I was a nurse and asked me about it at a party and I was stumped!

What is Salvia?
The full name is Salvia Divinorum and it is also known as Diviner's sage or Seers sage and is found in nature in shady, moist areas and is local to Oaxaca, Mexico.  It does have psychoactive properties and despite having a low risk potential of addiction, it as been used by Mazatec Shamans for religious purposes for hundreds of years, but is now being used by teens and young adults worldwide for a quick trip.

Is Salvia Legal?

It is legal in most countries and within the US, it is legal in almost all states; it as not yet be regulated by US federal drug laws.  Despite there being a decent amount of negative press regarding Salvia use by people, related to videos they've taken of themselves and posted online, there are virtually no reported cases by police or hospitals of arrests/deaths/etc related to Salvia usage, which may be why many states do not feel the need to make it illegal.

What actually happens?  

Salvia is usually smoked as a dried product, and causes a short "trip" that is psychedelic in nature, not to the extent of LSD (AKA Acid), but it lasts around 8 minutes on average.  Shamans usually make the leaves into a tea form that they sip on, to allow them to "Hear" the Virgin Mary.  It can also be chewed and swallowed with similar results.  The Salvia is an opioid agonist, similar to modern pain medications such as morphine or fentanyl, and it merely refers to how the drug works in the brain.  The interesting thing with Salvia is that it does not effect the serotonin receptors (the happy cells in your brain that elevate mood) like LSD (acid) or other hallucinogens.  So, depending on how the drug is ingested, the effects can last for different amounts of time; eating/drinking effects will be longer, and smoking will have shorter timeframe.  From various sources, the drug appears to cause a pretty intense out-of-body experience along with:

-intense laughter

-memories from childhood/past

-intense sensations of motions (pulled, twisted)

-feeling of becoming various objects

-spekaing in tongues

-intense meditation 

The drug as been studied, and due to the quickness of the "trip" from the drug, there have been no real reported cases of death, illness, or long term effects.  Do I suggest everyone run out and do it?  No, as it is an herbal "supplement" just like anything else and it can interact with various medications (prescribed or OTC) AND you never know ow you are going to react to a hallucinogen or how it will effect you (mentally) long term; a very difficult or repressed memory might come back that you don't want to remember.  These drugs effect everyone differently, and if you do decide to go ahead with it, just make sure that you are in a safe place and have someone who is sober who can ensure that you are safe.  And, if you have done it, and think something is wrong afterwards or feel strange, talk to your HCP and BE HONEST about what you have done; there will be no judgement, we just need to make sure you are healthy!!

Yours in Good Health

B