"Popularity of a Hallucinogen May Thwart Its Medical Uses"

Popularity of a Hallucinogen May Thwart Its Medical Uses
By KEVIN SACK and BRENT McDONALD
September 9, 2008

DALLAS — With a friend videotaping, 27-year-old Christopher Lenzini of Dallas took a hit of Salvia divinorum, regarded as the world’s most potent hallucinogenic herb, and soon began to imagine, he said, that he was in a boat with little green men. Mr. Lenzini quickly collapsed to the floor and dissolved into convulsive laughter.

When he posted the video on YouTube this summer, friends could not get enough. “It’s just funny to see a friend act like a total idiot,” he said, “so everybody loved it.”

Until a decade ago, the use of salvia was largely limited to those seeking revelation under the tutelage of Mazatec shamans in its native Oaxaca, Mexico.

Today, this mind-altering member of the mint family is broadly available for lawful sale online and in head shops across the United States.

Though older Americans typically have never heard of salvia, the psychoactive sage has become something of a phenomenon among this country’s thrill-seeking youth.

More than 5,000 YouTube videos — equal parts “Jackass” and “Up in Smoke” — document their journeys into rubber-legged incoherence.

Some of the videos have been viewed half a million times.

Yet these very images that have helped popularize salvia may also hasten its demise and undermine the promising research into its possible medical uses.

Pharmacologists who believe salvia could open new frontiers for the treatment of addiction, depression and pain fear that its criminalization would make it burdensome to obtain and store the plant, and difficult to gain government permission for tests on human subjects. In state after state, however, including here in Texas, the YouTube videos have become Exhibit A in legislative efforts to regulate salvia. This year, Florida made possession or sale a felony punishable by 15 years in prison. California took a gentler approach by making it a misdemeanor to sell or distribute to minors.

“When you see it, well, it sure makes a believer out of you,” said Representative Charles Anderson of Waco, a Republican state lawmaker who is sponsoring one of several bills to ban salvia in Texas.

When the federal government this year published its first estimates of salvia use, the data astonished many: some 1.8 million people had tried it in their lifetimes, including 750,000 in the previous year. Among males 18 to 25, where consumption is heaviest, nearly 3 percent reported using salvia in the previous year, making it twice as prevalent as LSD and nearly as popular as Ecstasy.

Recent studies at college campuses on both coasts have yielded estimates as high as 7 percent. The herb’s presence on military ships and bases has prompted enough concern about readiness that the Armed Forces Institute of Pathology was asked to develop the first urinalysis for salvia and is now testing 50 samples a month.

Though research is young and little is known about long-term effects, there are no studies suggesting that salvia is addictive or its users prone to overdose or abuse. Indeed, a salvia experience can be so intense, and at times so unsettling, that many try it just once, and even devotees use it sparingly.

Reports of salvia-related emergency room admissions are virtually nonexistent, likely because its effects typically vanish in just a few minutes.

With little data at its disposal, the Drug Enforcement Administration has spent more than a decade studying whether to add salvia to its list of controlled substances, as is the case in several European and Asian countries. In the meantime, 13 states and several local governments have banned or otherwise regulated the plant and its chemically enhanced extracts.

Known on the street by nicknames like Sally D and Magic Mint, salvia can have vastly different effects depending on dose, potency and the mindset and tolerance of its users, according to researchers and experienced smokers (though bitter, it can also be chewed or consumed as a tincture). Dozens of online vendors sell mild extracts for as little as $5 a gram; the strongest, at up to 100 times the potency of the raw leaf, sell for more than $50.

Users often report a sudden dissociation from self, as if traveling through time. The experience tends to be solitary, introspective and sometimes fearful: a 2003 bulletin from the Department of Justice concluded that salvia was unlikely ever to become a party drug.

“I’ve used several psychedelics, and salvia’s definitely the most intense experience that I’ve had,” said Brian D. Arthur, founder of Mazatec Garden, which sells salvia and other herbs online from a nondescript house in Houston. “Salvia takes you out of the world and puts you in a different place.”

Regular users say it can be a restorative, even spiritual tonic, and recall their visualizations with precision.

One night in August, Nathan K., a 29-year-old father of three from Waco, stretched back in his blue recliner and took a long, purposeful drag from his pipe. As he closed his eyes, he found himself transported into a dream state, he said, as if drifting down a rain forest river. A beatific smile spread lightly across his face.

The effects dissipated after five minutes, leaving him with a sense of well-being. It was, he said, as if a masseuse had rubbed out the knots in his psyche. “Just a very gentle letting go, a very gentle relaxing,” Nathan said on the condition that he not be fully identified.

Those who support the contemplative use of salvia disdain the YouTubers for disrespecting the herb’s power and purpose.

“They’re not really taking it as a tool to explore their inner psyche,” said Daniel J. Siebert, a Californian who pioneered the production of salvia extracts. “They’re just taking it to get messed up.”

At a legislative hearing near Dallas in August, Mr. Anderson argued that by not banning salvia, governments were communicating that it is benign. He noted that Internet purveyors advise that salvia should be used only with a “sober sitter,” and said its legal status might encourage experimentation among some who would never consider a back-alley drug deal.

He also told his colleagues about a video that depicts a salvia user behind the wheel of a car. (In fact, that video, “Driving on Salvia,” is one in a series of popular parodies featuring Erik J. Hoffstad, a production assistant in Los Angeles. In the two-and-a-half minute film, Mr. Hoffstad smokes salvia from a bong in a parked car — his friends made sure he did not have the real keys — and then freaks out when a cat unexpectedly pounces on the windshield.)

“What we really worry about,” Mr. Anderson said at the hearing, “is youngsters doing this and then getting in a vehicle or getting on a motorcycle or jumping in a pool somewhere.”

There have been rare claims of salvia-related deaths, but the links are speculative.

In March, Mario G. Argenziano, a 42-year-old restaurant manager from Yonkers, shot himself in the face 10 minutes after smoking salvia, a police report quoted his wife, Anna Argenziano, as saying. Ms. Argenziano said her husband, a gun collector and marksman, retrieved a handgun from a bedside table to show friends, then pointed it at himself and acted confused.

“Before the shot was fired, he was laughing,” Ms. Argenziano said. She said her husband had no psychiatric history; Yonkers police said they could not determine salvia’s role.

In 2006, Brett Chidester, a 17-year-old described by his family as a model student with no history of mental illness, committed suicide in Delaware at a time when he was apparently smoking salvia several times a week. Entries in his journal, provided by his mother, suggest that his salvia use influenced feelings that “our existence in general is pointless.”

Several months later, a medical examiner changed Mr. Chidester’s death certificate to list his salvia use as a contributing factor. Delaware’s Legislature immediately banned salvia by passing a bill it called Brett’s Law.

Such laws could pose a substantial burden to researchers at institutions like Harvard and the University of Kansas who are convinced that salvia’s active compound, Salvinorin A, holds great promise and will aid in the development of new lines of pain and psychiatric medications.

In 2002, Dr. Bryan L. Roth, now of the University of North Carolina at Chapel Hill, discovered that Salvinorin A, perhaps uniquely, stimulates a single receptor in the brain, the kappa opioid receptor. LSD, by comparison, stimulates about 50 receptors. Dr. Roth said Salvinorin A was the strongest hallucinogen gram for gram found in nature.

Though Salvinorin A, because of its debilitating effects, is unlikely to become a pharmaceutical agent itself, its chemistry may enable the discovery of valuable derivatives. “If we can find a drug that blocks salvia’s effects, there’s good evidence it could treat brain disorders including depression, schizophrenia, Alzheimer’s, maybe even H.I.V.,” Dr. Roth said.

Many scientists believe salvia should be regulated like alcohol or tobacco, but worry that criminalization would encumber their research before it bears fruit.

“We have this incredible new compound, the first in its class; it absolutely has potential medical use, and here we’re talking about throttling it because some people get intoxicated on it,” said Dr. John Mendelson, a pharmacologist at the California Pacific Medical Center Research Institute who, with federal financing, is studying salvia’s impact on humans. “It couldn’t be more foolish from a business point of view.”

Though states are moving quickly, Bertha K. Madras, a deputy director of the Office of National Drug Control Policy, said federal regulators remained in a quandary.

“The risk of any drug that is intoxicating is high,” Dr. Madras said. “You’re one car ride away from an event that could be life-altering. But in terms of really good studies, there is just very little. So what do you do? How do you make policy in the absence of good hard cold information?”