Recent national trends in Salvia divinorum use and substance-use disorders among recent and former Salvia divinorum users compared with nonusers

Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
Substance abuse and rehabilitation 04/2011; 2011(2):53-68. DOI: 10.2147/SAR.S17192
Source: PubMed


CONTEXT: Media and scientific reports have indicated an increase in recreational use of Salvia divinorum. Epidemiological data are lacking on the trends, prevalence, and correlates of S. divinorum use in large representative samples, as well as the extent of substance use and mental health problems among S. divinorum users. OBJECTIVE: To examine the national trend in prevalence of S. divinorum use and to identify sociodemographic, behavioral, mental health, and substance-use profiles of recent (past-year) and former users of S. divinorum. DESIGN: Analyses of public-use data files from the 2006-2008 United States National Surveys on Drug Use and Health (N = 166,453). SETTING: Noninstitutionalized individuals aged 12 years or older were interviewed in their places of residence. MAIN MEASURES: Substance use, S. divinorum, self-reported substance use disorders, criminality, depression, and mental health treatment were assessed by standardized survey questions administered by the audio computer-assisted self-interviewing method. RESULTS: Among survey respondents, lifetime prevalence of S. divinorum use had increased from 0.7% in 2006 to 1.3% in 2008 (an 83% increase). S. divinorum use was associated with ages 18-25 years, male gender, white or multiple race, residence of large metropolitan areas, arrests for criminal activities, and depression. S. divinorum use was particularly common among recent drug users, including users of lysergic acid diethylamide (53.7%), ecstasy (30.1%), heroin (24.2%), phencyclidine (22.4%), and cocaine (17.5%). Adjusted multinomial logistic analyses indicated polydrug use as the strongest determinant for recent and former S. divinorum use. An estimated 43.0% of past-year S. divinorum users and 28.9% of former S. divinorum users had an illicit or nonmedical drug-use disorder compared with 2.5% of nonusers. Adjusted logistic regression analyses showed that recent and former S. divinorum users had greater odds of having past-year depression and a substance-use disorder (alcohol or drugs) than past-year alcohol or drug users who did not use S. divinorum. CONCLUSION: S. divinorum use is prevalent among recent or active drug users who have used other hallucinogens or stimulants. The high prevalence of substance use disorders among recent S. divinorum users emphasizes the need to study health risks of drug interactions.

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    • ". , 2011 ; Mendelson et al . , 2011 ; Addy , 2012 ; Ranganathan et al . , 2012 ; MacLean et al . , 2013 ) . There have also been several questionnaire - based studies and clinical case studies of the effects of salvinorin A - containing preparations in humans ( Singh , 2007 ; Lange et al . , 2008 ; Przekop and Lee , 2009 ; Baggott et al . , 2010 ; Wu et al . , 2011 ; Perron et al . , 2012 ) . Carefully controlled studies in humans , initially experienced hallucinogen or Salvia divinorum users , characterized the effects of salvinorin A smoking ( 0 . 75 – 21 µg / kg ) . Salvinorin A ' s effects were of extremely rapid onset , peaked by 2 min after inhalation , and declined by 30 min ( Johnson et al "
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    ABSTRACT: Salvinorin A is a potent hallucinogen, isolated from the ethnomedical plant Salvia divinorum. Salvinorin A is a selective high efficacy kappa-opioid receptor (KOPr) agonist, and thus implicates the KOPr system and its endogenous agonist ligands (the dynorphins) in higher functions, including cognition and perceptual effects. Salvinorin A is the only selective KOPr ligand to be widely available outside research or medical settings, and salvinorin A-containing products have undergone frequent non-medical use. KOPr/dynorphin systems in the brain are known to be powerful counter-modulatory mechanisms to dopaminergic function, which is important in mood and reward engendered by natural and chemical reinforcers (including drugs of abuse). KOPr activation (including by salvinorin A) can thus cause aversion and anhedonia in preclinical models. Salvinorin A is also a completely new scaffold for medicinal chemistry approaches, since it is a non-nitrogenous neoclerodane, unlike other known opioid ligands. Ongoing efforts have the goal of discovering novel semi-synthetic salvinorin analogs with potential KOPr-mediated pharmacotherapeutic effects (including partial agonist or biased agonist effects), with a reduced burden of undesirable effects associated with salvinorin A.
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    • "In 2013, 3.4% of 12th graders in the US had used SD in the previous year, with highest use rate among males and Hispanics (Johnston et al., 2013). Use of SD is correlated with other hallucinogen use and with symptoms of depression and anxiety (Perron et al., 2012; Wu et al., 2011). "
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    ABSTRACT: This study examined the overall psychological effects of inebriation facilitated by the naturally-occurring plant hallucinogen Salvia divinorum using a double-blind, randomized, placebo-controlled trial. Thirty healthy individuals self-administered Salvia divinorum via combustion and inhalation in a quiet, comfortable research setting. Experimental sessions, post-session interviews, and 8-week follow-up meetings were audio recorded and transcribed to provide the primary qualitative material analyzed here. Additionally, post-session responses to the Hallucinogen Rating Scale provided a quantitative groundwork for mixed-methods discussion. Qualitative data underwent thematic content analysis, being coded independently by three researchers before being collaboratively integrated to provide the final results. Three main themes and 10 subthemes of acute intoxication emerged, encompassing the qualities of the experience, perceptual alterations, and cognitive-affective shifts. The experience was described as having rapid onset and being intense and unique. Participants reported marked changes in auditory, visual, and interoceptive sensory input; losing normal awareness of themselves and their surroundings; and an assortment of delusional phenomena. Additionally, the abuse potential of Salvia divinorum was examined post hoc. These findings are discussed in light of previous research, and provide an initial framework for greater understanding of the subjective effects of Salvia divinorum, an emerging drug of abuse. © The Author(s) 2015.
    Full-text · Article · Feb 2015 · Journal of Psychopharmacology
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    • "According to the Substance Abuse and Mental Health Services Administration (SAMHSA) publication, the 2006 National Survey on Drug Use and Health (NSDUH) database, it is estimated that 1.8 million adolescents or young adults have used S. divinorum in their lifetime and 756,000 people have used S. divinorum in the past year [13]. A previous study, analyzing the 2006e2008 NSDUH public-use data (N ¼ 166,453), indicated that the lifetime prevalence of S. divinorum use has increased by about 83% among individuals aged 12 years or older [14]. In 2010, the National Institute on Drug Abuse (NIDA) investigated 46,482 students in the 8 th , 10 th , and 12 th grades from 396 public and private schools and 5.5% reported having used S. divinorum , which is greater than other recreational drugs, including heroin (0.9%), cocaine (2.9%), LSD (2.6%), methamphetamines (1.5%), ecstasy (4.5%), g-hydroxybutyric acid (GHB) (1.4%), ketamine (1.6%), and oxycodone (5.1%) [15] [16]. "
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