Journal of Psychopharmacology 1–10 © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0269881115570081 jop.sagepub.com Introduction Salvia divinorum (SD) is a popular recreational hallucinogen amongst adolescent males. The plant, typically chewed or made into a water infusion, has been used by curanderos in Mexico for physical and spiritual healing for hundreds of years (Jenks et al., 2011). The principal psychoactive component in SD is salvinorin A (SA), a potent and selective non-nitrogenous kappa opioid receptor (KOR) agonist (Roth et al., 2002). Recreational use, in contrast, typically involves smoking an extract of SA, leading to quick onset and short duration of effects. Little is known about the subjective experience of SD inebriation, despite its ongoing recreational use. Several surveys have revealed that nontraditional SD use tends to be sporadic, with most users reporting less than 20 life- time uses (Baggott et al., 2010). Of Americans who had ever used SD as of 2012, only 2% had used in the past month and only 12% in the past year (SAMHSA, 2012). Self-reported reasons for using SD include “curiosity,” “interest in drug-induced states of consciousness,” and “spiritual purposes” (Sumnall et al., 2011). These data suggest few rewarding effects of SD at typical recrea- tional doses. Nevertheless, chronic daily use of a commercial preparation purported to be SD has been reported (Travis et al., 2012). Further, conditioned place preference (Braida et al., 2008) as well as conditioned place aversion (Sufka et al., 2014) have been demonstrated in rats. These conflicting results may be spe- cies and/or dose specific. SD is controlled in 20 US states (Drug Enforcement Administration, 2012) and is listed as a “drug of concern” by the US Drug Enforcement Administration (DEA) (Perron et al., 2012). SD is legally and commercially available in many states and countries, which likely contributes to its popularity (Khey et al., 2008). In 2012, 5.2 million individuals in the US (2% of the population) were estimated to have used SD in their lifetime, with highest use rate among young males (SAMHSA, 2012). 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 The subjective experience of acute, experimentally-induced Salvia divinorum inebriation Peter H Addy 1,2 , Albert Garcia-Romeu 3 , Matthew Metzger 4 and Jenny Wade 5 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. Keywords Consciousness, hallucinogens, neuropharmacology, pharmacology, psychedelics, qualitative research, receptors, opioid, kappa, Salvia divinorum, salvinorin A 1 Medical Informatics, VA Connecticut Healthcare System, West Haven, CT, USA 2 Department of Medical Informatics, Yale University School of Medicine, New Haven, CT, USA 3 Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, MD, USA 4 Goodwill Wellness Center, San Jose, CA, USA 5 Sofia University, Palo Alto, CA, USA Corresponding author: Peter H Addy, Department of Medical Informatics, VA Connecticut Healthcare System, West Haven, CT 06516, USA. Email: peter.h.addy.phd@gmail.com 570081JOP 0 0 10.1177/0269881115570081Journal of PsychopharmacologyAddy et al. research-article 2015 Original Paper by guest on February 18, 2015 jop.sagepub.com Downloaded from