Hallucinogenic salvia may also have medical use, causing controversy

WASHINGTON - Purple blossoms of midnight salvia and stems of blue chiquita salvia adorn the Jacqueline Kennedy Garden at the White House and thousands of other backyards.

The common garden flowers have a lesser-known hallucinogenic cousin. It's called salvia divinorum, or salvia for short, and it is the subject of controversy over whether it should be classified as an illegal drug. A few state and local governments have made it illegal or restricted its use.

About two miles from the White House garden, at B&K News Stand in the bar-strewn Adams Morgan neighborhood, packets of dried salvia leaves cost from $20 to $40, depending on the amount and potency.

The herb is also legal in Texas and available in El Paso at some local head shops.

Salvia is a genus in the mint family. When salvia is smoked or chewed, the Mexican native herb produces a short but intense psychoactive high, on par with that of synthetic

hallucinogens. Like its cultural cousin, marijuana, salvia may have medical uses.

"There is a lot of promising evidence that some work on this drug could lead to medications for a variety of disorders," said Matthew Johnson, a substance abuse researcher at Johns Hopkins University School of Medicine.

Legislators and Drug Enforcement Administration officials have been reviewing information about salvia and debating whether to regulate it like drugs such as marijuana or LSD. Salvia entered mainstream culture in the last two decades through its widespread availability, media attention and recreational use among young adults.

The DEA recently listed salvia as a drug of concern. In 2007, the DEA, in conjunction with the Department of Health and Human Services, began evaluating the substance for possible placement on the federal controlled substance schedule.

Researchers are afraid that could stunt pharmacological studies, said Naomi Long, the Washington office director of the Drug Policy Alliance Network, which promotes drug policies grounded in science, health and human rights.

"Once it's on a Schedule I list, it'll make it nearly impossible to be researched for medicinal purposes," Long said.

Under the Controlled Substances Act, Schedule I drugs have high potential for abuse, no approved medical use and a lack of accepted safety. The DEA analyzes the drug based on eight factors, outlined in the Controlled Substances Act.

"Until that is complete, we cannot say what schedule it would be in; however, Schedule I is for drugs with no legitimate medical purpose," DEA spokeswoman Barbara Wetherell said. "At this time, it would appear that it doesn't have one."

Salvia and its active constituent, salvinorin A, are not approved for medical use in the U.S. because research on the under-the-radar drug is still in its infancy, Long said.

Based on early research, salvia could help treat Alzheimer's disease, schizophrenia, bipolar disorder, dementia, pain and substance abuse.

Johnson said premature scheduling, similar to marijuana's path, may deter or slow development of medical uses. The DEA does not recognize an approved medical use for marijuana, although 14 states do.

"If we criminalize salvia, and the research ended up being very positive in terms of what disease it could address, then we would have to go through the exact same battle," Long said.

Johnson said researching a scheduled drug is harder because federal resources are limited and more barriers surface.

For, example, the University of Mississippi runs the only government-approved pot farm. Few institutions, including JHU, are granted funds from the U.S. Food and Drug Administration and National Institutes of Health to conduct federal research into controlled substances.

"Pharmaceutical companies are not likely to invest money in a drug or the modification of a drug that is already scheduled," Johnson said.

Toxicity and addiction among users is low, according a report Johnson presented to the Maryland General Assembly.

"The evidence of harm that has come from this drug is very, very, very small," Johnson said. "You compare it to something like alcohol, and there is no comparison in terms of the demonstrated harm that can be caused."

The psychedelic herb impairs motor skills, alters sensory perception and produces unearthly experiences and vivid hallucinations for five to 30 minutes.

Although it causes severe impairment, there is little evidence of public risk, Johnson said.

"This drug is so short acting that there's not much time for someone to cause themselves problems, and that might be why we really haven't seen any emergency department entries regarding this drug," Johnson said.

Despite salvia's buzz in the media and online, it is still relatively unknown compared to other controlled substances. According to the National Survey on Drug Use and Health, an estimated 1.8 million people have used salvia in their lifetimes, 750,000 of them in the last year.

According to the National Forensic Laboratory Information System, seizures grew from one in 2004 to 70 in 2008 at the state and local level. Through June, there were 34.

The Drug Abuse Warning Network, part of HHS, reported no emergency room visits attributable to salvia from 2004 to 2006. Over those three years, DAWN reported 192,000 emergency room visits linked to marijuana use.

Fourteen states regulate salvia and salvinorin A. Proposed legislation in several other states died.

"A lot of states are fearful of contradicting the [federal] government. So far, it's only been a state and local initiative, so if they want to change it, as of now, there would be no federal interference or regulation to bump up against," said Matthew Gever, policy associate for the National Conference of State Legislatures.