Natural Psychedelics _ ________________________________________________________________________
The leaves are the part of the plant used for hallucinogenic purposes. They are chewed and swallowed, chewed and sucked on, brewed into a tea, or smoked. The chemical thought to be responsible for its psychedelic effects is salvinorin A, which is also called divinorin A. Ingestion of this plant is reported to cause auditory, visual, tactile, and kinesthetic hallucinations [29; 99; 100; 101]. Although the growth and use of this plant is prohibited in some countries, it can be grown legally in some parts of the United States. As of 2023, it is considered a drug of concern by the DEA and in Canada. Mechanism of Action Salvinorin A is thought to cause hallucinations through activity at the kappa-opioid receptor. In contrast to many other natural psychedelic chemicals, salvinorin A does not seem to have activity at mu- or delta-opioid receptors, nor have any effect on serotonin, dopamine, or monoamine oxidase [101; 102; 103; 104; 105]. The onset of hallucinogenic effects occurs within 5 to 10 minutes of chewing on the leaves or within 10 seconds of inhaling the leaves. The effects seem to last for about one hour after chewing or about 20 to 45 minutes after inhalation. However, the duration of effect may be dose-dependent [29; 100; 106]. Clinical Effects Despite some interest in the use of salvinorin A for the treatment of depression and substance use disorders, there is no clinical research evaluating either the whole plant or the chemical for this purpose. One small, exploratory study in adults with a history of hallucinogen use shows that inhaling salvinorin A can affect the brain default mode network. This refers to the parts of the brain that are more active during passive tasks, as opposed to tasks that require direct attention. However, research in animals undergoing alcohol withdrawal found no benefit with salvinorin A [106; 107]. To date, it is unclear whether Salvia divinorum or salvinorin A may be beneficial for any therapeutic purposes. Safety Ingestion of Salvia divinorum has been reported to cause headache, restlessness, hyperactivity, disorientation, loss of coordination, dizziness, slurred speech, and fatigue [99; 100; 101; 103; 108]. Some people also report feelings of severe anxiety, fear, and panic with the use of this plant, and it has been associated with reports of both acute and chronic psychotic episodes [101; 108; 109]. Summary Although there is interest in the use of Salvia divinorum for medical purposes, there is no clinical research to support its use for any indication. It should not be recommended for any medical use.
CONCLUSION Although a number of psychedelic plants have a long history of use for various purposes, only some of these substances have been pursued as potential therapeutic agents. Regardless of whether a specific substance has been evaluated for therapeutic use, recreational use persists, and healthcare professionals should have a general understanding for potential risks and benefits. Due to natural variation in chemical concentrations within a given plant, which often depend on time of year, growing conditions, and processing methods, the form of the natural psychedelic will impact its safety and efficacy. When natural psychedelics are studied as therapeutic agents, researchers utilize the purified chemical responsible for the psychedelic effect. The use of whole plants will not necessarily mirror the outcomes reported with purified chemicals in clinical research. In general, natural psychedelics are associated with self-limiting adverse effects, including transient increases in blood pressure and heart rate, headache, mydriasis, sweating, and tremors. Although specific effects vary by chemical and plant, most adverse and hallucinogenic effects resolve within 6 to 12 hours of use. Although most patients report a positive experience, some patients (particularly those with pre-existing psychosis or a risk for psychotic episodes) do report a worsening of mental state and mental health issues after use; patients should be made aware of this risk. Some natural psychedelics can also cause very severe adverse effects. In some cases, they have been associated with reports of death. However, just as anecdotal reports of benefit should be interpreted with caution, case reports connecting serious adverse effects and death to a specific substance must also be interpreted with caution. The true benefits of some of these chemicals remain unclear, even those that have been the subject of higher-quality research, such as psilocybin. Methodological limitations, including inadequate blinding and controlling for response expectancy, continue to hamper the production of high-quality, reproducible research. Additionally, the legal status of many of these substances limits the widespread evaluation of their clinical use. As additional research is published, the place in therapy, if any, for these substances will become clearer. As this research receives attention from media and patients, healthcare professionals should critically evaluate any claims and consider the unique research limitations with these substances.
WORKS CITED https://qr2.mobi/Nat-Psych
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