Between 2006 and 2008, past-year use of Salvia divinorum among US residents aged 12 or older rose from 0.7% to 1.3%, an 83% increase. Users were typically 18–25 years old, male, white or multiracial, and living in large metropolitan areas. Salvia use was especially common among people who also used other drugs: 53.7% of recent users had used LSD, 30.1% ecstasy, 24.2% heroin, 22.4% PCP, and 17.5% cocaine. Polydrug use was the strongest predictor of both recent and former salvia use. An estimated 43% of past-year salvia users had an illicit or nonmedical drug-use disorder, compared with 2.5% of nonusers. Even after adjusting for other drug use, salvia users had higher odds of depression and substance-use disorders.
Salvia divinorum use is most common among young adults aged 18-25 and individuals who engage in risk-taking behaviors such as selling illicit drugs or stealing, as well as those who use other illicit drugs, particularly other hallucinogens or ecstasy. Self-reported depression and anxiety are also associated with salvia use. The findings indicate that salvia use is part of a broader pattern of psychosocial and behavioral problems among youth and young adults. Its accessibility, legal status, and psychoactive effects may pose additional health risks, especially for those with existing substance use problems.
Among American adults who used MDMA in the past year, one in five (20%) reported at least one clinical feature of hallucinogen use disorder, compared with about one in six (16%) of users of other hallucinogens. The prevalence of hallucinogen abuse was 4.9%, subthreshold dependence 11.9%, and dependence 3.6% among MDMA users. Most individuals with hallucinogen abuse also showed subthreshold dependence, and most with dependence exhibited abuse. Subthreshold hallucinogen dependence is relatively common and represents a clinically important group that warrants further research and consideration in diagnostic classification systems.