Why the body moves while awareness is elsewhere

On salvia the body can keep moving while the person inside feels absent from it, because salvinorin A disconnects awareness from the senses and the body map without stopping the muscles. Observers in controlled studies saw people talk, laugh, shift and make erratic movements that they did not remember afterwards. That gap between a moving body and an absent mind is the main practical risk, and the reason for a sober sitter.

What observers saw

Three controlled studies rated behaviour from the outside, and they did not see the same thing:

• More movement. In a 30-person study, a researcher rated each session. On an active dose of smoked salvinorin A, participants talked, laughed and moved more often than on a low control dose (Addy, 2012).
• Erratic movement at the top of the range. At Johns Hopkins, monitor ratings of motor activity rose with dose. Two of eight volunteers, at the highest doses, made erratic movements, appeared to have no awareness of the room and had no memory of their behaviour once the effects faded (MacLean et al., 2013).
• Stillness in a quiet setting. In the first four volunteers of the same programme, seated in a reclining chair with eyeshades, participants were "largely behaviorally inactive" despite intense inner experiences (Johnson et al., 2011).

The difference between still and restless seems to depend on dose, person and setting. None of these studies can say in advance which it will be for a given session.

Why the body and awareness come apart

Three findings fit together here, though how they connect in the brain is not proven.

The outside world is gated off. At the highest dose of vaporised salvinorin A, Barcelona volunteers lost contact with external reality while inner visions and sounds increased (Maqueda et al., 2015). A person in that state does not see the table edge or hear a warning.

The body map is scrambled. Volunteers described being pulled, pushed, spun or folded, and at the highest dose a loss of the sense of owning a body (MacLean et al., 2013; Maqueda et al., 2015). Balance and position signals are exactly what someone needs to stand up safely.

Movement continues and is not stored. The memory tests at Johns Hopkins showed dose-related gaps in what was heard at two to six minutes. Movements made in that window can be gone from memory as well, which is why people are sometimes surprised by what the sitter tells them afterwards.

How injuries happen

The UK drug service FRANK notes that most physical harm linked to salvia comes from people injuring themselves while under its influence, and less from the substance itself (FRANK). The combination above explains the pattern: a person who gets up during the first minutes has poor balance, does not perceive obstacles and may not remember why they moved.

Typical risk points follow from that. Standing up in the first minutes. Walking towards stairs, a balcony, a window or a road. A lit pipe or lighter still in hand. Hard furniture edges at head height.

What the sitter does

A sitter is a sober adult who stays in the room for the whole session and does not take anything. The laboratory studies worked the same way: a monitor stayed with the volunteer throughout, and the Johns Hopkins authors recommend psychiatric screening, support and monitoring for any human research with high doses (MacLean et al., 2013).

Before the session:

1. Agree on what the sitter will do: speak, keep a hand nearby, or only watch.
2. Clear the room of hard edges, glass and anything that can fall. Close windows and the door to stairs.
3. Sit low, on a mattress, sofa or floor cushion, so that standing up takes effort and a fall is short.
4. Agree that the sitter takes the pipe and lighter immediately after the inhale.

During the session:

• Note the time. Salvia effects after smoking are usually over within about 20 minutes (FRANK); a clock helps when time feels distorted for the person using.
• Keep the voice calm and short. Many volunteers did not respond during the peak, so silence is not a reason for alarm.
• Guide movement, do not wrestle. Steer someone who gets up back to a seat, away from danger.
• Stay until the person can talk normally and knows where they are.

Call emergency services (112 in the EU, 999 in the UK, 911 in the US) if someone is injured, has trouble breathing, has a seizure, or remains confused well beyond the usual time.

Who should not use salvia

• Anyone under 18.
• Anyone with a personal or family history of psychosis or serious mental health problems. FRANK warns that salvia could trigger psychotic episodes in that group, and the Dutch RIVM lists psychosis among the effects reported (RIVM, 2022).
• Anyone without a sober sitter, and anyone who has to drive or work afterwards on the same day.
• Anyone combining it with alcohol or other drugs.

Read on: out-of-body experiences on salvia, choosing a salvia extract for a stay in the Netherlands.

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