Health risks
There are no reports of Salvia divinorum being either physically or psychologically addictive. However, it is not advised to use salvia too often as it may become a habit hard to break. Also the unique experience salvia can give may become more difficult to obtain, when used too often in a short period of time, although there appears no tolerance with salvinorin A.
Salvia does not have any negative side-effects. Only a small number of people report headaches, irritated lungs and insomnia after smoking salvia. These effects are believed to be cause by the combustion products that are inhaled when smoking any plant material, and not so much by salvinorin.
It is nearly impossible to overdose on salvia, when used normally. The lethal dose is not established, but scientists believe it is very high. You are likely to pass out well before you come anywhere near a fatal overdose. Only when using a large dose of pure salvinorin, the risks are a lot higher. This should be avoided.
Combining drugs is usually a bad idea. Although there are no known interactions between drugs or medications and salvia, you should always be very careful, because unexpected effects may occur.
The major health risk when using salvia is that a person might lose awareness and cause physical injury to himself or others. Therefore it is very important to have a sitter present at any time. Read more about this below.
Guidelines
Salvia can produce a very unique, mind-altering experience. Therefore it is extremely important to choose the right time and place before using it. Make sure you are in a safe and private place with people you know well. Choose your dose without underestimating the powerful effects salvia may cause. After taking the salvia, lie down on a couch or bed for the duration of the experience and close your eyes.
If you are new to salvia or if you are taking a high dose, always make sure a sitter is present. There is a risk of a person losing awareness. A sitter should be sober and supportive, and preferably have some experience with salvia. His role is to keep you from hurting yourself or others, without interfering too much in the experience. He should also reassure you when you feel dissociated or disoriented. Finally, a sitter can also helpful in recalling the experience afterwards.
Other risks
Do not use salvia when dangerous objects (knifes etc.) are within easy reach. Do not drive when or directly after taking Salvia divinorum. Use your common sense.
Pregnant or breast-feeding women should not take any substance except on medical advice. We strongly recommend that any woman who could possibly be pregnant NOT use salvia. Salvia should not be given to minors, mentally unstable or violent people.