An 18-year-old woman was admitted to a psychiatric hospital, after reportedly smoking marijuana, with schizophrenia-type symptoms. She was agitated, disorganized and hallucinating. Several days later, her former boyfriend revealed that she had unknowingly smoked leaves and leaf extracts of Salvia divinorum added to her marijuana joint. The young woman had a long history of cannabis use with no untoward effects, but had never before used salvia. After increasing self-mutilating behavior in the hospital, she was involuntarily admitted to a closed ward. Despite large doses of intravenously and intramuscularly administered anti-psychotic drugs, she remained highly psychotic, with disordered thinking, delusions, and slow speech. A few nights later, she was transferred to an intensive care unit because of "a marked decrease of alertness." She had developed a toxic psychosis with stupor and catatonic excitement. Because the anti-psychotic medications (Zyprexa and Haldol) were having no useful effect, the young woman was given two series of electroconvulsive treatments, but these were discontinued because she had recurrent episodes in which her heart stopped for periods as long as 5 seconds. Her erratic heartbeat required a temporary external cardiac pacemaker.

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I think I needed a sitter, because I got so scared of being alone. I think panic brought me back to a vague, and lucid point of awareness of being in my apartment. Moment’s prior to this, the last thing I remember was feeling a presence outside of the blackness that was closed around me. I felt the presence of people or children of some sort, maybe fairies. As soon as the last layer of void and nothingness was zipped around me and there was no color left, I worried about how I was going to get out. I even wondered if I went insane, or if I had overdosed and died. My body apparently got up off the bed, but I couldn’t feel myself doing it, I was just doing it. I unlocked my door and as soon as I opened it, the light totally brought me back to a point where I knew that I had not died. (Because for a moment, it did feel like an experience of death and a possible rebirth of my soul).

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