Background and Objective Recreational use of salvia divinorum (salvia), a potent, naturally occurring hallucinogen, is on the rise internationally. Despite the paucity of information about its long‐term health effects, salvia is readily available and generally portrayed as a safe non‐addictive substance.

Methods and Results We report on two patients who presented with an enduring and pervasive pattern of salvia use.

Discussion and Conclusions Evaluating patients for salvia use during clinical assessment is strongly encouraged, especially among young polysubstance users.