Many people find that smoking the unprocessed dried Salvia leaf produces only light or unnoticeable effects, perhaps due to the large volume of plant material that must be smoked to produce psychoactive effects. However, responses vary widely. A concentrated preparation of Salvia leaf called Salvia extract, with relative strength suggested by terms such as 5x, 10x, 15x, 20x, may be smoked in place of natural strength leaves; this reduces the total amount of smoke inhaled for a given dosage of salvinorin overall, and facilitates more powerful experiences.
If Salvia is smoked the main effects are experienced quickly. The most intense 'peak' is reached within a minute or so and lasts for about 1-5 minutes, followed by a gradual tapering back. At 5-10 minutes, less intense yet still appreciable effects typically persist, but giving way to a returning sense of the more everyday and familiar until back to recognisable baseline after about 15-20 minutes.

Chewing the leaf makes the effects come on more slowly, over a period of 10-15 minutes, the experience then lasting for about 40-50 minutes.

Many find Salvia useful for meditation. Consciousness is retained until the highest doses, but body control, awareness of the external environment, and individual personality may be affected with even modest amounts. Even those experienced with the use of other psychoactive substances may feel confused and out of control.

At lower doses spontaneous laughter, mild closed-eye visuals, stuttering or strobing visual effects, changes in depth perception, and a heightened sense of color and texture may be experienced.

Moderate doses appear trance-like. Time distortion and open-eye visuals become increasingly apparent. Fractal patterns and geometric shapes may be noticeable with eyes open, and can be confusing. Many people experience sensations of falling, similar to, but more pronounced than what is occasionally felt at the onset of sleep. The user may experience fully formed visions of other places, people, and events, especially with eyes closed.

At high doses the effects become more powerful and may additionally include out-of-body experiences, perceptions of dimensional distortion, vertigo, feelings of intense exhilaration and/or panic, sensations of wind or physical pressure, hearing voices, flanging of sound, significant open and closed-eye visuals, experiencing alternate realities, visiting parallel universes, life changing experiences, contact with beings or entities, dissolution of one's ego, dissociation and loss of speech. Many users report twisting or splitting feelings. Ordinary objects can morph into powerful visually animated creatures. It is also not unusual that, while experiencing the effects, a person will not remember that they have taken Salvia, which can cause the user to panic. A strong feeling of déjà vu is commonly reported as an effect of large doses of Salvia.

After the main intoxication normal awareness of self and the immediate surroundings returns but lingering effects may be felt. These short-term lingering effects have a completely different character than the experience of the main intoxication. About half of users report a pleasing 'afterglow', or pleasant state of mind following the main intoxication. Researchers (Baggot, et al) from the University of San Francisco conducted a survey of 500 Salvia users which identified that they 'sometimes or often' experience the following common (>20% occurrence) effects that linger following the main intoxication:

Increased insight - 47%
Improved mood - 44.8%
Calmness - 42.2%
Increased connection with universe or nature - 39.8%
Weird thoughts - 36.4%
Things seem unreal - 32.4%
Floating feeling - 32%
Increased sweating - 28.2%
Body felt warm or hot - 25.2%
Mind racing - 23.2%
Lightheaded - 22.2%
Increased self-confidence - 21.6%

While 'improved mood' is one of the most commonly noted short-term effects following the primary intoxication, Baggot's Salvia user survey[6] results also found that 25.8% of respondents reported antidepressant-like mood improvements lasting 24 hours or longer. These findings are in-line with known properties of K-Opioid agonists as well as anecdotal reports and findings of clinicians.

Both scientific and anecdotal user evidence indicates that chemical constituents of Salvia may have potential as therapy for drug addictions to dangerous stimulants (e.g., amphetamines) and opiates. Research has shown that the plant contains neoclerodane diterpenes that have therapeutic potential for helping people who have drug abuse problems. The neoclerodane diterpenes in Salvia are k-Opioid agonists. k-Opioid agonists, according to Tidgewell et al, (AAPS Journal), "possess utility in the treatment of opioid dependence and have been shown to have anti-depressant activity as well as block stress-induced behavior responses."

Most users report no hangover or negative after-effects the next day. This is consistent with the apparent low toxicity of Salvia indicated by research conducted at the University of Nebraska.

Some media reports have raised concerns about Salvia flashbacks. These are not usually well substantiated. However, at least one user reported experiencing ongoing negative psychological effects, having three flashback experiences in four months after taking a concentrated form of Salvia (10x extract). - Though the linked account does mention other drug usage in a couple of cases: "During one of them I had smoked absurd amounts of marijuana, and during another I was on shrooms". Salvia flashbacks may be true enough but also ordinarily quite rare phenomena.

Salvia has not been found to be either physically or psychologically addictive. The results of the Baggot survey, which used the standard psychiatric drug dependence diagnostic framework, indicate that Salvia has little if any potential as a drug of dependence. While there are no proven health risks associated with the use of Salvia as a psychoactive drug, medical professionals generally caution against the ingestion of smoke from any substance into the lungs. Salvia's long-term effects on the human body are not well known at this time. Further study of its indigenous use in Mexico and its effect on the health of the Mazatec people who have been using it for centuries would be useful in this regard.