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Sceletium tortuosum, henceforth ‘Kanna’, is a psychoactive herb native to southern Africa, where it has a long history of use. Kanna is reported to be a mood enhancer, empathogen and to decrease stress and anxiety. Traditionally, Kanna was also used as an appetite suppressant by Shepherds walking long distances. Kanna is reported to have the interesting property of amplifying the effects of other psychoactives when taken in conjunction with them. Kanna is reported to be a potent SSRI  and should therefore not be taken with other SSRIs or MAOIs.
Kanna can be chewed, smoked, insufflated, made into tea, gel caps and tinctures. Some people report difficulties in getting effects from Kanna, or getting effects infrequently or inconsistently. This may be due to physiological differences, quality differences from different vendors or incorrect administration or preparation.
One very noteworthy fact that emerges from reading many reports by people who have tried Kanna through various routes of administration is that people often feel very strongly that a certain route of administration is far superior to other routes, yet people differ in opinion as to what that route is. Some, for example, claim smoking produces the best effects, while others claim insufflation is the best. Equally, others claim that, for example, smoking, produces no effects. This is probably because different routes of administration cause different effects, the judgement of superiority of which will be relative to individual preferences.
Many vendors and users state that fermentation of the Kanna plant is required to maximize its psychoactive effects. There is one scientific study that claims, however, that this may be not be completely accurate  Traditionally, the native peoples of southern Africa fermented Kanna inside animal skins.
In his journal, van der Stel, the second colonial governor of the Dutch Cape colony (1685), described how Kanna was traditionally prepared:
'They chew mostly a certain plant which they call Canna and which they bruise, roots as well as the stem, between the stones and store and preserve in sewn-up sheepskins. When we came to the Coperbergh in October, it was being gathered from the surrounding hills by everybody (to serve as a supply for the whole year).
And Thunberg in 1774:
'The Hottentots come far and near to fetch this shrub with the root, leaves and all, which they beat together, and afterwards twist them up like pig-tail tobacco; after which they let the mass ferment and keep it by them for chewing, especially when they are thirsty 
Step 1: Bruise (crush) the plant material, including stems and roots, with fingers or cut lightly with scissors/knife. This will encourage the fermentation process to begin and will help neutralize the plants oxalic acid.
The process of bruising will also change the alkaloid makeup and concentrations of the Kanna. Research indicates that Kanna processed in this way and then oven dried had a significantly different alkaloid makeup than Kanna which was oven dried without bruising.
Step 2: Put the bruised Kanna in a sealed container like a glass jar. The Kanna must now be left to ferment. After a day, the material will liquefy and turn dark green/brown. Vent off gas which is produced.
Step 3: After 5-8 days, pour the contents of the jar into a shallow container like a glass dish and let it dry in the sun. This may take a few days.
Step 4: Finish off the drying process in an oven at 90-100 degrees Celsius if not quite dry (this will also get rid of any bacteria or fungi).
For chewing or making tea, the dried product can be left un-powdered. For smoking, a rough grind is optimal (use a coffee grinder). For insufflations, a very fine grind is necessary.
100g fresh material will yield approximately 3.7g of dried finished product.
It should be noted that the dosages recommended here are for single use. Dosage when using Kanna daily as an SSRI is 25-100mg, usually 50mg. Also, caution (in the form of starting with low dosage) should be practiced for first time use as some are oversensitive to Kanna and anxiety and vomiting can occur when taken in the strong-heavy range.
The following passages report how Kanna was traditionally chewed by the native tribes:
If chewed immediately after fermentation, it intoxicates. The word kon, is said to signify the quid; the colonists call it Canna-root... The Hottentots, who live near this spot, hawke it about, frequently to a great distance, and exchange it for cattle and other commodities.' (written 1794)
They chew its stem as well as the roots, mostly all day, and become intoxicated by it, so that on account of this effect and its fragrance and hearty taste one can expect some profit from its cultivation' (1685) 
Sublingual/Chewing route specific effects: general intoxication, euphoria
Many report insufflation to cause pain/discomfort, nasal blockage, itchiness and bleeding if repeated.
Insufflation route specific effects: Euphoria is much more pronounced with insufflation, and analgesic effects less so.
Dry powdered or non-powdered Kanna plant matter can be smoked. The smoke is described as sweet tasting and not feeling harsh on the lungs or throat.
Smoking route specific effects: The come up, which hits within seconds to a minute, may be characterised by head rushes and slight jitteriness or 'butterflies in the stomach' which dissipates within minutes, giving way to a relaxed spacey feeling. Some experience a mood crash after smoking Kanna on its own (this mood crash is not an occurrence when Kanna is combined with cannabis). Euphoria is more pronounced with smoking and the analgesic effects less so.
The Kanna plant matter can be eaten or made into a tea which reportedly tastes like green tea but worse.
Oral ingestion dosage:
Oral Route specific effects: Narcotic sedative and analgesic properties more pronounced, especially at higher doses.
This route of administration is reported to be the best for combining with alcohol which reportedly synergies with alcohols euphoria, sociability and energy increases.
Sense of well-being
Few people report side effects. They are more common and stronger at higher doses and include:
Many report that Kanna has interesting synergistic properties when combined with other psychoactives.
Taking Kanna, especially the oral route, synergies the euphoria, sociability and energy aspects of alcohol.
Sceletium tortuosum was traditionally used by shepards as an appetite suppressant when on long trips through the desert
U.S. Patent 6288104 claims "A method of treating a patient suffering from a disease, said method comprising administering to said patient a composition comprising a plant material or an extract of a plant of the family Mesembryanthemaceae containing in each unit dose an amount of from 20 micrograms to 2 milligrams of a compound selected from the group consisting of mesembrine, mesembranol and mesembranone, or a mixture of two or more thereof wherein said disease is selected from the group consisting of mild to moderate depression, psychological and psychiatric disorders where anxiety is present, major depressive episodes, alcohol and drug dependence, bulimia nervosa, and obsessive-compulsive disorders. Each unit dose contains an amount of from 50 micrograms to 500 micrograms of the compound.
Kanna is an SSRI. It should not be combined with other SSRI's (Seroxat, Prozac) or Mono Oxidase Inhibitors (MAO-I), such as Syrian Rue (Peganum harmala), Banisteriopsis Caapi, Passionflower (Passiflora incarnata), Yohimbe, and certain anti-depressants.
In case of an overdose, nausea and headaches can occur and usually pass rapidly. A large overdose can result in rapid heartbeat, anxiety and elevated blood pressure. Unless these symptoms could complicate pre-existing medical conditions, there is not a health risk.
Kanna (Sceletium tortuosum) is uncontrolled in most if not all countries. This means all parts of the plant and its extracts are legal to cultivate, buy, possess, and distribute (sell, trade or give) without a license or prescription.
Individual countries will have separate policies regarding sale as supplement or drug.
The Sceletium species are native to South Africa, and the existing records of their use, which go back as far as the 17th century, predominantly refer to Khoikhoi and San nomadic groups who inhabited the Namaqualand and Little Karoo areas, two localities where Sceletium species are known to thrive. The earliest records  tell of how van Riebeeck bartered with locals for sheep and ‘kanna’, which appears to have been firmly ingrained in the culture of the tribes for its psychoactive properties and as a bartering currency. In 1685, Simon van der Stel, the second colonial governor of the Dutch Cape colony, wrote as a caption to a drawing of Sceletium tortuosum:
'This plant is found with the Namaquaas and then only on some of their mountains... It is held by them and surrounding tribes in as great esteem as the betel or areca with the Indians. They chew its stem as well as the roots, mostly all day, and become intoxicated by it, so that on account of this effect and its fragrance and hearty taste one can expect some profit from its cultivation'
The Khoikhoi and the San were distinct groups. The KhoiKhoi were nomadic herders who lived in an exogamous clan system with large herds of cattle and sheep, professed themselves as ‘Khoi-na’, or ‘real people’ and did so to distinguish themselves from the San; a smaller group of cattle-less hunter gatherers who lived off the veld. The Sceletium species was used by both groups.
European settlers, whose subsequent colonial expansion were to ultimately destroy the social organisation of the Khoikhoi, prized the ginseng-like herb. . Kolben (who wrote an account of the Khoikhoi people in the early 18th century) noted that the scarce root was 'the greatest Cheerer of the Spirits, and the noblest Restorative in the World'. He indicates some uncertainty about the plant, but cites a Father Tachart's commentary: 'tis something like the 'European Mandragora', but much less ... it resembles the 'Mandragora' pretty nearly in its effects too'. 
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