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Sceletium tortuosum was used by South African pastoralists and hunter-gatherers as a mood-altering substance from prehistoric times. The earliest written records of the use of the plant date back to 1662 and the plant was first illustrated in 1685. Sceletium was an item of barter in the time of Jan van Riebeeck, and there is documentation of trade from the Castle in Cape Town, South Africa. The traditionally prepared dried sceletium was often chewed as a quid, and the saliva swallowed, but it has also been made into teas and tinctures. Less commonly, it has been reported that Sceletium used to be inhaled as a snuff, or smoked, usually with the addition of other herbs.
Sceletium elevates mood and decreases anxiety, stress and tension, and it has also been used as an appetite suppressant by shepherds walking long distances in arid areas. In intoxicating doses it can cause euphoria, initially with stimulation and later with sedation. Long-term use in the local context followed by abstinence has not been reported to result in a withdrawal state. The plant is not hallucinogenic, and no severe adverse effects have been documented.
Sceletium tortuosum was used in rural areas in very small doses as a treatment for colic in infants, added to a teaspoon of breast milk, and this use still survives in some local communities.