Certain plants and herbal products, sold as dietary supplements, are emerging as popular drugs for recreational abuse. Like many synthetic drugs, plant and herbal supplements used recreationally can have a spectrum of clinical effects overlapping between euphoric, stimulant, and hallucino- genic experiences. Although some users may abuse a specific substance pri- marily to obtain an analgesic or euphoric effect, other individuals may be in search of the hallucinogenic effects from the same agent. Variations in indi- vidual response to certain drugs exist, and escalating doses may enhance some clinical effects while potentially decreasing others. Although attempts can be made to categorize herbal drugs of abuse based on the most com- monly desired effects, it is clear that some of these substances have a spec- trum of clinical effects and are used for various reasons. With marketing focused at teenagers and young adults, these products are advertised to provide a ‘‘safe, natural high.’’ Like many food supple- ments, however, these substances are largely unregulated and lack safety studies. Unfortunately, safety concerns are not often a deterrent for teen- agers experimenting with an herbal supplement billed as ‘‘all natural’’ and often undetectable in routine urine immunoassays. Laws regarding these herbal supplements and plants vary by country and product, but several of these agents are scheduled substances by the United States DEA. On- line purchasing by way of foreign-based Internet Web sites continues to make these products readily available and affordable. Despite the potential for abuse, addiction, and serious adverse effects, there may be a false percep- tion that these products are all safe, legal, and organic. Often, patients do not consider herbal products as medications or worthy of mention to their caregivers, and many significant herbal–drug interactions exist. It should be expected that many recreational users may avoid reporting misuse even if the dietary supplement is legal. One complementary alternative medicine survey of patients presenting to an urban emergency department reported that only 67% of patients would inform their physician about herbal med- ication use, and 16% believed herbal remedies were all safe [103]. These per- ceptions and the ease of accessibility to herbal products could result in greater potential for recreational abuse and subsequent complications pre- senting to emergency departments. Health care professionals must be cogni- zant of this emerging problem because increased media coverage and Internet marketing have made these products accessible and recognizable to many young adults and teenagers.