Kava-kava, or simply kava, is a mildly sedative herbal substance derived from the plant of the same name (scientific name: Piper Methysticum). It is a plant native to several islands in the western Pacific, including Vanuatu, Hawaii, Micronesia, Fiji and Samoa. In these island cultures, kava-kava has been used for thousands of years as a ceremonial drink and as a social, relaxing and antidepressant substance.
More recently, extracts of the plant have been imported into Western countries and packaged and sold as a herbal remedy or even as a “legal drug”.
Traditionally, the kava-kava root is crushed and pounded before being mixed with water, filtered and drunk. This preparation is said to cause relaxation, clarity of mind, mild euphoria and greater sociability. It is because of this last effect that some have compared the use of kava-kava to the consumption of alcohol.
These effects are attributed to the chemical substances contained in large quantities in the root of the plant, the kavalactones.
In the West, kava-kava is usually found in pills, capsules and powders that are mixed with water to make a plant-based drink. In the past, it was also found in some soft drinks. Kava-kava has been promoted as a natural solution for stress, anxiety, insomnia and general well-being.
In the 1990s, products containing kava-kava gained popularity in Europe, North America and the rest of the world. At that time, they were regularly available in health food stores, online and elsewhere.
In 2002, kava-kava was removed from the market and banned in many countries after several studies linked it to liver damage and even several deaths from liver failure.
However, the laws regarding its ban remain unclear in many cases, allowing some to continue using it. In the United Kingdom, for example, food and medicinal products containing kava-kava were banned from sale in January 2003 by the Food Standards Agency and the Medicines and Healthcare Products Regulatory Agency. However, possession of the product is not illegal, nor is its sale and importation for uses other than food or medicine.
Some advocates of kava-kava claim that its adverse effects on the liver are due to the fact that Western pharmaceutical companies have used the stem and leaves of the plant in their products while Pacific Islanders traditionally used only the root. However, no study has been sufficiently controlled to prove either hypothesis, so the laws regarding its sale remain largely unchanged.
In its traditional version as a ceremonial drink, kava-kava has different names depending on the islands where it is used, kava being the name given by the inhabitants of Tonga. In Fiji, Hawaii and Samoa, it is called yaqona, awa and ava respectively. In Fiji, it is also called grog.
The scientific name of the plant is Piper Methysticum, which roughly translates to “intoxicating pepper”.
In its westernized form, an herbal remedy, it has been sold under various brands and names (usually including the term kava-kava or kava), as a specific variety (e.g. Kava Melomelo) and as kava-kava root. It has also been sold as a soft drink under the names Lava Cola and Kava Cola.
Specific varieties of kava include Borugu, Sese and Tudei. The latter variety is particularly potent. It is cultivated in Vanuatu and its export from the country is prohibited.
Kava is mainly used as a sedative and, in sufficiently high doses, it causes drowsiness and deep sleep. At lower doses, as is often the case, it is said to promote calm and relaxation. It is also said to relax the muscles.
On the other hand, kava has proven anesthetic properties: during its use, the person can feel a numbness at the level of the stomach or the mouth, which can generate nausea.
In heavy users, kava-kava is known to have a number of visible adverse effects, including dry skin, redness and permanent bloodshot eyes.
According to some researchers in Australia, where kava-kava consumption is particularly problematic among aborigines (who are not traditional users of the drink), the main side effects of long-term use are chest pain, muscle spasms, weight loss and high blood pressure.
However, the most serious known adverse effect is liver damage, which is why it has been banned in many Western countries since 2002. This effect is specific to manufactured products containing the substance and has not been reported by traditional Pacific users.
There have been approximately 70 cases of liver damage worldwide and several deaths due to liver failure associated with this substance. However, further research is needed to determine whether kava is the sole culprit or whether these incidents are due to the inappropriate use of stems and leaves in manufactured products.
The plant called kava-kava (Piper Methysticum), from which the drug is derived, is native to several islands in the western Pacific. These include Vanuatu, Tonga, Papua New Guinea, Hawaii, Fiji, Micronesia and Samoa, which remain the world’s largest producers of the plant. Vanuatu is by far the first and it is estimated that there are more than 80 varieties of the plant. Many varieties, or cultivars, of kava-kava have been produced by selective breeding.
It is believed that the plant has been cultivated, prepared and consumed by these cultures for several thousand years and is deeply rooted in their social and religious practices. Its names vary widely among the languages and societies of the Pacific.
The plant itself is green and leafy and belongs to the pepper family. It can reach up to 3.5 meters in height but is usually smaller, between 1 and 3 meters. Kava-kava is distinguished by its heart-shaped leaves and flowers regularly, but its flowers are usually sterile and the plant needs human intervention to reproduce. To grow new plants, a cutting must be taken from the plant and replanted in moist soil.
Kava-kava can live for several decades but is usually harvested after four years, as it is potent enough to be eaten. However, due to the commercial focus of production for Western markets, the plants are harvested younger and younger.
Traditionally, only the roots of kava are used to prepare the drug called kava-kava, while the stems, leaves and other parts of the plant are discarded. However, some claim that European and North American-based herbal supplement manufacturers have imported and used the stems and leaves in their commercial preparations of the product in pill and powder form. This is believed to be the main cause of toxic reactions that have damaged the livers of some users of these supplements, and thus the reason kava-kava has been banned for human consumption in some countries.
Because kava-kava requires a particular tropical climate and soil type, it is not possible to grow it in other parts of the world. As a result, all commercial producers of kava products depend on the western Pacific islands for their preparation. In the 1990s, production of the plant skyrocketed in many of these islands in response to high demand from industrialized countries. At its peak, an estimated 10,000 hectares of land in the region were used to grow kava-kava. These growers were then severely affected by the ban on the substance in some countries, but commercial production and export continues.
Once the plant is harvested, the bulky roots are removed and the other parts are traditionally discarded. These roots are then chopped, cleaned and crushed to obtain a kind of pulp.
For commercial production, this pulp is then processed into dry powder or frozen for export and further processing.
At its destination, the preparation will be mixed with water and kneaded to release the plant’s active chemicals, the kavalactones.
The ground root powder can be purchased by users and prepared at home as a drink, but it is often already available in pill or food form. Although many countries have banned its sale, kava-kava remains accessible on the Internet and is unregulated in some countries.
In February 2011, scientists from Australia, Germany, and Vanuatu proposed a framework for the “safe” production and use of kava-kava to facilitate the lifting of product restrictions in countries where it is currently banned and to standardize the supply of raw materials. The framework proposed six key points for kava production, including the use of plants that are at least five years old, exclusive use of the plant’s root, recommendations on dosages, a quality process, and extensive human clinical trials and research.
Kava is still produced and consumed in the South Pacific Islands, but its prohibition by countries such as the United Kingdom, Canada and the European Union have limited its worldwide use in herbal medicine. Nonetheless, because the substance is not regulated or illegal like drugs such as cannabis, it can still be purchased by users even in countries where it is banned.
FACTS AND STATISTICS
- Kava-kava is derived from the plant of the same name, which is grown on many islands in the Pacific Ocean.
- In its traditional form, it has been used for ceremonial and social purposes for thousands of years.
- In the 1980s and 1990s, kava-kava gained popularity in Western countries as a botanical ingredient for natural dietary supplements, increasing production and export of the plant and products containing it.
- Kava-kava is said to be a source of relaxation and clarity of mind and, in higher doses, has a powerful sedative effect. This has led to its use to relieve anxiety and stress.
Previously available over the counter in health food stores in many countries, it has been banned from sale in some countries after being associated with liver damage and a number of liver failures. Advocates of the plant say this is because the stems and leaves have been used in manufactured preparations, while traditionally only the root is used.
In the United Kingdom, kava-kava was banned in food by the Food Standards Agency in early 2003, under the Kava Kava in Food Regulations 2002. At the same time, the
- Medicines for Human Use (Kava Kava) Probition Order 2002 banned its sale as a medicine. In Wales, the ban on kava was lifted in 2004 but remains in force in the rest of the UK.
- In Canada, kava-kava products are subject to a Stop Sale Order by Health Canada.
- In the United States, kava-kava is legal and not restricted in any way.
- In Australia, kava is legal but its importation is regulated.
- It is banned in some continental European countries such as France and Holland, but not in others.
- Kava-kava has been used by Pacific Island cultures for about 3000 years.
- Traditionally, kava plants are harvested after four years.
- In Papua New Guinea, the plant has nearly 40 different names and over 30 in Vanuatu.
- The British Food Standards Agency reports that it has recorded 110 cases of severe liver damage, called hepatotoxicity, worldwide that “may” have been caused by kava-kava. 11 of those affected required liver transplants and 9 died.
- Traditional kava drinks contain on average 250mg of active kavalactones, which produce the effects of the substance. In Western herbal remedies, the content of the pills is usually less than 150mg and can go down to 50mg.
- The root of the plant is said to contain 19 different types of kavalactones. Six of them have important effects on the body.
- For drinking preparations, the effects of kava usually appear after half an hour and can last between 2 and 3 hours.
- Travelers over 18 years old are allowed to bring up to 2kg of kava-kava into Australia. It is prohibited to import it commercially without a valid scientific or medical reason.
- Kava is widely used by some of Australia’s aboriginal populations. In the region called Arnhem Land, a study showed that 46% of men used the substance.
- In Hawaii, the commercial production of kava-kava dropped by 58% between 2002 and 2003, following international controversy over the risk of liver damage and the banning of kava products in some countries.
SIGNS OF ADDICTION
Kava-kava is not known to be physically or chemically addictive. In fact, if a regular user stops using it, he or she will not experience withdrawal effects.
However, it is believed that kava-kava may be psychologically and emotionally addictive to users. This is due to its relaxing and sociable effect, which users may constantly want to return to when using the substance. Kava can also become a “support” in situations of stress and anxiety. Like many drugs, excessive use can be harmful to health.
Various symptoms and visible signs have been observed in people who use it regularly and in high doses. One of the most notable signs is dry, flaky skin, which can even appear to peel. In addition, kava users may experience bloodshot eyes and appear emaciated and malnourished. These effects usually disappear after the substance is stopped. It has been suggested that some of these effects may be due to a vitamin deficiency caused by heavy use, but there are few studies in this area.
Yellowing of the skin has also been noted in users who actually suffered from liver damage, possibly due to inappropriate commercial preparations.
Finally, some have speculated that the simultaneous use of substances such as alcohol and prescription drugs may cause a reaction with kava-kava, explaining the adverse effects on the liver.
Since kava-kava is not addictive in the chemical sense of the word, it does not require treatment with specific substitutes or monitoring of recovery. At the time of its mass marketing in Europe and North America before 2003, it was generally considered a “non-addictive” herbal remedy and was even recommended as an alternative to certain addictive drugs such as alcohol.
However, like any substance, the user may well develop an emotional and psychological dependence on kava-kava. However, traditional studies are scarce on this subject and therefore there is no specific treatment method for heavy users. Although the plant and its derivatives have been used by Pacific Island cultures for thousands of years, it is a relatively new substance to Western science and culture.
Individuals who are concerned about losing control over their kava use or behavior, or those who are worried about their family or friends, may wish to consult with detox professionals for general counseling and addiction treatment.
If kava-kava is used for stress, nervous tension, social anxiety or a similar problem (its common use in the West), the solution may be to opt for another method or treatment for the condition. Some people will consult a doctor, who may prescribe medications such as antidepressants, and others may prefer a therapeutic solution that teaches them new management and relaxation strategies that do not involve these substances. Cognitive behavioural therapy (CBT) is an option to consider.
In the case of psychological dependence on a kava drink or other preparation, the person may try to replace the ritual with something else, such as a soothing tea, to recreate the act.
But again, stopping kava-kava after a long period of heavy use is not known to cause any particular withdrawal effects. Regular users can nevertheless develop a psychological dependence, as with other psychoactive and antidepressant substances.
Note that some studies show that kava-kava may be useful for addiction to more serious drugs and to legal substances used regularly, such as alcohol and cigarettes. The effects of kava-kava may alleviate the withdrawal symptoms caused by chemically addictive drugs and the insatiable desire that goes with them. However, research has slowed since kava was banned in several countries and no conclusive results have been published to support its use.
In some Aboriginal communities in Australia, kava-kava was introduced in the 1980s in the hope of calming the destructive alcohol abuse suffered by these impoverished regions. However, it was later discovered that it too had become a source of abuse, leading to a number of health problems.