Kava
   HOME

TheInfoList



OR:

Kava or kava kava (''Piper methysticum'':
Latin Latin ( or ) is a classical language belonging to the Italic languages, Italic branch of the Indo-European languages. Latin was originally spoken by the Latins (Italic tribe), Latins in Latium (now known as Lazio), the lower Tiber area aroun ...
'pepper' and Latinized Greek 'intoxicating') is a plant in the pepper family, native to the
Pacific Islands The Pacific islands are a group of islands in the Pacific Ocean. They are further categorized into three major island groups: Melanesia, Micronesia, and Polynesia. Depending on the context, the term ''Pacific Islands'' may refer to one of several ...
. The name ''kava'' is from Tongan and Marquesan, meaning 'bitter'. Kava can refer to either the plant or a psychoactive beverage made from its
root In vascular plants, the roots are the plant organ, organs of a plant that are modified to provide anchorage for the plant and take in water and nutrients into the plant body, which allows plants to grow taller and faster. They are most often bel ...
. The beverage is a traditional ceremonial and recreational drink from
Polynesia Polynesia ( , ) is a subregion of Oceania, made up of more than 1,000 islands scattered over the central and southern Pacific Ocean. The indigenous people who inhabit the islands of Polynesia are called Polynesians. They have many things in ...
,
Micronesia Micronesia (, ) is a subregion of Oceania, consisting of approximately 2,000 small islands in the Northwestern Pacific Ocean. It has a close shared cultural history with three other island regions: Maritime Southeast Asia to the west, Poly ...
, and
Melanesia Melanesia (, ) is a subregion of Oceania in the southwestern Pacific Ocean. It extends from New Guinea in the west to the Fiji Islands in the east, and includes the Arafura Sea. The region includes the four independent countries of Fiji, Vanu ...
. Nakamals and kava bars exist in many countries. Traditional kava is made by grinding fresh or dried kava root, mixing it with water or coconut milk, and straining it into a communal bowl. Outside the South Pacific, kava is typically prepared by soaking dried root powder in water and straining it. It is consumed socially for its
sedative A sedative or tranquilliser is a substance that induces sedation by reducing irritability or Psychomotor agitation, excitement. They are central nervous system (CNS) Depressant, depressants and interact with brain activity, causing its decelera ...
, hypnotic, muscle relaxant, anxiolytic, and euphoric effects, comparable to those produced by
alcohol Alcohol may refer to: Common uses * Alcohol (chemistry), a class of compounds * Ethanol, one of several alcohols, commonly known as alcohol in everyday life ** Alcohol (drug), intoxicant found in alcoholic beverages ** Alcoholic beverage, an alco ...
. Kava also produces a numbing sensation in the mouth. Kava consists of sterile cultivars clonally propagated from its wild ancestor, ''Piper wichmanii''. It originated in northern Vanuatu, where it was domesticated by farmers around 3,000 years ago through selective cultivation. Historically, the beverage was made from fresh kava; preparation from dry kava emerged in response to the efforts of
Christian A Christian () is a person who follows or adheres to Christianity, a Monotheism, monotheistic Abrahamic religion based on the life and teachings of Jesus in Christianity, Jesus Christ. Christians form the largest religious community in the wo ...
missionaries in the 18th and 19th centuries to prohibit the drinking of kava. According to ''
in vitro ''In vitro'' (meaning ''in glass'', or ''in the glass'') Research, studies are performed with Cell (biology), cells or biological molecules outside their normal biological context. Colloquially called "test-tube experiments", these studies in ...
'' research, the pharmacological effects of kava stem primarily from six major
kavalactone Kavalactones are a class of lactone compounds found in kava roots and ''Alpinia zerumbet'' (shell ginger) and in several Gymnopilus, Phellinus and Inonotus fungi. Some kavalactones are bioactive. They are responsible for the psychoactive, analges ...
s that modulate GABAA,
dopamine Dopamine (DA, a contraction of 3,4-dihydroxyphenethylamine) is a neuromodulatory molecule that plays several important roles in cells. It is an organic chemical of the catecholamine and phenethylamine families. It is an amine synthesized ...
,
norepinephrine Norepinephrine (NE), also called noradrenaline (NA) or noradrenalin, is an organic compound, organic chemical in the catecholamine family that functions in the brain and human body, body as a hormone, neurotransmitter and neuromodulator. The ...
, and CB1 receptors, and inhibit MAO-B and
ion channel Ion channels are pore-forming membrane proteins that allow ions to pass through the channel pore. Their functions include establishing a resting membrane potential, shaping action potentials and other electrical signals by Gating (electrophysiol ...
mechanisms. Reviews of research have indicated an effect of kava on
anxiety Anxiety is an emotion characterised by an unpleasant state of inner wikt:turmoil, turmoil and includes feelings of dread over Anticipation, anticipated events. Anxiety is different from fear in that fear is defined as the emotional response ...
, but its specific efficacy for
generalized anxiety disorder Generalized anxiety disorder (GAD) is an anxiety disorder characterized by excessive, uncontrollable and often irrational worry about events or activities. Worry often interferes with daily functioning. Individuals with GAD are often overly con ...
remains inconclusive. There appears to be no significant cognitive impairment from consumption. Kava does not exhibit the addictive properties associated with many other substances of abuse. Moderate consumption of kava in its traditional form, as a water-based suspension of kava roots, is considered by the
World Health Organization The World Health Organization (WHO) is a list of specialized agencies of the United Nations, specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Gen ...
to present an "acceptably low level of health risk." However, consumption of kava
extract An extract (essence) is a substance made by extracting a part of a raw material, often by using a solvent such as ethanol, oil or water. Extracts may be sold as tinctures or absolutes or dried and powdered. The aromatic principles of ma ...
s produced with organic solvents or excessive amounts of low-quality kava products may be linked to an increased risk of adverse health outcomes, including liver injury.


History and common names

Kava is conspecific with ''Piper wichmannii,'' indicating kava was domesticated from ''Piper wichmannii'' (syn. ''Piper subbullatum''). Kava was spread by the Austronesian
Lapita culture The Lapita culture is the name given to a Neolithic Austronesian peoples, Austronesian people and their distinct material culture, who settled Island Melanesia via a seaborne migration at around 1600 to 500 BCE. The Lapita people are believed t ...
after contact eastward into the rest of Polynesia. It is endemic to
Oceania Oceania ( , ) is a region, geographical region including Australasia, Melanesia, Micronesia, and Polynesia. Outside of the English-speaking world, Oceania is generally considered a continent, while Mainland Australia is regarded as its co ...
and is not found in other Austronesian groups. Kava reached
Hawaii Hawaii ( ; ) is an island U.S. state, state of the United States, in the Pacific Ocean about southwest of the U.S. mainland. One of the two Non-contiguous United States, non-contiguous U.S. states (along with Alaska), it is the only sta ...
, but it is absent in
New Zealand New Zealand () is an island country in the southwestern Pacific Ocean. It consists of two main landmasses—the North Island () and the South Island ()—and List of islands of New Zealand, over 600 smaller islands. It is the List of isla ...
, where it cannot grow. Consumption of kava is also believed to be the reason why betel nut chewing, ubiquitous elsewhere, was lost for Austronesians in Oceania. According to Lynch (2002), the reconstructed Proto-Polynesian term for the plant, ''*kava'', was derived from the Proto-Oceanic term ''*kawaR'' in the sense of a "bitter root" or "potent root sed as fish poison. It may have been related to reconstructed ''*wakaR'' (in Proto-Oceanic and Proto-Malayo-Polynesian) via metathesis. It originally referred to '' Zingiber zerumbet'', used to make a similar mildly psychoactive bitter drink in Austronesian rituals. Cognates for ''*kava'' include Pohnpeian ''sa-kau''; Tongan, Niue, Rapa Nui, Tuamotuan, and Rarotongan ''kava''; Samoan, Tahitian, and Marquesan ''ava''; and Hawaiian ''awa''. In some languages, most notably Māori ''kawa'', the cognates have come to mean "bitter", "sour", or "acrid" to the taste. In the
Cook Islands The Cook Islands is an island country in Polynesia, part of Oceania in the South Pacific Ocean. It consists of 15 islands whose total land area is approximately . The Cook Islands' Exclusive Economic Zone (EEZ) covers of ocean. Avarua is its ...
, the reduplicated forms of ''kawakawa'' or ''kavakava'' are also applied to the unrelated members of the genus ''
Pittosporum ''Pittosporum'' ( or The first pronunciation is that expected for traditional English pronunciation of Latin, Anglo-Latin; the second is common in nurseries. ''Sunset Western Garden Book,'' 1995:606–607) is a genus of about 250 species of flow ...
''. In other languages, such as Futunan, compound terms like ''kavakava atua'' refer to other species belonging to the genus '' Piper''. The
reduplication In linguistics, reduplication is a Morphology (linguistics), morphological process in which the Root (linguistics), root or Stem (linguistics), stem of a word, part of that, or the whole word is repeated exactly or with a slight change. The cla ...
of the base form is indicative of falsehood or likeness, in the sense of "false kava". In New Zealand, it was applied to the kawakawa ('' Piper excelsum''), which is
endemic Endemism is the state of a species being found only in a single defined geographic location, such as an island, state, nation, country or other defined zone; organisms that are indigenous to a place are not endemic to it if they are also foun ...
to New Zealand and nearby
Norfolk Island Norfolk Island ( , ; ) is an States and territories of Australia, external territory of Australia located in the Pacific Ocean between New Zealand and New Caledonia, directly east of Australia's Evans Head, New South Wales, Evans Head and a ...
and
Lord Howe Island Lord Howe Island (; formerly Lord Howe's Island) is an irregularly crescent-shaped volcanic remnant in the Tasman Sea between Australia and New Zealand, part of the Australian state of New South Wales. It lies directly east of mainland Port ...
. It was exploited by the Māori based on previous knowledge of the kava, as the latter could not survive in the colder climates of New Zealand. The Māori name for the plant, ''kawakawa'', is derived from the same etymon as kava, but reduplicated. It is a sacred tree among the Māori people. It is seen as a symbol of death, corresponding to the rangiora ('' Brachyglottis repanda''), which is the symbol of life. However, ''kawakawa'' has no psychoactive properties. Its connection to kava is linked to its similarity in appearance and bitter taste. Other names for kava include ''ʻawa'' (Hawaii), ''ʻava'' (
Samoa Samoa, officially the Independent State of Samoa and known until 1997 as Western Samoa, is an island country in Polynesia, part of Oceania, in the South Pacific Ocean. It consists of two main islands (Savai'i and Upolu), two smaller, inhabited ...
), ''yaqona'' or ''yagona'' (
Fiji Fiji, officially the Republic of Fiji, is an island country in Melanesia, part of Oceania in the South Pacific Ocean. It lies about north-northeast of New Zealand. Fiji consists of an archipelago of more than 330 islands—of which about ...
), ''sakau'' ( Pohnpei), ''seka'' (
Kosrae Kosrae ( ), formerly known as Kusaie or Strong's Island, is an island in the Caroline Islands archipelago, and States of Micronesia, state within the Federated States of Micronesia. It includes the main island of Kosrae, traditionally known as Ual ...
), and ''malok'' or ''malogu'' (parts of
Vanuatu Vanuatu ( or ; ), officially the Republic of Vanuatu (; ), is an island country in Melanesia located in the South Pacific Ocean. The archipelago, which is of volcanic origin, is east of northern Australia, northeast of New Caledonia, east o ...
).


Characteristics

Kava was historically grown only in the Pacific islands of Hawaii,
Federated States of Micronesia The Federated States of Micronesia (, abbreviated FSM), or simply Micronesia, is an island country in Micronesia, a region of Oceania. The federation encompasses the majority of the Caroline Islands (excluding Palau) and consists of four Admin ...
, Vanuatu, Fiji, the Samoas, and Tonga. It appears to have originated in Vanuatu; an
inventory Inventory (British English) or stock (American English) is a quantity of the goods and materials that a business holds for the ultimate goal of resale, production or utilisation. Inventory management is a discipline primarily about specifying ...
of ''P. methysticum'' distribution showed it was cultivated on numerous islands of
Micronesia Micronesia (, ) is a subregion of Oceania, consisting of approximately 2,000 small islands in the Northwestern Pacific Ocean. It has a close shared cultural history with three other island regions: Maritime Southeast Asia to the west, Poly ...
,
Melanesia Melanesia (, ) is a subregion of Oceania in the southwestern Pacific Ocean. It extends from New Guinea in the west to the Fiji Islands in the east, and includes the Arafura Sea. The region includes the four independent countries of Fiji, Vanu ...
, Polynesia, and Hawaii, whereas specimens of ''P. wichmannii'' were all from
Papua New Guinea Papua New Guinea, officially the Independent State of Papua New Guinea, is an island country in Oceania that comprises the eastern half of the island of New Guinea and offshore islands in Melanesia, a region of the southwestern Pacific Ocean n ...
, the
Solomon Islands Solomon Islands, also known simply as the Solomons,John Prados, ''Islands of Destiny'', Dutton Caliber, 2012, p,20 and passim is an island country consisting of six major islands and over 1000 smaller islands in Melanesia, part of Oceania, t ...
, and Vanuatu. Traditionally, plants are harvested around four years of age, as older plants have higher concentrations of kavalactones. After reaching about in height, plants grow a wider stalk and additional stalks, but not much taller. The roots can reach a depth of .


Cultivars

Kava consists of sterile cultivars cloned from its wild ancestor, ''Piper wichmanii''. Today it comprises hundreds of different cultivars grown across the Pacific. Each cultivar has not only different requirements for successful cultivation, but also displays unique characteristics both in terms of its appearance and its psychoactive properties.


Noble and non-noble kava

Scholars make a distinction between the so-called noble and non-noble kava. The latter category comprises the so-called tudei (or "two-day") kavas, medicinal kavas, and wild kava (''Piper wichmanii'', the ancestor of domesticated ''Piper methysticum''). Traditionally, only noble kavas have been used for regular consumption, due to their more favourable composition of kavalactones and other compounds that produce more pleasant effects and have lower potential for causing negative side effects, such as nausea, or "kava hangover". The perceived benefits of noble cultivars explain why only these cultivars were spread around the Pacific by Polynesian and Melanesian migrants, with presence of non-noble cultivars limited to the islands of Vanuatu, from which they originated. More recently, it has been suggested that the widespread use of tudei cultivars in the manufacturing of several kava products might have been the key factor contributing to the rare reports of adverse reactions to kava observed among the consumers of kava-based products in Europe. Tudei varieties have traditionally not been grown in Hawaii and Fiji, but in recent years there have been reports of farmers attempting to grow "isa" or "palisi" non-noble cultivars in Hawaii, and of imports of dried tudei kava into Fiji for further re-exporting. The tudei cultivars may be easier and cheaper to grow: while it takes up to 5 years for noble kava to mature, non-noble varieties can often be harvested just one year after being planted. The concerns about the adverse effects of non-noble varieties, produced by their undesirable composition of kavalactones and high concentrations of potentially harmful compounds ( flavokavains, which are not present in any significant concentration in the noble varieties), have led to legislation prohibiting exports from countries such as Vanuatu. Likewise, efforts have been made to educate non-traditional customers about the difference between noble and non-noble varieties and that non-noble varieties do not offer the same results as noble cultivars. In recent years, government regulatory bodies and non-profit NGOs have been set up with the declared aim of monitoring kava quality; producing regular reports; certifying vendors selling proper, noble kava; and warning customers against products that may contain tudei varieties.


Growing regions

In Vanuatu, exportation of kava is strictly regulated. Only cultivars classified as noble are allowed to be exported. Only the most desirable cultivars for everyday drinking are classified as noble to maintain quality control. In addition, their laws mandate that exported kava must be at least five years old and farmed organically. Their most common noble cultivars are "Borogu" or "Borongoru" from Pentecost Island, "Melomelo" from Aoba Island (called ''Sese'' in the north Pentecost Island), and "Palarasul" kava from Espiritu Santo. In Vanuatu, Tudei ("two-day") kava is reserved for special ceremonial occasions and exporting it is not allowed. "Palisi" is a common Tudei variety. In Hawaii, there are many other cultivars of kava (). Some of the most common cultivars are ''Mahakea'', ''Moʻi'', ''Hiwa'', and ''Nene''. The '' Aliʻi'' (kings) of precolonial Hawaii coveted the ''Moʻi'' variety, which had a strong cerebral effect due to a predominant amount of the kavalactone kavain. This sacred variety was so important to them that no one but royalty could ever experience it, "lest they suffer an untimely death". The reverence for Hiwa in old Hawaiʻi is evident in this portion of a chant recorded by Nathaniel Bright Emerson and quoted by E. S. Craighill and Elizabeth Green Handy: "This refers to the cup of sacramental ʻawa brewed from the strong, black ʻawa root (ʻawa hiwa), which was drunk sacramentally by the kumu hula": Winter describes a
hula Hula () is a Hawaiian dance form expressing chant (''oli'') or song (Mele (Hawaiian language), ''mele''). It was developed in the Hawaiian Islands by the Native Hawaiians who settled there. The hula dramatizes or portrays the words of the oli ...
prayer for inspiration that contains the line, ''He ʻike pū ʻawa hiwa.'' Pukui and Elbert translated this as "a knowledge from kava offerings". Winter explains that ʻawa, especially of the Hiwa variety, was offered to hula deities in return for knowledge and inspiration. More recently, specialized kava varieties have been introduced to
South Florida South Florida, sometimes colloquially shortened to SoFlo, is the Regions of the United States#Florida, southernmost region of the U.S. state of Florida. It is one of Florida's three most commonly referred to directional regions; the two others are ...
which have been acclimated and adapted to grow well in South Florida's unique soil and climate and have significant resistance to pest and disease pressures. As of 2024, cultivation of these varieties is limited to a small number of commercial farms and backyard growers.


Relationship with kawakawa

The Kawakawa (''Piper excelsum'') plant, known also as "Māori kava", may be confused with kava. While the two plants look similar and have similar names, they are different, but related, species. Kawakawa is a small tree endemic to New Zealand, having importance to traditional medicine and
Māori culture Māori culture () is the customs, cultural practices, and beliefs of the Māori people of New Zealand. It originated from, and is still part of, Polynesians, Eastern Polynesian culture. Māori culture forms a distinctive part of Culture of New ...
. As noted by the Kava Society of New Zealand, "in all likelihood, the kava plant was known to the first settlers of Aotearoa ew Zealand It is also possible that (just like the Polynesian migrants that settled in Hawaii) the Maori explorers brought some kava with them. Unfortunately, most of New Zealand is simply too cold for growing kava and hence the Maori settlers lost their connection to the sacred plant." Further, "in New Zealand, where the climate is too cold for kava, the Maori gave the name kawa-kawa to another ''Piperaceae M. excelsum'', in memory of the kava plants they undoubtedly brought with them and unsuccessfully attempted to cultivate. The Maori word kawa also means "ceremonial protocol", recalling the stylized consumption of the drug typical of Polynesian societies". Kawakawa is commonly used in Maori traditional medicine for the treatment of skin infections, wounds, and cuts, and (when prepared as a tea) for stomach upsets and other minor illnesses.


Composition

Fresh kava root contains on average 80%
water Water is an inorganic compound with the chemical formula . It is a transparent, tasteless, odorless, and Color of water, nearly colorless chemical substance. It is the main constituent of Earth's hydrosphere and the fluids of all known liv ...
. Dried root contains approximately 43%
starch Starch or amylum is a polymeric carbohydrate consisting of numerous glucose units joined by glycosidic bonds. This polysaccharide is produced by most green plants for energy storage. Worldwide, it is the most common carbohydrate in human diet ...
, 20%
dietary fiber Dietary fiber (fibre in English in the Commonwealth of Nations, Commonwealth English) or roughage is the portion of plant-derived food that cannot be completely broken down by human digestive enzymes. Dietary fibers are diverse in chemical co ...
, 15% kavalactones, 12% water, 3.2%
sugar Sugar is the generic name for sweet-tasting, soluble carbohydrates, many of which are used in food. Simple sugars, also called monosaccharides, include glucose Glucose is a sugar with the Chemical formula#Molecular formula, molecul ...
s, 3.6%
protein Proteins are large biomolecules and macromolecules that comprise one or more long chains of amino acid residue (biochemistry), residues. Proteins perform a vast array of functions within organisms, including Enzyme catalysis, catalysing metab ...
, and 3.2% minerals. In general, kavalactone content is greatest in the roots and decreases higher up the plant into the stems and leaves. Relative concentrations of 15%, 10%, and 5% have been observed in the root, stump, and basal stems, respectively. The relative content of kavalactones depends not only on plant segment but also on the kava plant variety, plant maturity, geographic location, and time of harvest. The kavalactones present are kavain, desmethoxyyangonin, and yangonin, which are higher in the roots than in the stems and leaves, with dihydrokavain, methysticin, and dihydromethysticin also present. The mature roots of the kava plant are harvested after a minimum of four years (at least five years, ideally) for peak kavalactone content. Most kava plants produce around of root when they are harvested. Kava root is classified into two categories: crown root (or chips) and lateral root. Crown roots are the large-diameter pieces that look like -diameter wooden poker chips. Most kava plants consist of approximately 80% crown root upon harvesting. Lateral roots are smaller-diameter roots that look more like a typical root. A mature kava plant is about 20% lateral roots. Kava lateral roots have the highest content of kavalactones in the kava plant. "Waka" grade kava is made of lateral roots only.


Pharmacology


Constituents

A total of 18 different kavalactones (or kavapyrones) have been identified to date, at least 15 of which are active. However, six of them, including kavain, dihydrokavain, methysticin, dihydromethysticin, yangonin, and desmethoxyyangonin, have been determined to be responsible for about 96% of the plant's pharmacological activity. Some minor constituents, including three chalcones flavokavain A, flavokavain B, and flavokavain Chave also been identified, as well as a toxic alkaloid (not present in the consumable parts of the plant), pipermethystine.
Alkaloid Alkaloids are a broad class of natural product, naturally occurring organic compounds that contain at least one nitrogen atom. Some synthetic compounds of similar structure may also be termed alkaloids. Alkaloids are produced by a large varie ...
s are present in the roots and leaves.


Pharmacodynamics

The following pharmacological actions have been reported for kava and/or its major active constituents: * Potentiation of GABAA receptor activity (by kavain, dihydrokavain, methysticin, dihydromethysticin, and yangonin). * Inhibition of the reuptake of
norepinephrine Norepinephrine (NE), also called noradrenaline (NA) or noradrenalin, is an organic compound, organic chemical in the catecholamine family that functions in the brain and human body, body as a hormone, neurotransmitter and neuromodulator. The ...
(by kavain and methysticin) and possibly also of
dopamine Dopamine (DA, a contraction of 3,4-dihydroxyphenethylamine) is a neuromodulatory molecule that plays several important roles in cells. It is an organic chemical of the catecholamine and phenethylamine families. It is an amine synthesized ...
(by kavain and desmethoxyyangonin). * Binding to the CB1 receptor (by yangonin). * Inhibition of voltage-gated sodium channels and voltage-gated calcium channels (by kavain and methysticin). * Monoamine oxidase B reversible inhibition (by all six of the major kavalactones). Methanolic leaf extracts of Hawaiian kava cultivars showed stronger binding inhibition to several CNS receptors—including GABAA, dopamine D2, opioid ( μ, δ), and histamine (H1, H2)—than root extracts, suggesting that compounds beyond the main kavalactones may contribute to the pharmacological effects of kava leaves.


Detection

Recent usage of kava has been documented in forensic investigations by quantitation of kavain in blood specimens. The principal urinary metabolite, conjugated 4'-OH-kavain, is generally detectable for up to 48 hours.


Pharmacokinetics

Kavalactones are quickly absorbed in the gut and vary in bioavailability. They primarily act on brain areas like the limbic system,
amygdala The amygdala (; : amygdalae or amygdalas; also '; Latin from Greek language, Greek, , ', 'almond', 'tonsil') is a paired nucleus (neuroanatomy), nuclear complex present in the Cerebral hemisphere, cerebral hemispheres of vertebrates. It is c ...
, and reticular formation, but their exact molecular mechanisms are not yet fully understood. Data on the pharmacokinetics of kavalactones remain limited. In animal studies, particularly in rats, kavain—the primary kavalactone found in traditional kava preparations—was shown to be well absorbed, with an estimated bioavailability of approximately 50%. In humans, kavain undergoes extensive hepatic metabolism, primarily via
cytochrome P450 Cytochromes P450 (P450s or CYPs) are a Protein superfamily, superfamily of enzymes containing heme as a cofactor (biochemistry), cofactor that mostly, but not exclusively, function as monooxygenases. However, they are not omnipresent; for examp ...
(CYP) enzyme-mediated pathways, followed by further phase II biotransformation processes such as sulfonation, glucuronidation, and glutathione (GSH) conjugation. In rats administered a 100 mg/kg bodyweight dose of kavain, over 90% was eliminated within 72 hours through
urine Urine is a liquid by-product of metabolism in humans and many other animals. In placental mammals, urine flows from the Kidney (vertebrates), kidneys through the ureters to the urinary bladder and exits the urethra through the penile meatus (mal ...
and
feces Feces (also known as faeces American and British English spelling differences#ae and oe, or fæces; : faex) are the solid or semi-solid remains of food that was not digested in the small intestine, and has been broken down by bacteria in the ...
, either as unchanged compound or as metabolites. No evidence of
bioaccumulation Bioaccumulation is the gradual accumulation of substances, such as pesticides or other chemicals, in an organism. Bioaccumulation occurs when an organism absorbs a substance faster than it can be lost or eliminated by catabolism and excretion. T ...
has been observed in rats, mice, or humans.


Preparations


Traditional preparation

The traditional kava beverage is prepared through aqueous extraction of the fresh or dried roots of the ''Piper methysticum'' plant. When using fresh roots, the outer layer is typically peeled before the root is either chewed or mechanically ground into a fine, fibrous pulp, which is then mixed with water. For dried roots, the material is finely ground, placed in a porous cloth, and infused in water. The resulting brew is usually consumed immediately after preparation, often from a communal bowl. Traditional and recreational preparation of kava beverage involves macerating, grinding, or pounding fresh or dried rhizome/root (1.0–1.5 g) and mixing it with water or coconut milk (100–150 mL) to form an emulsion, which is then agitated and strained through cloth or bark filters into a communal bowl. The resulting drink is grey and slightly pungent, with fresh rhizome/root producing a stronger and more complex beverage than dried forms due to the retention of volatile compounds. In
Vanuatu Vanuatu ( or ; ), officially the Republic of Vanuatu (; ), is an island country in Melanesia located in the South Pacific Ocean. The archipelago, which is of volcanic origin, is east of northern Australia, northeast of New Caledonia, east o ...
, fresh root is commonly used, while in non-Pacific countries, kava is typically prepared from dried root powder soaked in water (about one tablespoon per cup) for 30 minutes before straining. On Pohnpei in
Micronesia Micronesia (, ) is a subregion of Oceania, consisting of approximately 2,000 small islands in the Northwestern Pacific Ocean. It has a close shared cultural history with three other island regions: Maritime Southeast Asia to the west, Poly ...
, preparation also includes mixing the kava root with the fibrous bark of ''Hibiscus tiliaceus'' before pressing. Chewing produces the strongest effect because it produces the finest particles. The strength also depends on the species and techniques of cultivation. In Vanuatu, a strong kava drink is normally followed by a hot meal or tea. The meal traditionally follows some time after the drink so that the psychoactives are absorbed into the bloodstream more quickly. Traditionally, no flavoring is added. In Papua New Guinea, the locals in Madang province refer to their kava as ''waild koniak'' ("wild cognac" in English).
Fijians Fijians () are a nation and ethnic group Indigenous peoples of Oceania, native to Fiji, who speak Fijian language, Fijian and English language, English and share a common history and culture. Fijians, or ''iTaukei'', are the major indigenous ...
commonly share a drink called ''grog'', made by pounding sun-dried kava root into a fine powder, straining and mixing it with cold water. Traditionally, grog is drunk from the shorn half-shell of a coconut, called a ''bilo''. Grog is commonly used in
Fiji Fiji, officially the Republic of Fiji, is an island country in Melanesia, part of Oceania in the South Pacific Ocean. It lies about north-northeast of New Zealand. Fiji consists of an archipelago of more than 330 islands—of which about ...
, especially among young men, and often brings people together for storytelling and socializing. Drinking grog for a few hours brings a numbing and relaxing effect to the drinker; grog also numbs the tongue, and grog drinking typically is followed by a "chaser" or sweet or spicy snack to follow a ''bilo''.


Supplements and pharmaceutical preparations

Water extraction is the traditional method for preparation of the plant. Pharmaceutical and herbal supplement companies extract kavalactones from the kava plant using solvents such as supercritical carbon dioxide,
acetone Acetone (2-propanone or dimethyl ketone) is an organic compound with the chemical formula, formula . It is the simplest and smallest ketone (). It is a colorless, highly Volatile organic compound, volatile, and flammable liquid with a charact ...
, and
ethanol Ethanol (also called ethyl alcohol, grain alcohol, drinking alcohol, or simply alcohol) is an organic compound with the chemical formula . It is an Alcohol (chemistry), alcohol, with its formula also written as , or EtOH, where Et is the ps ...
to produce pills standardized with between 30% and 90% kavalactones.


Concerns

Numerous scholars and regulatory bodies have raised concerns over the safety profile of such products. One group of scholars say that organic solvents introduce compounds that may affect the liver into the standardized product; these compounds are not extracted by water and are consequently largely absent from kava prepared with water. For instance, when compared with water extraction, organic solvents extract vastly larger amounts of flavokavains, compounds associated with adverse reactions to kava that are present in very low concentrations in noble kava, but significant in non-noble. Also, "chemical solvents used do not extract the same compounds as the natural water extracts in traditional use. The extraction process may exclude important modifying constituents soluble only in water". In particular, it has been noted that, unlike traditional water-based preparations, products obtained with the use of organic solvents do not contain glutathione, an important liver-protecting compound. Another group of researchers noted: "The extraction process (aqueous vs. acetone in the two types of preparations) is responsible for the difference in toxicity as extraction of glutathione in addition to the kava lactones is important to provide protection against hepatotoxicity". It has also been argued that kavalactone extracts have often been made from low-quality plant material, including the toxic aerial parts of the plant that contain the hepatotoxic alkaloid pipermethystine, non-noble kava varieties, or plants affected by mold which, in light of the chemical solvents' ability to extract far greater amounts of the potentially toxic compounds than water, makes them particularly problematic. In the context of these concerns, the
World Health Organization The World Health Organization (WHO) is a list of specialized agencies of the United Nations, specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Gen ...
advises against the consumption of ethanolic and acetonic kavalactone extracts, and says that "products should be developed from water-based suspensions of kava". The government of Australia prohibits the sales of such kavalactone extracts, and only permits the sale of kava products in their natural form or produced with cold water.


Kava culture

Kava is used for medicinal, religious, political, cultural, and social purposes throughout the Pacific. These cultures have a great respect for the plant and place a high importance on it. In Fiji, for example, a formal ''yaqona'' (kava) ceremony will often accompany important social, political, or religious functions, usually involving a ritual presentation of the bundled roots as a ''sevusevu'' (gift) and drinking of the ''yaqona'' itself. Due to the importance of kava in religious rituals and the seemingly (from the Western point of view) unhygienic preparation method, its consumption was discouraged or even banned by Christian missionaries. The nakamal, traditionally the central meeting place in Vanuatu, serves as a cultural and social hub where kava is consumed to facilitate communal gathering, dialogue, and the exchange of knowledge across different groups and generations.


Kava bars

Bars serving kava beverage exist outside of the South Pacific. Kava bars exist in several American cities as social, alcohol-free spaces, with the number increasing to around 180 establishments between 2012 and 2017.


Effects of consumption

The nature of effects will largely depend on the cultivar of the kava plant and the form of its consumption. Traditionally, only noble kava cultivars have been consumed, as they are accepted as safe and produce desired effects. The specific effects of various noble kavas depend on various factors, such as the cultivar used (and the related specific composition of kavalactones), age of the plant, and method of consumption. However, it can be stated that in general, noble kava produces a state of calmness, relaxation, and well-being without diminishing cognitive performance. Kava may produce an initial talkative period, followed by muscle relaxation and eventual sleepiness. The beverage has initial numbing and astringent effect in the mouth caused by the local anesthetic action of kavalactones and chewing it has local anesthetic effects similar to that of
cocaine Cocaine is a tropane alkaloid and central nervous system stimulant, derived primarily from the leaves of two South American coca plants, ''Erythroxylum coca'' and ''Erythroxylum novogranatense, E. novogranatense'', which are cultivated a ...
and longer lasting than
benzocaine Benzocaine, sold under the brand name Orajel amongst others, is a local anesthetic, belonging to the amino ester drug class, commonly used as a topical painkiller or in cough drops. It is the active ingredient in many over-the-counter ...
. As noted in one of the earliest Western publications on kava (1886): "A well prepared Kava potion drunk in small quantities produces only pleasant changes in behavior. It is therefore a slightly stimulating drink which helps relieve great fatigue. It relaxes the body after strenuous efforts, clarifies the mind and sharpens the mental faculties". Despite its psychoactive effects, kava is not considered to be physically addictive and its use does not lead to dependency.


Long-term effects

Regular use of large amounts of kava may cause mood swings, apathy, dry, scaly skin, malnutrition, weight loss, increased susceptibility to infections, and shortness of breath. Long-term use has also been associated with liver damage; however, the available evidence remains inconclusive. The risk is higher with alcoholic or acetonic extracts, or concentrated forms like pills. Water-based kava extracts in moderate doses are considered safer, but should not be consumed with alcohol, particularly in those with a history of liver issues.


Toxicity, safety, and potential side effects


General observations

There is limited safety information available on the effects of kava consumption, but in general, moderate consumption appears unlikely to be harmful, while there is evidence of harm from heavy use.


Threshold intake levels for adverse effects

Adverse health and social effects associated with kava consumption—such as
skin rash A rash is a change of the skin that affects its color, appearance, or texture. A rash may be localized in one part of the body, or affect all the skin. Rashes may cause the skin to change color, itch, become warm, bumpy, chapped, dry, cracked ...
es, increased
body mass index Body mass index (BMI) is a value derived from the mass (Mass versus weight, weight) and height of a person. The BMI is defined as the human body weight, body mass divided by the square (algebra), square of the human height, body height, and is ...
(BMI), elevated gamma-glutamyl transferase (GGT) enzyme levels, and higher
lymphocyte A lymphocyte is a type of white blood cell (leukocyte) in the immune system of most vertebrates. Lymphocytes include T cells (for cell-mediated and cytotoxic adaptive immunity), B cells (for humoral, antibody-driven adaptive immunity), an ...
counts—may begin to appear at intake levels of approximately 240 to 440 grams of kava powder per week, corresponding to 3,500 to 6,440 mg of kavalactones per day. One shell of kava contains an average of 250 mg kavalactones. Published and anecdotal evidence further indicates that recreational consumption of kava beverages can often exceed these levels, surpassing the kavalactone doses used in clinical settings for the treatment of anxiety, where aqueous extracts containing 140–250 mg per day over six weeks have demonstrated no significant toxicity.


Effects on the liver

Long-term use of kava has been associated with potential hepatoxicity; however, the evidence remains inconclusive. Some kava extracts have demonstrated hepatotoxic. Concerns about this led to kava being omitted from the US Pharmacopeia. Kava has been linked to rare but serious liver disease cases, prompting warnings from health authorities in the United States, Australia, and Canada. The potential causes include contamination with toxic alkaloids from kava leaves and stems, differences in traditional versus commercial preparations, drug interactions affecting liver enzymes, and genetic variations in
metabolism Metabolism (, from ''metabolē'', "change") is the set of life-sustaining chemical reactions in organisms. The three main functions of metabolism are: the conversion of the energy in food to energy available to run cellular processes; the co ...
among populations. While kava appears safe in traditional South Pacific use, caution is advised, especially during pregnancy, in people having preexisting liver conditions, or when combined with
alcohol consumption Drinks containing alcohol (drug), alcohol are typically divided into three classes—beers, wines, and Distilled beverage, spirits—with alcohol content typically between 3% and 50%. Drinks with less than 0.5% are sometimes considered Non-al ...
, prescription drugs or dietary supplements. The risk is higher with alcoholic or acetonic extracts, or concentrated forms like pills. Water-based kava extracts in moderate doses are considered safer, but should not be consumed with alcohol, particularly in those with a history of liver issues.


Other adverse reactions

Adverse reactions may result from the poor quality of kava raw material used in the manufacturing of various kava products. In addition to the potential for hepatotoxicity, adverse reactions from chronic use may include visual impairment, rashes or dermatitis, seizures, weight loss, and malnutrition, but there is only limited high-quality research on these possible effects.


Potential interactions

Several adverse interactions with drugs have been documented, both prescription and nonprescription — including, but not limited to, anticonvulsants, alcohol, anxiolytics (central nervous system depressants such as benzodiazepines),
antipsychotics Antipsychotics, previously known as neuroleptics and major tranquilizers, are a class of psychotropic medication primarily used to manage psychosis (including delusions, hallucinations, paranoia or disordered thought), principally in schizo ...
, levodopa, diuretics, and drugs metabolized by CYP450 in the liver. A few notable potential drug interactions are, but are not limited to: * Alcohol: It has been reported that combined use of alcohol and kava extract can have additive sedative effects. Regarding cognitive function, kava has been shown to have additive cognitive impairments while taken with alcohol when compared to taking placebo and alcohol alone. * Anxiolytics (CNS depressants such as benzodiazepines and barbiturates): Kava may have potential additive CNS depressant effects (such as sedation and anxiolytic effects) with benzodiazepines and barbiturates. Kava taken in combination with alprazolam can cause a semicomatose state in humans. *
Dopamine Dopamine (DA, a contraction of 3,4-dihydroxyphenethylamine) is a neuromodulatory molecule that plays several important roles in cells. It is an organic chemical of the catecholamine and phenethylamine families. It is an amine synthesized ...
agonist An agonist is a chemical that activates a Receptor (biochemistry), receptor to produce a biological response. Receptors are Cell (biology), cellular proteins whose activation causes the cell to modify what it is currently doing. In contrast, an R ...
levodopa: One of levodopa's chronic side effects that Parkinson's patients experience is the "on-off phenomenon" of motor fluctuations, where there will be periods of oscillations between "on", where the patient experiences symptomatic relief, and "off", where the therapeutic effect wears off early. When taking levodopa and kava together, it has been shown that there is an increased frequency of this "on-off phenomenon".


Kava dermopathy

Long-term and heavy kava consumption is associated with a reversible
skin condition A skin condition, also known as cutaneous condition, is any medical condition that affects the integumentary system—the organ system that encloses the body and includes skin, nails, and related muscle and glands. The major function of this ...
known as "kava dermopathy", or ''kanikani'' (in the
Fijian language Fijian (') or iTaukei is an Austronesian languages, Austronesian language of the Malayo-Polynesian languages, Malayo-Polynesian family spoken by some 350,000–450,000 ethnic Fijians as a native language. The 1997 Constitution of Fiji#New Consti ...
), characterised by dry and scaly skin covering the palms of the hands, soles of the feet, and back. The first symptom to appear is usually dry, peeling skin; some Pacific Islanders deliberately consume large quantities of kava for several weeks in order to get the peeling effect, resulting in a layer of new skin. These effects appeared at consumption levels between to a week of kava powder. Despite numerous studies, the mechanism that causes kava dermopathy is poorly understood "but may relate to interference with cholesterol metabolism". The condition is easily treatable with abstinence or lowering of kava intake as the skin appears to be returning to its normal state within a couple of weeks of reduced or no kava use. Kava dermopathy should not be confused with rare instances of allergic reactions to kava that are usually characterised by itchy rash or puffy face.


Research

A 2003
systematic review A systematic review is a scholarly synthesis of the evidence on a clearly presented topic using critical methods to identify, define and assess research on the topic. A systematic review extracts and interprets data from published studies on ...
found that kava extract reduced anxiety symptoms compared to
placebo A placebo ( ) can be roughly defined as a sham medical treatment. Common placebos include inert tablets (like sugar pills), inert injections (like saline), sham surgery, and other procedures. Placebos are used in randomized clinical trials ...
, with a small effect size and mostly mild, transient side effects. Kava may help with anxiety after several weeks of use, but current evidence does not support its effectiveness for generalized anxiety disorder or other conditions. Meta-analyses suggest kava can reduce anxiety symptoms — sometimes comparably to medications like oxazepam and
buspirone Buspirone, sold under the brand name Buspar among others, is an anxiolytic, a medication primarily used to treat anxiety disorders, particularly generalized anxiety disorder (GAD). It is a serotonin 5-HT1A receptor, 5-HT1A receptor partial ag ...
— with strongest evidence seen in multiweek studies using aqueous extracts for generalized anxiety disorder, although results were mixed and
standardized Standardization (American English) or standardisation (British English) is the process of implementing and developing technical standards based on the consensus of different parties that include firms, users, interest groups, standards organiza ...
trials are limited. A study of heavy and long-term kava users in
northern Australia The unofficial geographic term Northern Australia includes those parts of Queensland and Western Australia north of latitude 26th parallel south, 26° and all of the Northern Territory. Those local government areas of Western Australia and Q ...
found no evidence of cognitive or brain dysfunction despite some physical health effects, including liver enzyme elevation and skin changes. Kava extracts have no proven effects on cancer, cognitive function, or microbial infections.


Traditional medicine

Over centuries, kava has been used in the
traditional medicine Traditional medicine (also known as indigenous medicine or folk medicine) refers to the knowledge, skills, and practices rooted in the cultural beliefs of various societies, especially Indigenous groups, used for maintaining health and treatin ...
of the South
Pacific Islands The Pacific islands are a group of islands in the Pacific Ocean. They are further categorized into three major island groups: Melanesia, Micronesia, and Polynesia. Depending on the context, the term ''Pacific Islands'' may refer to one of several ...
.


Regulation


Australia

In Australia, the supply of kava is regulated through the National Code of Kava Management. Travellers to Australia are allowed to bring up to 4 kg of kava in their baggage, provided they are at least 18 years old and the kava is in root or dried form. Commercial import of larger quantities is allowed, under licence for medical or scientific purposes. These restrictions were introduced in 2007 after concern about abuse of kava in indigenous communities. Initially, the import limit was 2 kg per person; it was raised to 4 kg in December 2019, and a pilot program allowing for commercial importation was implemented on 1 December 2021. The Australian Therapeutic Goods Administration has recommended no more than 250 mg of kavalactones be taken in a 24‑hour period. Kava possession is limited to 2 kg per adult in the
Northern Territory The Northern Territory (abbreviated as NT; known formally as the Northern Territory of Australia and informally as the Territory) is an states and territories of Australia, Australian internal territory in the central and central-northern regi ...
. While it was previously banned in
Western Australia Western Australia (WA) is the westernmost state of Australia. It is bounded by the Indian Ocean to the north and west, the Southern Ocean to the south, the Northern Territory to the north-east, and South Australia to the south-east. Western Aust ...
in the 2000s, the Western Australian Health Department announced the lifting of the ban in February 2017, bringing Western Australia "into line with other States" where it has always remained legal, albeit closely regulated.


Europe

Following discussions on the safety of certain pharmaceutical products derived from kava and sold in Germany, the EU imposed a temporary ban on imports of kava-based pharmaceutical products in 2002. The sale of kava plant became regulated in
Switzerland Switzerland, officially the Swiss Confederation, is a landlocked country located in west-central Europe. It is bordered by Italy to the south, France to the west, Germany to the north, and Austria and Liechtenstein to the east. Switzerland ...
,
France France, officially the French Republic, is a country located primarily in Western Europe. Overseas France, Its overseas regions and territories include French Guiana in South America, Saint Pierre and Miquelon in the Atlantic Ocean#North Atlan ...
, and in prepared form in the
Netherlands , Terminology of the Low Countries, informally Holland, is a country in Northwestern Europe, with Caribbean Netherlands, overseas territories in the Caribbean. It is the largest of the four constituent countries of the Kingdom of the Nether ...
. Some Pacific island states which had been benefiting from the export of kava to the pharmaceutical companies have attempted to overturn the EU ban on kava-based pharmaceutical products by invoking international trade agreements at the WTO:
Fiji Fiji, officially the Republic of Fiji, is an island country in Melanesia, part of Oceania in the South Pacific Ocean. It lies about north-northeast of New Zealand. Fiji consists of an archipelago of more than 330 islands—of which about ...
,
Samoa Samoa, officially the Independent State of Samoa and known until 1997 as Western Samoa, is an island country in Polynesia, part of Oceania, in the South Pacific Ocean. It consists of two main islands (Savai'i and Upolu), two smaller, inhabited ...
,
Tonga Tonga, officially the Kingdom of Tonga, is an island country in Polynesia, part of Oceania. The country has 171 islands, of which 45 are inhabited. Its total surface area is about , scattered over in the southern Pacific Ocean. accordin ...
, and Vanuatu argued that the ban was imposed with insufficient evidence. The pressure prompted
Germany Germany, officially the Federal Republic of Germany, is a country in Central Europe. It lies between the Baltic Sea and the North Sea to the north and the Alps to the south. Its sixteen States of Germany, constituent states have a total popu ...
to reconsider the evidence base for banning kava-based pharmaceutical products. On 10 June 2014, the German Administrative Court overturned the 2002 ban, making selling kava as a medicine legal (personal possession of kava has never been illegal), albeit strictly regulated. In Germany, kava-based pharmaceutical preparations are currently prescription drugs. Furthermore, patient and professional information brochures have been redesigned to warn about potential side effects. These strict measures have been opposed by some of the leading kava scientists. In early 2016, a court case was filed against the Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM/German Federal Institute for Drugs and Medical Devices), arguing that the new regulatory regime is too strict and not justified. In the
United Kingdom The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Northwestern Europe, off the coast of European mainland, the continental mainland. It comprises England, Scotlan ...
, it is a criminal offence to sell, supply, or import any medicinal product containing kava for human consumption. It is legal to possess kava for personal use or to import it for purposes other than human consumption (e.g., for animals). Until August 2018, Poland was the only EU country with an "outright ban on kava" and where the mere possession of kava was prohibited and may have resulted in a prison sentence. Under the new legislation, kava is no longer listed among prohibited substances and it is therefore legal to possess, import, and consume the plant, but it remains illegal to sell it within Poland for the purpose of human consumption. In the Netherlands, for unknown reasons, the ban was never lifted, and it is still prohibited to prepare, manufacture, or trade kava or goods containing kava. Due to safety concerns, including reports of hepatotoxicity and limitations in clinical evidence, the Committee on Herbal Medicinal Products (HMPC) concluded in 2017 that the benefit-risk balance for the oral use of kava in the treatment of anxiety disorders is unfavorable, and therefore a
European Union The European Union (EU) is a supranational union, supranational political union, political and economic union of Member state of the European Union, member states that are Geography of the European Union, located primarily in Europe. The u ...
herbal monograph could not be established.


New Zealand

When used traditionally, kava is regulated as a food under the Food Standards Code. Kava may also be used as an herbal remedy, where it is currently regulated by the Dietary Supplements Regulations. Only traditionally consumed forms and parts of the kava plant (i.e., pure roots of the kava plant, water extractions prepared from these roots) can legally be sold as food or dietary supplements in New Zealand. The aerial parts of the plant (growing up and out of the ground), unlike the roots, contain relatively small amounts of kavalactones; instead, they contain a mildly toxic alkaloid, pipermethysticine. While not normally consumed, the sale of aerial plant sections and non-water based extract (such as , acetonic, or ethanol extractions) is prohibited for the purpose of human consumption (but can be sold as an ingredient in cosmetics or other products not intended for human consumption).


Canada

In 2002,
Health Canada Health Canada (HC; )Health Canada is the applied title under the Federal Identity Program; the legal title is Department of Health (). is the Structure of the Canadian federal government#Departments, with subsidiary units, department of the Gove ...
issued an order prohibiting the sale of any product containing kava. While the restrictions on kava were lifted in 2012, Health Canada lists five kava ingredients, as of 2017, although manufactured products containing kava or its extracts must be approved by the federal government before marketing.


United States

In the United States, kava is sold mainly as a dietary supplement and is not approved by the FDA as a drug. Manufacturers are responsible for ensuring product safety and proper labeling, while consumers are advised to consult healthcare professionals before using kava supplements. In 2002, the U.S.
Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respo ...
warned that kava-containing dietary supplements, promoted for relaxation and other uses, may cause rare but severe liver injury—including
hepatitis Hepatitis is inflammation of the liver parenchyma, liver tissue. Some people or animals with hepatitis have no symptoms, whereas others develop yellow discoloration of the skin and whites of the eyes (jaundice), Anorexia (symptom), poor appetite ...
,
cirrhosis Cirrhosis, also known as liver cirrhosis or hepatic cirrhosis, chronic liver failure or chronic hepatic failure and end-stage liver disease, is a chronic condition of the liver in which the normal functioning tissue, or parenchyma, is replaced ...
, and liver failure—and advised consumers, especially those with liver issues or on liver-impacting drugs, to consult a doctor before use and to report any related
adverse effect An adverse effect is an undesired harmful effect resulting from a medication or other intervention, such as surgery. An adverse effect may be termed a "side effect", when judged to be secondary to a main or therapeutic effect. The term compli ...
s. The FDA concluded in 2020 that kava is not
generally recognized as safe Generally recognized as safe (GRAS) is a United States Food and Drug Administration (FDA) designation that a chemical or substance added to food is considered safe by experts under the conditions of its intended use. An ingredient with a GRAS d ...
(GRAS) for use in conventional foods due to evidence of toxicity, potential liver damage, possible carcinogenicity, drug interactions, and a lack of sufficient safety data. In response to the FDA’s determination, the Hawaii Department of Health concluded in 2024 that traditionally prepared beverages made from noble kava root using water or coconut water are considered under specific conditions, based on historical use prior to 1958.


Vanuatu

The Pacific island-state of Vanuatu has passed legislation to regulate the quality of its kava exports. Vanuatu prohibits the export or consumption of non-noble kava varieties or the parts of the plant that are unsuitable for consumption (such as leaves and stems).


See also

* List of herbs with known adverse effects * Alcohol and Drugs History Society * Betel * Domesticated plants and animals of Austronesia * Kava culture * Nakamal * Paan * Samoa 'ava ceremony *
Samoan plant names Below are some Samoan plant names in alphabetical order in the Samoan language and their corresponding descriptions in English language, English. Many are used in traditional medicines in the Samoa Islands comprising Samoa and American Samoa. Se ...


References


External links

*
Kava ban documents

''Piper methysticum'' information
from the Hawaiian Ecosystems at Risk project
HEAR
* {{Authority control Anxiolytics Drinks Entheogens Culture of Fiji Medicinal plants Oceanian drinks Piper (plant) Culture of Samoa Culture of Tonga Drugs in Tonga Culture of Vanuatu Ceremonial food and drink GABAA receptor positive allosteric modulators Sodium channel blockers Calcium channel blockers Norepinephrine–dopamine reuptake inhibitors Monoamine oxidase inhibitors CB1 receptor agonists Opioids Polynesian words and phrases Melanesian drinks Polynesian drinks Austronesian spirituality Taxa named by Georg Forster Austronesian agriculture