Kava

How is kava used?

Traditionally, the root and stump of the kava shrub are crushed, ground, then soaked in cold water producing a drink for ceremonies and cultural practices.²

Kava use is popular in Pacific Islander communities in Australia and has been reported as a way of expressing and maintaining cultural identity.^{2, 7}

Kava extract is also used in some herbal preparations which are sold as over-the-counter tablets and powders to be used in the treatment of insomnia, stress, and anxiety.²

Effects of kava

The use of any drug can have risks. It’s important to be careful when taking any type of drug.

Kava can affect everyone differently, based on:

• size, weight and health
• whether the person is used to taking it
• whether other drugs are taken around the same time
• the amount taken
• the strength of the drug (varies from batch to batch)
• the environment (where the drug is taken).

Onset and duration of effects

​How fast a drug takes effect and how long it lasts can vary depending on how it's taken - for example, whether it's drunk or taken as a tablet.

Kava is quickly absorbed by the body, reaching peak effects about 2 to 3 hours after use.⁸

It can remain in the body for more than 24 hours.⁹

Effects

Effects can include:

• feeling happy and relaxed
• mild sleepiness
• reduced anxiety/stress
• numb mouth and throat
• reduced or loss of appetite
• headache
• nausea
• stomach-ache
• abdominal pain.^{2, 7, 10}

Impact of mood and environment

Drugs that affect a person’s mental state (psychoactive drugs) can also have varied effects depending on a person’s mood (often called the ‘set’) or the environment they are in (the ‘setting’): 

• Set: a person’s state of mind, previous encounters with the drug, and expectations of what’s going to happen. For example, feelings of stress or anxiety before using kava may result in an unpleasant experience and make those feelings worse.
• Setting: the physical and social environment where you take kava – whether it’s known and familiar, who you're with, if you're indoors or outdoors, the type of music or sounds, and lighting. The ideal setting to take kava will vary based on the individual and drug they’re using. For example, one person might enjoy kava in a loud social setting like a party, while another may prefer a quieter place with close friends.¹¹

Being in a good state of mind, with trusted friends and a safe environment before taking kava reduces the risk of having a bad experience.¹¹

Overdose

If you have a large amount of kava or a strong batch, you could overdose. 

Your risk of overdose can also increase if you mix kava with alcohol or other drugs, including medications.

There have been no reported deaths from kava overdose in Australia.

However, the symptoms of kava overdose can be very unpleasant or even dangerous for some people with health issues.^{12, 13}

Call triple zero (000) and request an ambulance if you or someone else has any of the following symptoms (emergency services are there to help and can provide more instructions).

Signs of kava overdose include:

• extreme drowsiness
• loss of muscle control or muscle weakness
• sore or red eyes
• confusion
• paranoia
• mild fever
• seizures
• hallucination (seeing or hearing things that aren’t there).^{2, 10, 14}

Learn more on overdose and drug-related emergencies here.

Mixing kava with other drugs

Mixing kava with other drugs can have unpredictable effects and increase the risk of harm.

Mixing includes using more than one drug (including alcohol or medications) at the same time, or one after another. You should also consider what drugs you’ve taken in the last 24 hours.

• Kava and alcohol: can make you feel more drunk and increases risk of liver damage. Alcohol may also increase the effects of kava.
• Kava and benzodiazepines such as (Valium®) or (Xanax®)/GHB/opioids: may lead to extreme drowsiness and other symptoms such as feeling clumsy or uncoordinated, slow breathing, nausea and vomiting, memory loss, passing out.
• Kava and dissociatives (such as ketamine/nitrous oxide): can make you more uncoordinated and tired. At high doses, you may suddenly lose consciousness. If you vomit while unconscious, there’s a risk of choking on the vomit.
• Kava and stimulants (such as amphetamines/caffeine/cocaine): can mask the effects that each drug is having. This can lead to taking higher doses and may result in an overdose.
• Kava and hepatic route medications/anticoagulants/antiplatelets: Kava changes the way that the liver processes some types of medications and drugs. Talk to your healthcare provider before using kava.^{13, 15, 16}

Using more than one drug or type of drug at the same time is called polydrug use.¹⁷

Reducing harm 

There are ways in which you can reduce the risks associated with using kava.

• Start low, go slow – try a little bit first to see how you feel. Wait at least 30 minutes before deciding whether to take more.
• Stay hydrated by taking small sips of water regularly – to avoid dehydration.
• Use kava in moderation to reduce the risk of dry, itchy and scaly skin associated with heavy use.
• Talk with your health professional before starting new medications.
• Avoid use if you have a history of seizures or Parkinson’s disease – as it may lead to worse symptoms. 
• Don’t use if you have liver disease, are pregnant or are breastfeeding.
• Don’t operate machinery, drive, or swim.^{12, 18-20}

Coming down

Kava is not known to cause comedown effects. 

Long-term effects

Long-term effects can vary depending on how much, how often and how kava is consumed. Regular use may eventually contribute to:

• malnutrition
• weight loss
• shortness of breath.^{7, 10}

Kava use has also been linked to dermopathy, a skin condition that can cause a rash, itching or scaly skin.^{2, 7}

This rash should go away within a few weeks of stopping kava use.²¹

Long-term use of Kava has also been linked to liver damage.^{2, 22}

The exact reason for this link is not fully understood. It may be related to mould or contamination on raw kava plant material, or an individual reaction to kava in some people.²²

Speak with your doctor or healthcare provider if you have any concerns about your use of kava.

Kava and mental health

Kava has been explored as a treatment for anxiety disorders, with some studies showing positive results for the short-term relief of symptoms.^{2, 23, 24}

However, there isn’t any strong evidence to suggest it is effective as a long-term treatment.^23-25

It is not currently recommended as a medicine or treatment for anxiety disorders.²³

Tolerance

Kava is not known to cause normal tolerance (where someone needs to take larger amounts to get the same effects).

But, there have been anecdotal reports of kava causing ‘reverse tolerance’ (also known as sensitisation).^{15, 26}

This means the effects of a drug can feel stronger the more times someone uses it.²⁶

However, this may be because people become more familiar with kava after using it, making its effects easier to recognise rather than stronger.²⁶

Dependence

In rare cases, people who regularly use kava may become dependent. They may feel they need to use kava to go about usual activities like working, studying and socialising, or just to get through the day.²

Withdrawal

Withdrawal refers to the symptoms that can occur when someone who is dependent on a drug, or who has been using it regularly over time, stops or reduces their use.²⁷

Withdrawal can include physical symptoms (such as headaches, or nausea) and psychological symptoms (such as anxiety, or depressed mood).²⁷

Symptoms - including how strong they are and how long they last - will vary depending on the type of drug and a person’s history of use.²⁷

There are no known physical withdrawal symptoms for kava, however if you experience symptoms after stopping or reducing your use, or have concerns, contact your doctor or the help and support services listed below for advice and support.²

Pregnancy and breastfeeding

​There is limited evidence on the health impacts of kava use during pregnancy and breastfeeding.⁸

The safest option for people who are trying to get pregnant, who are pregnant, or who are breastfeeding is to not use kava.⁹

Regular kava use during pregnancy may cause the baby to be born with a skin rash similar to the rash sometimes seen in adults who use kava for a long time or in high doses.²¹

There is some evidence that kava can be passed on to the baby in breastmilk.⁸

Getting help

If your use of kava is affecting your health, family, relationships, work, school, financial or other life situations, or you’re concerned about someone, there is help and support. 

• Call the National Alcohol and Other Drug Hotline on 1800 250 015 for free and confidential advice, information and counselling about alcohol and other drugs 
• Search our Help and Support directory to find your preferred support, by adding your location or postcode and filtering by service type.