Kava

How is kava used?

Pacific Islands

Traditionally, Pacific Islander communities crushed, chewed and ground the root and stump of the shrub, then soaked it in cold water to produce a drink for ceremonies and cultural practices. These rituals were said to strengthen ties among groups, reaffirm status and help people communicate with spirits.²

Many Pacific Islanders who have settled in Australia have continued drinking kava or using kava extracts.⁴

Aboriginal and Torres Strait Islander peoples

Kava was introduced to the communities in the north of Australia in the 1980s as a substitute for alcohol, to reduce alcohol-related harms in the community. The kava drink is often used for sedative, hypnotic and muscle-relaxant effects, in much the same way that alcohol is used.²

Herbal preparations

Kava extract is used in some herbal preparations which are sold as over-the-counter tablets and preparations to be used in the treatment of insomnia, stress and anxiety.⁵

Effects of kava

There is no safe level of drug use. Use of any drug always carries some risk. It’s important to be careful when taking any type of drug.

Kava affects 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).

The following effects may be experienced:

• feeling happy and relaxed
• mild sleepiness
• numb mouth and throat
• reduced or loss of appetite.^6,7

If a large amount of kava is taken the following effects may also be experienced:

• drowsiness
• nausea
• loss of muscle control
• mild fever
• pupil dilation and red eyes.^6,7

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 drugs, and expectations of what’s going to happen. For example, feelings of stress or anxiety before using kava may result in an unpleasant experience.8
• Setting: the environment in which someone consumes kava – whether it’s known and familiar, who they’re with, if they’re indoors or outdoors, the type of music and light. For example, using kava in a calm, quiet and relaxed environment can lead to, or contribute to, a pleasant experience but being in a noisy, crowded place may result in a negative experience.⁸
• Being in a good state of mind, with trusted friends and a safe environment before taking kava reduces the risk of having a negative experience.⁸

Long-term effects

Regular use of large amounts of kava may eventually cause:

• mood swings
• apathy
• dry, scaly skin
• malnutrition and weight loss
• getting infections more easily
• shortness of breath.^6,7

Long term use of Kava has also been linked to liver damage – although the evidence on this is not clear.⁹ The risk can be higher if Kava is taken in an alcoholic or acetonic extract, or in other concentrated forms such as pills.^6,10 Traditional kava beverages in moderate doses are considered

more safe for consumption. For this reason water based extracts of Kava (as a drink or tablet) should not be consumed with alcohol, especially if there is a history of liver damage or disease.^6,10

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. However, there isn’t any strong evidence to suggest it is effective as a long-term treatment and there are concerns around its overall safety.^11-13 It is not currently recommended as a medicine or treatment for anxiety disorders.¹¹

Tolerance and Dependence

Evidence suggests it is unlikely that a person will become dependent on Kava. However, ongoing and frequent use of kava that causes harm has been known to occur in certain contexts.¹⁴

Mixing kava with other drugs

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

• Kava and alcohol: can make you feel more drunk and increase risk of liver damage.¹⁴
• Kava and benzos/GHB/opioids: may lead to higher sedation and other symptoms such as may feel clumsy or uncoordinated, slow breathing, nausea and vomiting, memory loss, passing out.¹⁵
• Kava and hepatic route drugs/anticoagulants/antiplatelets: Kava changes the way that the liver processes some types of medications and drugs, therefore you should consult with your healthcare provider before taking kava.⁶

Reducing harm

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

• avoid taking kava if you plan to drive or use machinery
• avoid using kava and alcohol together
• children, pregnant and breastfeeding women should not use kava
• do not use kava if you have liver disease
• have regular breaks from kava use
• drink kava in moderation as drinking large quantities may produce dry, itchy, and scaly skin
• kava has the potential to interact with several drugs and medications. Talk with a health professional before use.

Withdrawal

There is no evidence that people who regularly use kava become dependent on the drug, so if you stop taking it, you are unlikely to experience withdrawal symptoms. However, if you have health problems seek medical advice.⁶

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 a loved one, you can find 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
• Help and Support Services search. Find a service in your local area from our list. Simply add your location or postcode and filter by service type to quickly discover help near you.

If you're looking for other information or support options, send us an email at druginfo@adf.org.au