Kava, a traditional herb with a long history of use, is known for its powerful relaxation effects. This article explores the many benefits of kava as a modern supplement, including its ability to reduce anxiety, promote calm, and improve sleep. However, we also examine potential adverse effects and important safety precautions when using kava. By addressing common misconceptions, we aim to provide a well-rounded understanding of kava, nature’s relaxation elixir, empowering you to make informed decisions about its use.

A traditional medicine

Kava is derived from the root, stump, or base of the stem of the Kava shrub, scientifically known as Piper methysticum, a plant in the black pepper family. It naturally grows in the Pacific Islands, including Samoa, Fiji, Vanuatu, and Hawaii.¹ Indigenous cultures traditionally crush the root, infuse it with cold water or coconut juice, and create a kava tea known for its earthy, peppery flavour and sometimes numbing effect. Also called “Kava kava,” “kawa,” “waka,” or “‘awa” depending on the region, it has been revered as “nature's relaxation elixir.” The beverage has long been used in ritualistic ceremonies, promoting calm and fostering social interactions across the South Pacific.¹

Does kava cause hallucinations?

Contrary to some belief, Kava is not a hallucinogen (a substance that causes hallucinations), Kava, much like alcohol or caffeine, is a natural psychoactive substance (a substance that alters the mind).¹ Therefore, those natives who drink Kava tea, at Fijian weddings or Samoan rituals, do not end up interacting with talking elephants or begin chasing flying sorcerers. Instead, they feel an overarching sensation of relaxation which can reduce their stress and is said to aid with the release of tension in both mind and body. That said, traditional kava extracts come in a variety of forms which can be split up into noble and non-noble kava. Where noble forms are sourced from a younger plant and are used daily to give calming effects, non-noble extracts are far stronger in composition, have safety concerns associated with them, and exert longer-lasting effects.

What is kava made from?

To fully understand the modern potential of kava, it’s important to explore its main constituents, particularly the kavalactones. Kava contains 19 different kavalactones, but only 6 are known to be the active ingredients responsible for its therapeutic effects.² Think of kava as a raffle where the molecules are the tickets, and the active kavalactones are the winning prizes. Here are the key active kavalactones:^2,3

• Kavain, Dihydrokavain, and Methysticin are responsible for kava’s depressant effects, which help slow down nervous system activity, much like alcohol or anti-anxiety medications
• Methysticin has been shown to reduce brain cell damage during ischemic stroke (a type of stroke caused by reduced blood flow to the brain)
• Yangonin is thought to protect liver cells, particularly from injuries affecting bile production (important for digestion)
• Desmethoxyyangonin and Dihydromethysticin are also active kavalactones contributing to kava’s effects

These kavalactones work together to provide kava’s calming, anti-anxiety, and therapeutic benefits.

In addition to kavalactones, chalcones make up a small portion of the active ingredients in kava, accounting for less than 4% of the "winning tickets" in this therapeutic raffle. Here are the chalcones found in kava:^6,7,8

• Flavokavain A: May have anti-cancer properties
• Flavokavain B: Has been shown to kill specific cancer cells in studies, though it may also contribute to liver toxicity associated with kava
• Flavokavain C: Present in kava, but its effects have not been studied extensively

These chalcones, though less abundant, play a role in kava’s potential health benefits and side effects.

Is kava a drug?

Kava is not classified as a drug in the traditional sense but has drug-like properties due to its depressant effects on the nervous system. It is commonly used as a supplement for anxiety relief and muscle relaxation. Scientific studies support its use as an anxiolytic (anti-anxiety agent), with clinical trials showing that it can alleviate anxiety symptoms in the short term (up to 6 weeks).⁹ One study found that a daily dose of 210 mg of kavalactones was safe over a 6-month period with minimal side effects, though caution is advised as kava can interact negatively with other medications.¹⁰ Kava has also been explored for its potential as a muscle relaxant, but more research is needed to confirm its effectiveness.¹¹ While kava has a long history of traditional use, it has been misused recreationally, with cases of severe liver damage and even death linked to unregulated consumption.¹² This misuse has led to investigations into its safety, highlighting the importance of understanding its potential risks before use.

Is kava legal?

Kava's legal status varies around the world due to concerns over safety and potential side effects. Here’s a summary of its legal status in several countries:

• Poland: Banned
• Switzerland: Some restrictions, unclear legal status
• UK and Netherlands: Restricted; in the UK, it's illegal for human consumption but available as a supplement
• Germany and France: Initially banned, but regulations now allow use under certain conditions
• Canada: Legal, but sold as a regulated dietary supplement
• Australia: Legal but heavily regulated, with complex import and distribution laws
• United States: Legal
• Japan: Legal but heavily regulated after an initial ban

Always check local regulations before purchasing or using kava.

Is kava safe?

Kava is generally safe when used properly, but its safety depends on quality and preparation methods. The WHO investigation into kava safety found that liver damage was most often linked to pre-existing liver disease, heavy alcohol consumption, and improper dosing, including using low-quality extracts or alcohol in preparation. To improve safety, the WHO recommends the following measures:¹²

• Use noble cultivars of kava to ensure proper kavalactone levels, avoiding non-noble varieties
• Prepare kava using water, not alcohol or acetones, to extract active ingredients
• Harvest and store high-quality kava plants properly to prevent contamination
• Limit dosage to 250mg of kavalactones per day, as higher doses can increase the risk of liver damage

When can I take kava?

Before using kava for anxiety management, it's essential to consult with your healthcare practitioner. Kava can interact negatively with several drugs and supplements, either increasing or reducing their effects. Since kava is metabolized by the liver and may be toxic to it, it should not be taken with alcohol and is not recommended if you are on the following medications:¹³

• Sedatives and over-the-counter sleep aids
• Antidepressants
• Anxiety medications
• Diuretics (water pills)
• Blood thinners
• Levodopa (for Parkinson's disease), since kava can worsen symptoms
• Proton pump inhibitors
• Antipsychotics, especially for those with schizophrenia or bipolar disorder

Always check with your healthcare practitioner to ensure it's safe to incorporate kava into your routine.

Potential kava side effects

After consulting with your healthcare practitioner and ensuring kava is safe for you, be aware of the following potential side effects:¹³

• Liver damage
• Reversible yellowing of the skin
• Discomfort
• Nausea
• Dizziness
• Headaches

If you experience any of these side effects, it's important to stop using kava and consult with your healthcare practitioner immediately.

Summary

Kava is a traditional herb with deep roots in Pacifica culture, where it has been used in rituals for centuries. Its psychoactive properties have made it a popular relaxation supplement worldwide, particularly for anxiety relief. While studies support its effectiveness, concerns over liver toxicity have led to heavy regulation, especially in the Western world. Kava interacts with various substances, so it’s crucial to consult a healthcare practitioner before use. Although kava shows great potential, it should be used with caution and under professional guidance.