Genus; Species: Piper methysticum
CAM Type: biologically based
Common Names: kava kava, ‘awa (Hawaii), ‘ava (Samoa), sakua (Pohnpei), yaqona (Fiji)
Introduction to Kava:
Kava is an ancient western Pacific crop related to the black pepper – both having heart-shaped leaves and flowers similar to the flower spike of the anthurium. Kava also has a peppery taste, and has long been part of religious, political and cultural life throughout the Pacific region. The drink was the beverage of choice for the South Pacific royal families.
It is believed to have originated in Melanesia, and grows abundantly in the sunny Polynesian islands. Drank for hundreds of years by native islanders, it was only during Captain Cook’s voyage to the Pacific in 1768-1771 that the white man first encountered the plant and its consumption in sacred ceremonies. According to his account, natives would chew or pound the root and mix it with water to produce a brownish, often bitter brew which they then consumed for its psychoactive properties.
sleep, fatigue, restlessness, insomnia, asthma, urinary tract infections, anxiety, menopausal symptoms, muscle tension, pain relief
In the Western world, kava is used as an herbal remedy to ease symptoms of anxiety, stress and depression. The effects of drinking kava include slight tongue and lip numbing due to the contraction of blood vessels in these areas, talkative and euphoric behavior, calmness, a sense of well-being, and clear thinking. Kava promotes deep sleep without affecting restful REM sleep, and there are no after-effects the next day.
Kava produces brain wave changes similar to those that occur with calming medicines such as diazepam (Valium, for example). Kava also can prevent convulsions and relax muscles. Although kava is not addictive, its effect may decrease with use.
Kava has also interestingly been employed by the military in Fiji to aid in vigilance and anxiety reduction, to provide concentration and focus, to provide muscle control before sports and music performances, to reduce anxiety associated with public speaking and other public performances, and in corporate meetings to aid in mental clarity, sociability and improved decision making.
Some indigenous communities in Australia have used kava as a safer alternative to alcohol. Many of these communities have problems with alcohol abuse and related violence.
Kava is traditionally consumed as an herbal tea, produced by straining a mixture of water and shredded, dried, pounded or fresh root and/or stump. It may also be chewed as part of preparation – this will affect the resulting mixture due to enzymes in the saliva.
Pharmacology and Phytochemicals:
Kava is not pharmacologically addictive. Its main ingredients are kavalactones. While kava has been considered relatively safe, some kava herbal supplements may contain pipermethystine from aerial stem peelings which may contribute to rare but severe hepatotoxic reactions to kava.
Mechanisms of Action:
The precise mechanism by which kava works is not fully understood, but numerous effector sites are involved. The anxiolytic and sedative effects of kava suggest that it potentiates GABA neurotransmission. Kava may affect neurotransmitters such as serotonin and dopamine, but there is no concrete evidence of this.
Safety, Side Effects and Warnings:
In recent years, concerns have been raised about the safety of kava use. Several reports were released that kava may cause severe liver toxicity, including liver failure in some people who have used dietary supplements containing kava extract. While no conclusive link to these conditions in conjunction with kava has been established, the severity of the liver damage prompted action by numerous regulator agencies. Regulatory drug agencies in Switzerland and France subsequently outlawed kava completely. The health agency of Canada issued a stop-sale order in 2002 for kava. However, legislation in 2004 rendered the legal status of kava in question. The United States CDC has released a report which expressive reservations about kava’s use and its possibly adverse side effects (specifically noting severe liver toxicity), as has the FDA.
Some counter that the cases which resulted in liver toxicity included concomitant use of alcohol or other drugs. Another claim is that kava extracts used by patients who experienced liver toxicity were made with solvents other than the traditional water and that the whole plant was used rather than just the roots, as is traditional. No single conclusive case of adverse liver effects has been reported by natives, who have used the plant for centuries.
The German Federal Institute for Drugs and Medical Devices (BfArM), which was the first to evoke a total ban on kava, has since agreed with other teams of experts that on closer inspection, evidence does not support such a stance. Thus, the BfArM has agreed to a partial revocation of its actions.
Heavy use of kava has been associated with kava dermopathy, a scaly eruption of the skin which is reversible by discontinuing kava use. It is considered to be a harmless curiosity. Ancient Hawaiians would drink excessive amounts of kava to encourage this in order to bring about a smoother layer of new skin. With normal use the effect is non-existent.