Kava – beneficial or root of evil?

The benefits of kava are considerable. Scientific research has confirmed its effectiveness in the treatment of anxiety, nervous tension, insomnia, stress, menopausal anxiety and mild depression. An Australian study published in 2009 showed significant benefits, comparable to the results achieved with prescription tranquilisers such as benzodiazepam.

Water-based extracts of the roots from the kava plant are used traditionally in many Pacific Island cultures for their mood-altering properties. Contrary to popular belief, kava is not banned and has just been released on the market in a safe, water-based liquid extract by Queensland manufacturer Mediherb. An advantage of this new liquid preparation is herbalists can formulate herbal mixtures combining kava with other medicinal herbs for effective treatments.

Despite centuries of use of kava in Pacific Island cultures, when taken out of its traditional milieu, kava has had a chequered and controversial history.

It was introduced to Indigenous communities in northern Australia from Fiji in the 1980s as it was believed it could provide a safer option to alcohol consumption. However, without the traditional cultural guidelines for appropriate use and the fact that kava was frequently used alongside alcohol, many serious health and social problems occurred.

Complex regulations occurred, with kava variously classed as a food, a poison, a drug, a scheduled medicine, a dangerous good and a prohibited botanical, with local Arnhem Land, State, Territory, and national restrictions at different times.

A voluntary withdrawal of all kava products was put in place in Australia in 2002 when German reports of liver toxicity were associated with the use of kava tablets. In the majority of cases, patients had also been taking other medications and some had pre-existing liver disease. Research also indicated that, unlike the traditional water-based extractions of kava, some brands of tablets were manufactured using ethanol and acetone (yes, nail polish remover!). These methods of extraction yielded active ingredient levels hundreds of times higher than traditional methods and at these levels the compounds may have become toxic.

Considerable research was conducted, which confirmed the safety of kava using traditional water extraction methods. Ethanol and acetone preparations have been banned while water-based and pure rhizome products are approved. A cap on the quantity of kava lactones (naturally occurring active ingredients) in a preparation is in place to ensure safety.

Modern science has confirmed its effective anti-anxiety and anti-depressant benefits but it is not recommended for people with a history of excessive alcohol consumption or liver disease.

People might question whether kava should be used at all as a medicine, if excessive quantities can be toxic to the liver. However, many foods and medicines are beneficial in normal quantities but toxic in large amounts. It is possible to induce liver failure from excessive amounts of carrot juice (or wine). With current manufacturing and usage guidelines, kava is once again a beneficial adjunct to the herbal dispensary. Much of the recent problematic history of kava came about through it being taken out of its cultural traditions and also being commercialised by pharmaceutical companies with insufficient understanding of its photochemistry. Hopefully lessons have been learnt.

Trish Clough has been a practising herbalist for more than 30 years. The information in the column is meant for general interest only and should not be considered as medical advice. You can follow her blog at traditional



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