Kava

Overview

Kava is a beverage made from the root of the Piper methysticum plant and has traditionally been used in rituals and social gatherings across Polynesia, Micronesia, and Melanesia in the South Pacific. It’s also sold as tea, extracts, and supplemental powders globally. Kava contains kavalactones, which are found in the resin of kava roots and are responsible for its psychoactive effects by serving as central nervous system depressants.

The immediate effects of kava include:

• Anxiolysis, or a reduction in anxiety through feelings of relaxation and calm

• Mild euphoria

• Mental clarity in low-to-moderate doses

• Sedation in higher doses or specific strains that make it easier to fall asleep

• Oral numbness since kavain, one of the kavalactones, serves as a local anesthetic

• Muscle relaxation

• Analgesia, or pain relief, particularly in the case of stress-induced headaches or body aches

• Motor impairment, usually at very high doses that can cause issues with balance and delay reflexes

Long-term effects include:

• Dermopathy, or irritated skin that starts on the palms, soles, or back and becomes dry, scaly, itchy, or yellowed

• Gastrointestinal distress, such as nausea, indigestion, or upset stomach, though this can vary by the quality of kava

• Lethargy as a persistent fatigue or brain fog that lasts after consumption stops

• Hepatotoxicity, or liver toxicity that results because kava binds to enzymes that the liver also would use to filter alcohol, sedatives, and certain medications

Kava is not considered chemically addictive in the same way that substances like alcohol or heroin are, but the risk of liver injury is still noteworthy and doesn’t mean it’s a “safe substance.” Many people who have a history of substance use disorders may attempt to use kava as a safer alternative to drinking alcohol or using other substances, but this can compound stress that the liver might already be under from past substance use. Heavy alcohol use is especially damaging to the liver, and while the liver can heal and recover substantially, kava might interfere with that or come with an increased risk of hepatotoxicity.

Interestingly though, kava actually induces a reverse tolerance effect where the substance becomes more effective over time and requires smaller doses to get the same effect. Researchers are still exploring why, but some theories include kavalactones accumulating in fat instead of clearing the body instantly, GABA receptors increasing rather than decreasing as they do for the sedative effects of alcohol, and liver adaptation that optimizes the way enzymes metabolize kavalactones.