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Drawing of P. methysticum
|Common names||Kava(-kava), ʻawa, ava, yaqona, sakau, malok, malogu|
|Active constituents||Kavalactones, Yangonin|
Kava or kava-kava (Piper methysticum: Latin "pepper" + Latinized Greek "intoxicating") is a crop of the western Pacific. The name kava refers to both the plant itself and the psychoactive beverage prepared from its rootstock.
- 1 History and culture
- 2 Chemistry
- 3 Pharmacology
- 4 Subjective effects
- 5 Toxicity and harm potential
- 6 Legal status
- 7 See also
- 8 External links
- 9 References
History and culture
Kava has been consumed in Pacific Island communities for over 3,000 years in both social and religious rituals, often as a drink. Kava's consituents have a sedative effect and act mainly on the GABA and dopamine receptors, as well as the sodium and calcium ion channels, but have also been found to have action upon the endocannabinoid system, specifically the CB1 receptor sites. Kava has been likened to the effects of alcohol without the heavy mental effects. Kava is primarily used to relieve anxiety (anxiolytic), to relieve pain (analgesic), and to boost sociability.
Commonly, kava is drank throughout the day by Pacific Islanders such as those on Vanuatu or the Islands of Hawaii. This drink is popularly consumed before spiritual rituals and before social events due to its mild psychotropic effects and its more potent sociability inducing effects. Kava replaces alcohol in many Pacific communities.
Kava cultures are the religious and cultural traditions of western Oceania which consume kava.
Kava is found to contain eighteen different chemicals called kavalactones. Kava's effects are believed to only relate to six psychoactive and medicinal kavalactones: methysticin, dihydromethysticin, kavain, dihydrokavain, yangonin, and desmethoxyyangonin.
Pharmacologically, kava's effects stem from 18 different chemicals found within the plant called kavalactones, six of which have been found to be directly psychoactive in the body. The first of these are methysticin, dihydromethysticin, dihydrokavain, all of which act on the GABAA receptor and behave as an agonist, creating the well-known anxiolytic effects. Dihydromethysticin is also a reversible selective Monoamine Oxidase Inhibitor, specifically acting upon the MAO-B enzyme. Next is yangonin, which is unique in its ability to activate the CB1 receptor in the endocannabinoid system. Desmethoxyyangonin is also an MAO-B inhibitor and is able to increase dopamine levels in the Nucleus Accumbens. This, along with the potential increases of serotonin and other catecholamine concentrations, may be responsible for the purported attention-promoting effects of kava. Lastly is kavain. Kavain has shown evidence to be a serotonin-norepinephrine reuptake inhibitor (SNRI). It also shows evidence of being an activator of NMDA receptors. Kavain has also been proven to be an effective GABAA receptor agonist and a positive allosteric modulator of GABA efficacy. Kavain is also weak anti-epileptic due to its sodium ion (Na+) channel antagonism. It is also an effective mood stabilizer, working as an antagonist on Ca2+ (calcium ion) channels and as a positive modulator on K+ channels (potassium ion). Its effects on calcium ion channels also make it an effective anticonvulsant and, in synergy with yangonin, makes an effective analgesic (Pain reliever) working with both calcium ion channels and the endocannabinoid system.
- Spontaneous physical sensations - One may feel 'stoned' or heavy, in a similar way to cannabis and alcohol at the same time, without cognitive impairment.
- Motor control loss - In moderate to high doses, kava may impair motor control in a similar but less pronounced way than alcohol. For most, this feeling is similar to moderate doses of alcohol, and some users report forgetting how to move their legs temporarily, however this is typically not described as an unpleasant feeling.
- Sedation - Kava can induce a sedated state on a user and may help to relieve anxiety and physical tension
- Pain relief - Kava can be used to suppress mild to moderate pain
- Mouth numbing - When consumed orally, kava produces a temporary mouth-numbing effect similar to that of cocaine. Most users enjoy this feeling and consider it an important part of the experience, and as a way to measure the quality or potency of their kava.
- Perception of bodily heaviness - This effect is comparable to bodily heaviness experienced when cannabis and alcohol are consumed together.
- Physical euphoria - Kava can induce positive physical sensations as well as pain relief and muscle relaxation.
- Muscle relaxation
- Headaches - Users sometimes report unpleasant headaches or head fog. This is usually only produced by low-quality kavas.
- Dizziness - In higher doses, some users report mild to moderate dizziness.
- Salivation - For some, the mouth-numbing effects can cause increased salivation in users.
- Disinhibition - The disinhibiting effects of kava are usually considered to be less intense than those of alcohol and benzodiazepines.
- Dream potentiation - With continued use, many users report increasingly frequent dreams, as well as more detailed and complex dream plots with better recall.
- Empathy, affection, and sociability enhancement - Kava tends to have a notable effect on users' sociability, tolerance of others, empathy, and talkativeness. Users report lowered inhibitions and a desire to open up to others, especially on emotionally-related content from the user's past.
- Addiction suppression - Kava is used by many to reduce withdrawal symptoms from GABAergic substances, such as alcohol and benzodiazepines. It may also help to stifle cravings for many other substances.
- Cognitive euphoria - Kava has positive effects on serotonin, dopamine, and GABA activity, and can induce a euphoric state of mind in the user.
- Spatial disorientation - In some users, in very high doses, kava can mild to moderately impair ones spacial orientation, and may impair ones ability to determine the distance an object is from the user, as well as throwing off a user's ability to discern self-position in relation to other objects, which may cause dizziness and an inability to balance the vision
- Increased libido - Kava is a purported aphrodisiac.
- Increased music appreciation
- Increased sense of humor
- Spirituality enhancement - Kava is historically known as an entheogen of the Pacific Island and Polynesian communities and was used in various spiritual and ritualistic rites.
- Colour enhancement - In higher doses, especially when combined with psychedelics or cannabis, kava can cause colors to appear more vibrant than normal.
- Vibrating vision - In higher doses, a person's vision may become somewhat distorted, but not significantly to the point of impairment.
- After images - As with other visual effects produced by kava, this too usually comes into effect in higher doses.
- Visual haze - In higher doses, kava can produce a mild blur or inability to focus the eyes similar to that but more mild than that of alcohol.
There are currently no anecdotal reports which describe the effects of this compound within our experience index. Additional experience reports can be found here:
Toxicity and harm potential
Studies have shown that kava can and will induce a low level of hepatic apoptosis similar to how paracetamol affects the liver and also can affect hepatic enzymes. Because of this, certain medications can make kava unsuitable and even dangerous for some users. Noble kava root alone can not, without consuming very large amounts of the substance, induce toxic levels and no overdose has ever been recorded. The consumption of 'noble' kava root has very low toxicity, however consumption 'tudei' kava and the stems and leaves of kava plants may increase the risk of liver damage.
Some research has been done into finding the LD50 of kavalactones with results stating that around 300-400 Mg/Kg daily would be the likely lethal dose based on animal studies. 
Tolerance and addiction potential
Kava is known to produce a "reverse tolerance" in many users, in a similar fashion to substances like kanna. This means that continued use is required in order to experience full effects. Some users do not experience this.
Kava is traditionally regarded as non-addictive especially in comparison to other chemically related drugs such as benzodiazepines. In some Pacific Island communities, there is some record of people who have a psychological addiction to kava and drink it like an alcoholic drinks alcohol.
- Depressants (1,4-Butanediol, 2M2B, alcohol, benzodiazepines, barbiturates, GHB/GBL, methaqualone, opioids) - This combination potentiates the muscle relaxation, amnesia, sedation, and respiratory depression caused by one another. At higher doses, it can lead to a sudden, unexpected loss of consciousness along with a dangerous amount of depressed respiration. There is also an increased risk of suffocating on one's vomit while unconscious. If nausea or vomiting occurs before a loss of consciousness, users should attempt to fall asleep in the recovery position or have a friend move them into it.
- Stimulants - It can be dangerous to combine depressants with stimulants due to the risk of accidental excessive intoxication. Stimulants mask the sedative effect of depressants, which is the main factor most people use to gauge their level of intoxication. Once the stimulant effects wear off, the effects of the depressant will significantly increase, leading to intensified disinhibition, motor control loss, and dangerous black-out states. This combination can also potentially result in severe dehydration if one's fluid intake is not closely monitored. If choosing to combine these substances, one should strictly limit themselves to a pre-set schedule of dosing only a certain amount per hour until a maximum threshold has been reached.
- Dissociatives - This combination can unpredictably potentiate the amnesia, sedation, motor control loss and delusions that can be caused by each other. It may also result in a sudden loss of consciousness accompanied by a dangerous degree of respiratory depression. If nausea or vomiting occurs before consciousness is lost, users should attempt to fall asleep in the recovery position or have a friend move them into it.
- Hepatic Route drugs - Kava inhibits several liver enzymes in the CYP family. Consequentially, combining kava with drugs metabolized via CYP pathways, such as paracetamol, may cause adverse effects. For a list of medications click here
In some countries, kava has been banned but in most, it is simply regulated.
- Australia - Kava is regulated by the National Code of Kava Management. Only 18 year olds may have it and can only possess 2 Kg in their baggage.
- United Kingdom - In the UK it is illegal to sell, supply or import any medicinal product containing kava for human consumption. It is legal to possess kava for personal use, or to import it for purposes other than human consumption (e.g. for animals).
- United States - In the U.S., kava was once noted as a potential "Liver Damaging substance" but this remark has since been archived by the FDA and kava is legal for sale, trade, possession, use, and all other uses.
- Canada - While Health Canada has similar remarks to the U.S. regarding kava, there is no ban on the substance.