Kava Addiction and Abuse

Kava, also known as kava-kava, is a herbal substance that is produced from the roots of Piper methysticum, a plant indigenous to the western Pacific Islands. The name kava is derived from the Polynesian word “awa,” meaning “intoxicating pepper.” Kava has been used for centuries by native islanders for various medical and religious purposes due to its euphoric, sedative, and psychotropic properties. It is also gaining popularity in the modern world, as people are becoming keener on treating various diseases and ailments through natural and herbal remedies.

Generally consumed as either an extract or beverage, kava is regarded as a non-alcoholic psychoactive substance. It is legally sold in the US as a dietary supplement and marketed as a muscle relaxant and sleep aid. Nevertheless, research is still underway on the possibility of kava as a treatment for conditions such as anxiety, insomnia, and chronic stress. Some studies have conveyed that kava could be an effective alternative to benzodiazepines, but the scope of this topic is still limited.

Research indicates that kava is possibly effective in reducing the symptoms of anxiety and generalized anxiety disorders as it affects the brain in a similar manner to anti-anxiety drugs. As a matter of fact, this supplement has turned into a popular natural alternative to benzodiazepines such as Ativan and Xanax since benzos bring in a number of negative side effects such as tiredness, weakness, confusion, nausea, depression, irritability, and hostility.

Kavalactones, the active ingredients in kava, are believed to be responsible for kava’s effects on the brain and other parts of the central nervous system. Kavalactones are sticky, insoluble substances that pass through the bloodstream while being absorbed, causing kava to act as a muscle relaxant. Many research indicates that consuming kava extracts with 70 percent kavalactones can reduce anxiety as it works just as effectively as some prescription anti-anxiety medications. In addition to anxiety-relief, some individuals take kava to boost their mood and to fall asleep faster. Due to these relaxing properties, kava is sometimes used to treat attention-deficit-hyperactivity disorder (ADHD) and withdrawal from certain drugs.

Kava is available for consumption in various forms. Traditionally, people take kava roots and chew them or mash them into a pulp and add them to water. However, currently, kava is available in various non-traditional forms such as pre-made liquid, tablets, tea, and tinctures (liquid extracts). Many describe the taste of kava as earthy or very similar to dirt.

Some of the most common ways of consuming kava are: 

The above–mentioned consumption options are available in addition to kava tea, supplements, and tablets. There are also various drinks available for consumption that includes kava as an ingredient.

Kava is known to significantly reduce anxiety and improve sleep, mood, and appetite in some users. However, kava also produces a number of negative and potentially harmful effects that range from mild to severe.

Some of the side effects of kava are:

• Drowsiness
• Impaired co-ordination
• Nausea
• Skin rash
• Numbness
• Diarrhea
• Blurred vision
• Fever
• Dizziness
• Weight gain
• Depression
• Tremors
• Headache

Individuals who regularly use kava say that the herb generates a calming sensation similar to benzodiazepines and alcohol. However, unlike alcohol, they claim to feel “clear-headed” while under the substance’s influence. Since kava acts as a central nervous system depressant by impacting the receptors of neurotransmitter gamma-aminobutyric acid (GABA) and stimulating dopamine production in the brain, the calming and mood-boosting effects of the substance can encourage users to abuse the drug compulsively to intensify the feelings.

Abuse refers to any situation in which a substance is used as opposed to the recommendation, such as taking it in higher doses or mixing it with other drugs or alcohol. Most users tend to abuse kava to enjoy its effects faster and to enhance the sedation of other central nervous system depressants, such as alcohol. Nevertheless, kava abuse of any kind can increase the risks of complications such as troubled breathing, abdominal cramping, and slowed cognitive function.

Although kava is generally non-addictive, it can be habit-forming and lead to tolerance. As the substance induces a euphoric high that can be used as a form of escapism or self-medication, users can take a great liking to the drug. This can pave the way for abuse, which can then lead to a vicious cycle of addiction.

Some of the telling signs of kava addiction are:

• Requiring more and more of the supplement to obtain the desired effects.
• Wanting to stop taking kava but being unable to do so: this is particularly true for individuals who use kava for generalized anxiety disorder.
• Continuing to use the supplement despite the negative outcomes.
• Spending excessive time in places like kava bars.
• Encouraging kava use in others and ceasing activities that do not involve the drug.
• Feeling an overwhelming urge to take the drug, especially during stressful situations.
• Obsessing over the next kava hit throughout the day.
• Withdrawing from social gatherings to stay at home and consume the supplement.
• Experiencing withdrawal symptoms when attempting to quit or reduce kava use, including rebound anxiety, headache, nausea, fatigue, and intense cravings for the substance

Combining kava with other substances to enhance its effects is also another sign of kava addiction. Relaxants such as kava are most commonly abused along with alcohol as the combination enhances the effects of both the substances, resulting in a more intense high or sedation. Some people may also use kava as a come-down from stimulants, such as cocaine or Adderall.

The US Food and Drug Administration (FDA) has expressed concerns regarding the safety and effectiveness of kava. In 2002, the FDA publicly announced that kava products were associated with potentially adverse effects on the liver. The FDA further cited that long-term use of kava results in hepatitis, cirrhosis, and liver failure. Regular consumption of the supplement for as little as one to three months has led to users requiring liver transplants or even the cause of death. Thus, these reports led certain countries such as Germany, France, Canada, Switzerland, and the UK to regulate the substance within their borders. Nevertheless, kava still remains legal in the US.

Many theories revolve around why the repeated use of kava leads to liver damage. One theory focuses on the fact that kava is metabolized by a set of liver enzymes that also metabolizes many other drugs. The theory stresses that kava ties up these enzymes so that they cannot effectively process the other drugs, resulting in those drugs accumulating and damaging the liver. Another theory states that kava is metabolized into substances that directly harm the liver cells, whereas many other researchers believe that liver toxicity occurs due to kava being mixed with alcohol. Another similar theory states that the inflammation and depletion of important substances in the liver cause liver toxicity. However, since the mechanism between kava and liver toxicity is not clear, the FDA has warned individuals with liver disease to avoid taking kava before consulting a physician. Kava must also be avoided by individuals who abuse other drugs that cause liver damage.

Some of the other health complications associated with prolonged kava use are:

• Irritation of the stomach
• Kidney injury
• Shortness of breath
• Disorientation
• Hallucinations
• Dermopathy (scaly skin disorder that is most often found in people abusing kava)