The health and social effects of drinking water-based infusions of kava: A review of the evidence

Drug and Alcohol Review

Volumn 30, Issue 1, 2011, Pages 74-83

  Rychetnik, Lucie ^a   Madronio, Christine M ^a  

^a UNIVERSITY OF SYDNEY   (Australia)

Author keywords

Evidence; Health effect; Kava; Review; Social effect

Indexed keywords

ANXIOLYTIC AGENT; GAMMA GLUTAMYLTRANSFERASE; KAVA; PLANT EXTRACT; WATER;

AUSTRALIA; BEHAVIOR; DRUG EFFECT; ENZYMOLOGY; HEALTH; HUMAN; LIVER; MALE; METABOLISM; NEOPLASM; REVIEW;

ANTI-ANXIETY AGENTS; AUSTRALIA; BEHAVIOR; GAMMA-GLUTAMYLTRANSFERASE; HEALTH; HUMANS; KAVA; LIVER; MALE; NEOPLASMS; PLANT EXTRACTS; WATER;

EID: 78651231882     PISSN: 09595236     EISSN: 14653362     Source Type: Journal    
DOI: 10.1111/j.1465-3362.2010.00184.x     Document Type: Review

References (61)

1. Gorringe R. Piper methysticum: an anxiolytic. Aust J Med Herbalism 1999;11:145-51.
2. Gregory RJ. The mental side of kava. Aborig Health Work 1988;12:13-17.
3. Lebot V, Lindstrom L, Merlin M. Kava: the Pacific Drug. Psychoactive plants of the world series. New Haven: Yale University Press, 1992.
4. McDonald D, Jowitt A. Kava in the pacific islands: a contemporary drug of abuse? Drug Alcohol Rev 2000;19:217-27.
5. Clough AR. Enough! or too much. What is 'excessive' kava use in Arnhem Land? Drug Alcohol Rev 2003;22:43-51.
6. Urquhart B, Thomson N. Review of the misuse of kava among Indigenous people. 2008 Available at: (accessed February 2010).
7. Alexander K, Watson C, Fleming J. Kava in the north: a study of kava in Arnhem Land Aboriginal communities. Aborig Health Inf Bull 1988;10:32-7.
8. Clough AR, Burns CB, Mununggurr N. Kava in Arnhem Land: a review of consumption and it social correlates. Drug Alcohol Rev 2000;19:319-28.
9. Clough AR, Guyula T, Yunupingu M, Burns CB. Diversity of substance use in eastern Arnhem Land (Australia): patterns and recent changes. Drug Alcohol Rev 2002;21:349-56.
10. Clough AR, Currie BJ, Yunupingu MW, Conigrave KM. Action is required to reduce kava supply in Arnhem Land . again! Med J Aust 2006;184:91-2.
11. Abbott T, Johnston D. Kava importation into Australia. Joint release by The Hon Tony Abbott MHR, Minister for Health and Ageing and Senator the Hon David Johnston, Minister for Justice and Customs. 2007 Available at: (accessed April 2009).
12. NH & MRC Quality of Care and Health Outcomes Committee. A guide to the development, implementation and evaluation of clinical practice guidelines. Canberra: Australian Government Publishing Service, 1999.
13. Oxford Centre for Evidence-based Medicine. Levels of Evidence. 2009 Available at: (accessed April 2009).
14. Bradford-Hill A. A short textbook of medical statistics. Kent: Hodder and Stoughton, 1977.
15. Susser MW. What is a cause and how do we know one? A grammer for pragmatic epidemiology. Am J Epidemiol 1991;133:635-48.
16. Clough AR, Jacups SP, Wang Z, et al. Health effects of kava use in an eastern Arnhem Land Aboriginal community. Intern Med J 2003;33:336-40.
17. Riley M, Fejo L, Munoz E, et al. Health effects of kava. Annual Report of the Menzies School of Health Research. Report No. 1030-1550. 1987. p. 71-2.
18. Riley M, Bujevich J, Collins L, Mathews J. Are the chronic ill effects of heavy kava use reversible? Annual Report of the Menzies School of Health Research. Report No. 1030-1550. 1987. p. 73-4.
19. Kava R. The adverse effects of kava. Pac Health Dialog 2001;8:115-18.
20. Mathews J, Collins L, Riley M. Bad effects of kava on the body. Aborig Health Worker 1988;12:10-12.
21. Mathews J, Riley M. The effects of heavy usage of kava on physical health. Med J Aust 1988;149:342.
22. Mathews J, Riley M, Fejo L, et al. Effects of the heavy usage of kava on physical health: summary of a pilot survey in an Aboriginal community. Med J Aust 1988;148:548-55.
23. Grace R. Kava-induced urticaria. J Am Acad Dermatol 2005;53:906.
24. Russmann S, Barguil Y, Cabalion P, Kritsanida M, Duhet D, Lauterburg BH. Hepatic injury due to traditional aqueous extracts of kava root in New Caledonia. Eur J Gastroenterol Hepatol 2003;15:1033-6.
25. Chanwai LG. Kava toxicity. Emerg Med 2000;12:142-5.
26. Clough AR, Rowley K, O'Dea K. Kava use, dyslipidaemia and biomarkers of dietary quality in Aboriginal people in Arnhem Land in the Northern Territory (NT), Australia. Eur J Clin Nutr 2004;58:1090-3.
27. Brown A, Onopa J, Holck P, et al. Traditional kava beverage consumption and liver function tests in a predominantly Tongan population in Hawaii. Clin Toxicol 2007;45:549-56.
28. Assan T. Kava drinking in Arnhem Land. Aborig Health Worker 1987;11:22-4.
29. Drury C, Torres M, Parker G, Gordon P. A Kimberley view of kava-from an Arnhem Land visit. Aborig Health Worker 1987;11:25-31.
30. Foo H, Lemon J. Acute effects of kava, alone or in combination with alcohol, on subjective measures of impairment and intoxication and on cognitive performance. Drug Alcohol Rev 1997;16:147-55.
31. Clough AR, Cairney S, Maruff P, Currie BJ. Possible toxicity and withdrawal seizures in Aboriginal kava drinkers in Arnhem Land. South Pac J Psychol 2001;13:26-33.
32. Spillane PK, Fisher DA, Currie BJ. Neurological manifestations of kava intoxication. Med J Aust 1997;167:172-3.
33. Currie BJ, Fisher DA, Howard DM, et al. Endemic Melioidosis in Tropical Northern Australia: a 10-year prospective study and review of the Literature. Clin Infect Dis 2000;31:981-6.
34. Clough AR, Wang Z, Bailie RS, Burns CB, Currie BJ. Case-control study of the association between kava use and ischaemic heart disease in Aboriginal communities in eastern Arnhem Land (Northern Territory) Australia. J Epidemiol Community Health 2004;58:140-1.
35. Young MC, Fricker PA, Thomson NJ, Lee KAP. Sudden death due to ischaemic heart disease in young Aboriginal sportsmen in the Northern Territory, 1982-1996. Med J Aust 1999;170:425-8.
36. Steiner GG. The correlation between cancer incidence and kava consumption. Hawaii Med J 2000;59:420-2.
37. Prescott J, Jamieson D, Emdur N, Duffield P. Acute effects of kava on measures of cognitive performance, physiological function and mood. Drug Alcohol Rev 1993;12:49-57.
38. Cairney S, Clough AR, Maruff P, Collie A, Currie BJ, Currie J. Saccade and cognitive function in chronic kava users. Neuropsychopharmacol 2003;28:389-96.
39. Cairney S, Maruff P, Clough AR, Collie A, Currie J, Currie BJ. Saccade and cognitive impairment associated with kava intoxication. Human Psychopharmacol 2003;18:525-33.
40. Russell PN, Bakker D, Singh NN. The effects of kava on alerting and speed of access of information from long-term memory. Bull Psychon Soc 1987;25:236-7.
41. Clough AR, Bailie RS, Currie BJ. Liver function test abnormalities in users of aqueous kava extracts. J Toxicol Clin Toxicol 2003;41:821-9.
42. Clough AR, Wang Z, Bailie RS, Burns CB, Currie BJ. Case-control study of the association between kava use and pneumonia in eastern Arnhem and Aboriginal communities (Northern Territory, Australia). Epidemiol Infect 2003;131:627-35.
43. Clough AR. Does kava cause hallucinations in Aboriginal populations in eastern Arnhem Land (Australia)? South Pac J Psychol 2001;13:34-7.
44. Food Standards Australia New Zealand. Kava-A human health risk assessment. Technical Report Series No. 30. 2005, FSANZ: Canberra.
45. Food Standards Australia New Zealand. Final assessment report-Proposal P256-Review of Kava. Report No 30. 2004, FSANZ: Canberra.
46. Therapeutic Goods Administration. Kava fact sheet. Department of Health and Ageing [Internet] 2005 2006 Aug 22. Available at: (accessed October 2006).
47. Drug Info Clearinghouse. Kava. Fact Sheets [Internet] 2006 Mar. Available at: (accessed October 2006).
48. Better Health Channel. Kava. Health and medical information for consumers, quality assured by the Victorian government (Australia). Fact Sheets A-Z. [Internet] 2008 Jul 2008 Available at: (access April 2009).
49. Tropical Health Working Group of the Top End Division of General Practice. Toxins. In: Johnston F, ed. Tropical health in the Top End: an introduction for health practitioners. Darwin: Top End Division of General Practice, 2003:115-31.
50. NT Government Department of Health and Community Services. (formerly Territory Health Services). The Public Health Bush Book. 2002 Available at: (accessed October 2006).
51. Clough AR. Kava. In: Ewald D, ed. CARPA standard treatment manual reference book. Alice Springs: Central australian rural practitioners association, 2004:174-8.
52. Ministerial Council on Drug Strategy. National Drug Strategy: Aboriginal and Torres Strait Islander Peoples Complementary Action Plan 2003-2009. Background paper. 2006, Ministerial Council on Drug Strategy: Canberra.
53. Ernst E. A re-evaluation of kava. Br J Clin Pharmacol 2007;64:415-17.
54. Fu P, Xia Q, Guo L, Yu H, Chan P. Toxicity of kava kava. J Environ Sci Health C 2008;26:89-112.
55. Teschke R, Schwarzenboeck A, Akinci A. Kava hepatotoxicity: a European view. NZ Med J 2008;121:90-8.
56. ABC News. Kava ban 'sparks black market boom'. [Internet] 2007 2007 Aug 23 Available at: (accessed August 2007).
57. ABC News. Kava ban leads to crime rise. 2007 2007 Aug 25 Available at: (accessed August 2007).
58. Pinomi S. Kava restriction puts an unfair burden on Pacific culture, in Sydney Morning Herald. 2008, Fairfax digital: Sydney.
59. ABC News. Support for Indigenous kava ban. [Internet] 2007 Available at: (accessed August 2007).
60. ABC News. Kava's grip on NT communities must be loosened. [Internet] 2007 Available at: (accessed August 2007).
61. Rychetnik L, Madronio C. A kava literature review; prepared for the Laynhapuy Homelands Association Inc. 2007, Sydney Health Projects Group, The University of Sydney: Sydney.