I recently was talking with a patient who informed me that she went to Kava bars for a social outlet and to find her community. I was intrigued to learn that these have become a blossoming social movement since the first kava bar opened up in Florida in 2002. After hearing about this, I had to check one of Portland’s better-known Kava bar, Nalu Kava tea lounge. They use the space as a venue for various meetings ranging from music circles to erotic open mics. I went to the song circle and brought my guitar. After ordering a mushroom kava latte, I sat down and prepared to receive the gift of a music circle and to offer my songs to the group. I’m not sure if it was the kava, but I was on cloud 9, as if our song circle became a small community of lovers of the word, music, and life.

In this article, Julian Dollente, RN writes about the reported benefits of this ancient Polynesian elixir. If you haven’t tried it yet, check out and see if there is a kava bar near you.

Christopher M. Cirino, DO, MPH

People have used medicinal plants to treat diseases and enhance general health and well-being for thousands of years. Surprisingly, — even with the growing options of medical technology in these modern times — the majority of the world still relies on traditional medicine to treat illness every day. And for a good reason. Natural remedies such as ayahuasca, psilocybin (magic mushrooms), and kava have shown several potential health benefits with fewer side effects than most drugs.

Kava, in particular, is known for its stress and anxiety relief properties. Started strictly as a beverage for ceremonial purposes in the Pacific islands, kava has been increasingly used by the general population since the 20th century. In addition, kava’s calming effects have drawn substantial interest from Western cultures. And it appears to be gaining momentum as the safer, healthier alternative to drugs and alcoholic drinks. 

In recent years, kava has become readily available in kava bars and cafes in the United States. And it’s slowly becoming a great social drink, consumed recreationally to relax the body and achieve a mild euphoria. 

In this article, we’ll take a closer look at the potential health benefits of kava and its risks for liver toxicity. We’ll also discuss why kava is better than alcohol, especially in relieving anxiety and promoting better sleep.

What is Kava?

Kava is an anxiolytic drink made from the ground roots of the Piper methysticum plant — a tall shrub in the pepper family that grows in the Pacific islands. People native to these islands have traditionally used kava for centuries during ceremonies and social gatherings to create a state of relaxation. Taking it can help relieve pain, reduce stress and anxiety, and illicit feelings of euphoria. In the Tongan language, the word “kava” means bitter.

How is it used?

Kava contains substances called kavalactones, which are responsible for its mild to moderate sedative effects. They can make you feel calm, relaxed, and happy, much like the effects of alcohol on your brain. Pacific cultures traditionally grind the kava roots into a paste, mix it with water, strain it, and consume it like alcoholic beverages.  

Today, you can buy kava as a supplement in health food stores or online, which now comes in various forms, such as capsules, powders, tablets, or tinctures (dissolved in alcohol). Based on current trends, kava is increasingly becoming a popular social drink, leading to the rise of kava bars and cafes in major American cities.

What are the potential health benefits of kava?

Beyond its recreational and ceremonial use, most people drink kava as an alternative medicine, helping them with stress and anxiety. Kava consumption can loosen users up and plunge them into a happy and relaxed mood. Studies suggest that the psychoactive properties of kavalactones have several potential health benefits, including:

1. Reduce anxiety

Anxiety disorders are among the most common mental health concerns today, affecting up to 40 million individuals (19.1%) in the U.S. every year. Usual treatment includes talk therapy and medications, many of which may come with unwanted side effects and risk for misuse. This is why the demand for presumably safe, natural remedies like kava has increased in recent years.

The current evidence suggests that kava may be an effective treatment for anxiety, regardless of the symptoms and type of disorder. According to a 2003 clinical trial involving 129 people with generalized anxiety disorder (GAD), 400 mg of kava extract was as effective as taking anti-anxiety drugs such as Buspirone (10mg) and Opripramol (100mg). After eight weeks of receiving kava, about 60% of the treatment group achieved complete remission.

A 2013 study in which 75 participants with GAD used kava in a six-week double-blind trial supported these findings.  In the 7th week, the results showed a significant reduction in anxiety, where 26% of participants who took kava experienced remission in anxiety symptoms. 

In addition, unlike most anti-anxiety drugs, drinking kava has shown no side effects related to withdrawal or dependency. Several other reviews came to a similar conclusion, reporting that kava is an effective alternative to anxiety drugs and other antidepressants. [1, 2, 3, 4, 5, 6].

2. Promote better sleep

Lack of sleep and insomnia can be associated with various health issues, including physical illness or pain, stress and anxiety, depression, and poor lifestyle habits. In the United States, around 25% of the population experience insomnia each year, leading many to rely on sleep medications or alcohol to help them sleep better. 

By increasing neurotransmitter binding to GABA-A receptors, kava produces similar sedative effects. And the best part is it does not cause users a nasty hangover the following morning or develop addiction long-term.

Research suggests that kava can help reduce stress and improve sleep quality. In one study, 24 patients with stress-induced insomnia were treated for six weeks with kava. The results show that total stress severity was significantly relieved. There was also improvement in sleep quality without dependence potential or any appreciable side effects. 

Another study in 2004 found kava extract to be an effective and safe treatment for 61 people with sleep disturbances associated with non-psychotic anxiety disorders. 

Despite promising results, however, more clinical trials on larger populations are required to confirm the potential benefits of kava in people with sleeping disorders.

Related: Insomnia: Why Getting Poor Sleep is Cause for Alarm

3. Reduce risks of cancer

The World Health Organization lists cancer as the leading cause of death worldwide, accounting for nearly 10 million deaths in 2020. Besides cancer screening and lifestyle changes, kava is another promising alternative to help reduce cancer risk.

Based on preliminary animal and cell studies, researchers have found that kava extracts may have anticancer effects, including cancers of the lungs, prostate, colon, and urothelial cells. In one study, flavokawain A (a predominant chalcone identified in kava plants) prevented the progression and recurrence of bladder cancer in mice. Flavokawain A also shows potential in suppressing the growth of bladder tumor cells in a nude mice model (57%).

Furthermore, flavokawain B can help reduce prostate tumor growth in both mice and cell studies. It kills tumor cells by activating the pathways that cause cell death (caspase-3/9 and Bax protein) and inhibiting two proteins needed for cell growth (PLK1 and FOXM1). 

Some studies suggest that kava consumption can reduce the size of breast cancer cells, prevent their spread, and increase their death. There is also evidence that can prevent the growth of human colon cells in vitro through the release of cytochrome c and Bax protein.

Related: Smoking and Cancer: What are the Risks?

Safety concerns for kava consumption

Like any other drug, kava consumption has side effects, such as headaches, restlessness, depression, tremors, diarrhea, or mild stomach upset. It may also cause allergic skin reactions (contact dermatitis) and dry eyes, particularly when used frequently and in high doses. And although kava is generally safe to use, there are some concerns about liver toxicity and damage. 

Due to several cases of liver toxicity associated with kava consumption in the early 2000s, the US Food and Drug Administration (FDA) issued a consumer advisory regarding the its use. Cases of hepatoxicity from using kava include acute hepatitis, fatty liver, and cirrhosis. In worst cases, kava consumption has led to liver failure and even death. 

But while the evidence suggests that kava has caused harm to the liver of its users, many of these cases involved pre-existing liver disease, excessive doses, and heavy alcohol use. There is a need for more research to determine the safety threshold for using kava.

Nevertheless, because of the potential risks to the liver, some countries have restricted or banned the use of kava in any form, including Germany, Canada, France, Poland, and Switzerland. However, further research later revealed insufficient evidence of alleged risks (less than 1% incidence), which prompted Germany to lift the ban in 2015.

Is kava Legal in the US?

The FDA does not approve supplements, but you can legally purchase kava for personal use as a dietary supplement in the US. Currently, no existing law prohibits its use and distribution. It is legal in most countries and may be available in supermarkets, bars, and cafes near you. 

Kava vs. Alcohol

Traditionally, Pacific Islanders used kava for ceremonial, medicinal, and recreational purposes. In today’s current trend, many societies consume it, similar to how Western cultures drink alcohol. Hence kava’s increasing popularity and the proliferation of kava bars and cafes in major cities across the United States.  

Both kava and alcohol are known for their “relaxing” effects and are often consumed in social settings to foster positive social interactions and develop great relationships. Although kava and alcohol have a lot in common, they also have several significant differences, which make kava the better choice. Here’s why:

• Unlike alcohol, users experience “reverse tolerance” with kava, meaning the more you drink it, the less you need to feel and enjoy its effects. When you need less to enjoy the benefits, it eliminates the potential for addiction.

• Unlike alcohol, long-term use of kava does not lead to addiction or dependency. Moreover, users who stop kava consumption after using it for a long time do not appear to be experiencing withdrawal effects.   

• Unlike excessive alcohol consumption, kava rarely leads to violence. Kava is known to produce a sense of calmness, which promotes peaceful dispositions and interactions.      

• While people may fall asleep after drinking alcohol, their sleep quality may not be as hoped. Meanwhile, drinking kava has been shown to induce sleep and improve sleep quality — without the nuisance of a hangover the following day.

Related: Alcohol: The World’s Most Harmful Drug

Conclusion

Kava has a long history of consumption in the Pacific islands, and it’s currently gaining popularity beyond its origins. Some evidence suggests that it can be a safe and enjoyable beverage, helping users relax, sleep better, or deal with stress. 

Although others may argue about its potential risks for liver toxicity, studies since then have continued to dispute the previous claims. The concerns mainly arise from the improper cultivation and preparation of kava roots, especially those sold in the market, since there’s no control and regulation. One thing is clear, though, more research on kava is necessary to understand its safety and risks better.

Ultimately, the health benefits of kava greatly outweigh the risks. When taken alone, the features of kava make it an attractive replacement for alcohol and some anti-anxiety medications. Mixing it with alcohol and other drugs may cause adverse reactions or diminish its effectiveness. So, before you take it as a medical treatment, consult your doctor first. Because, just like any other alternative treatment, it may not be for everyone. 

As for recreational purposes or social lubricants, kava is safer, healthier, and better than alcoholic beverages. But as for the taste, you be the judge. Cheers!