Article at a Glance:

  • Kava is native to the South-Pacific and a medicinal treatment used for religious ceremonies.
  • Kava comes from the stems and roots of a shrub and is considered psychoactive.
  • In western culture, Kava is used to treat anxiety, stress, and insomnia.
  • Kava comes in the forms of a liquid, tablet, or tea.
  • Kava may pose risks to the liver and have other health effects due to limited research.

What is Kava?

You may have heard of kava and wondered what it is. As people have become increasingly interested in the concept of natural remedies and herbs to deal with various conditions and ailments, kava has become more popular and well-known.

So, what is kava?

Kava, also called kava-kava is a substance that comes from a root native to the South Pacific region. It’s been used by native islanders for centuries as a medicinal treatment and also as part of their religious ceremonies.

In fact, there are estimates that show kava has been used for more than 3,000 years by Pacific Islanders, and in villages, it’s still used during gatherings and social events. Pacific Islanders may use kava occasionally, or they may do a complete kava ceremony if there is a special occasion. In a kava ceremony, everyone gathers and shares from a bowl that’s kept in the middle of the circle. A chosen person does the serving.

The following are some of the primary things to know about kava.

  • Kava is also known as ‘awa and piper methysticum. It comes from the roots and stems of a small shrub, and it’s considered non-alcoholic but psychoactive. It’s used in Fiji, Tonga, and Hawaii and has been for many years.
  • When kava is prepared traditionally, it’s done so by putting the root and stem into a sack and putting them in water. You can then squeeze the juice from the sack into a wood bowl, and it’s served as if from a punch bowl.
  • Kava is said to help with relaxation, but according to people who use it, it doesn’t cloud their thoughts.
  • In western culture, kava has been increasingly looked as a treatment for anxiety and stress, as well as insomnia. Some research has shown kava may be as effective as benzodiazepines, although research is still limited on the topic.
  • There has been some worry about the effects of kava on the liver.
  • As with other supplements, it’s important that people who take kava don’t mix it with prescription drugs. This is because it can inhibit their effectiveness or cause more serious side effects.

These are just a few things to know about kava-kava. Below is an overview of all of the key facts about this substance including more details about what it is, kava dosages, whether or not you get high from kava and what the other effects are.

Why Do People Take Kava?

In the past decade, there has been a lot of attention put on the damaging effects of prescription drugs in the U.S. This includes opioids and benzodiazepines like Xanax. People have increasingly relied on these drugs for a variety of reasons and may end up abusing them. There has also been worry about the rising use of alcohol and things like binge drinking, and in an effort to avoid these dangerous scenarios, more people have started looking for herbal remedies and supplements that could help them relax.

Once such option is kava-kava. It’s said that kava serves as a natural alternative to widely used drugs like Xanax and Ativan. These drugs are prescribed to millions of people each year, and they are part of the class of drugs called benzodiazepines. While not exactly understood, medical professionals believe benzos work because they raise levels of GABA in the brain, which calms neurotransmitter activity and reduces symptoms of anxiety.

Despite the therapeutic effects of these prescription drugs, they have many side effects. Taking benzos can lead to feeling tired, confused, weak, or dizzy. It can have mood and psychological effects including depression, irritability, and aggressiveness. There’s even research showing that long-term use of benzos can raise your chances of later getting dementia. Anti-anxiety medicines are only meant to be a short-term solution that people take for a few weeks and no more than a few months. Unfortunately, they’re incredibly addictive, and people develop a tolerance to them, meaning they need more to get the same effect.

Benzos are extremely difficult to stop taking once you’re addicted, and the withdrawal side effects can be dangerous or deadly. In some cases, people who take these drugs may end up with paradoxical side effects, which means they react with an amplified set of the same symptoms that led them to take them in the first place including heightened anxiety.

With these scary facts staring people in the face, it’s no wonder they look for alternatives to anti-anxiety medications, and kava is one that a lot of people are interested in.

A bit of research has been done on kava and shown that it is possibly effective at helping with the symptoms of anxiety and generalized anxiety disorder, and this is believed to be because it works in a way that’s similar to anti-anxiety drugs. It increases GABA.

With that being said, frequently people hear natural and think safe, and there needs to be more research before the safety claim can be fully be made. There’s also the potential that kava doesn’t help anxiety as much as people believe since there isn’t a lot that’s scientifically proven about the substance.

According to WebMD kava does have a calming effect that occurs because of the way it changes brain waves, much like Valium. It’s also stated that kava can relax muscles and prevent convulsions.

Proponents of kava say that the active ingredients which are called kavalactones are the reason that it works to relieve anxiety. Along with anxiety-relief, some people take kava because they feel it boosts their mood and helps them fall asleep more easily.

How is Kava Taken?

Kava is available in many different forms. In the traditional sense and places where kava is native people will usually take the roots and chew them or turn them into a pulp and add water. Then they have a brew, and it’s not uncommon for this drink to be offered to visitors in the Pacific Islands.

In western culture, kava is available as a liquid, a tablet, or tea. It’s also available as tinctures. You can order kava powder as well, and make it more traditionally. With kava powder, people usually put it in something like cheesecloth, add it to water, let it soak and strain it. They can then drink the resulting brew. Kava can be taken as a regular supplement as well, and there are many different drinks that include kava that you can purchase.

Below is a specific overview of some of the ways kava can be taken.

  • Ground Kava Root: If you want a traditional kava experience you might opt for the kava root. The preparation for kava root was touched on above. You would have ground kava root that you would put in a muslin cloth and steep in water. This process can be lengthy, and it requires kneading and straining, but some people prefer this method of preparing kava because they feel it maximizes the effects.
  • Micronized Kava: Micronized kava is a fine powder, and it’s kind of like an instant version of the root. You simply add it to a drink, and you don’t have to do the steeping or the kneading.
  • Kava Concentrate: Kava concentrate is a concentrated drink form of kava that can be added to another drink.

These options are in addition to kava tea and supplements.

The taste of kava is often described as very earthy and a lot like dirt. It’s recommended people take it on an empty stomach to maximize the effects.

Kava Dosage

For people who are exploring kava, they may be wondering what kava dosage to take. This is a difficult question to answer, because a safe kava dosage can vary depending on how you’re taking it and what you’re taking it for, as well as the specific chemotype and type of kava you’re having.

Some people may take a kava dosage only at night before bed, and they may choose to have it as a tea, while other people might take it as a supplement throughout the day.

The lack of clear guidelines about kava dosage is one of the reasons it’s important to use caution with this substance and other herbal remedies. There’s not a sense of clarity or regulation in kava dosages, so people don’t necessarily know what’s safe, or what’s right for them based on what they hope to achieve with the use of kava.

In general, the kava dosage often recommended is between 100 and 300 mg per day. Currently, the FDA hasn’t approved the use of kava for any medical conditions. According to natural remedy writer Dr. Axe, the suggested dosage for the treatment of non-psychotic anxiety is 105 to 210 mg per day, for a period of three to four weeks.

The Effects of Kavalactones

As mentioned, there is a belief that the kavalactones in kava plants are the active ingredients. The science on how these components work is still limited, but there is a theory that kavalactones interact with the limbic system. The limbic system is the part of the brain responsible for fear and anxiety. When kavalactones bind to those brain receptors, they may naturally reduce anxiety, although this is just a theory.

Something else important to understand when researching kava is called a chemotype. Different types of kava have chemotypes, which are numbers that list the percentages of kavalactones. In simple terms, you could say this might mean that by looking at the chemotypes you can figure out which type of kava will be strongest, or which type will have certain effects.

Kava being made

Does Kava Make You High?

Along with “what is kava,” one of the most common questions people have is does kava make you high. While people who have used it say that they feel calm and it’s somewhat similar to the use of alcohol or benzodiazepines, they also say that they remain clear-headed, so it’s different from substances like alcohol.

You may feel a bit of a buzz like you would if you drank some alcohol, but it’s not necessarily going to be a “high” at least not in the way you think of it. Some people may experience euphoria or an increased level of sociability when taking kava, but this can vary pretty significantly from one person to the next. For example, someone who has a lower body mass index might experience more of a buzz from kava kava than a larger person.

When people drink kava, they may find that their lips and tongue feel numb for a few minutes, and that’s probably because of the action of certain kavalactones. Some people may think this is a pleasant feeling while others might not. Some people then say they start to feel warm or tingly and they feel like their muscles relax. A bit of euphoria may occur, or it may not. You may simply feel calmer and more relaxed.

So, does kava make you high?

Not exactly. You may feel a bit like you were drinking alcohol, but the effects are usually less profound.

Kava Risks

One of the most important things to know about kava side effects and the potential risks of kava is that it can lead to liver problems. There have been a few reported instances of liver damage or failure with the use of Kava. That has led to the supplement being banned in some countries.

In the U.S. the FDA has issued a warning that people who have liver disease or liver problems, or who take medicines that can affect the liver speak to a doctor before they take kava kava.

Some of the signs of liver problems the FDA warns people to look out for when taking kava includes brown urine, yellowing of the skin or eyes, nausea, light stools, tiredness, weakness, or stomach pain.

Other warnings about potential kava side effects include:

  • Kava shouldn’t be used for more than three months at a time unless you talk to your doctor
  • You should never combine kava of any kind with alcohol or psychotropic medicines used to treat psychiatric disorders including antidepressants and mood stabilizers.
  • It’s important that you don’t drive or operate machinery when using kava because it can slow your reaction time
  • Kava can rarely cause allergic reactions

Some of the long-term potential side effects of kava use can include liver problems, shortness of breath and facial swelling. Another relatively common side effect of kava seen in heavy, long-term users is the development of scaly skin rashes.

It’s also possible to develop a kava tolerance if you use it over time.

According to Web MD, kava is classified as “possibly unsafe.” They cite the risks of liver damage and highlight the fact that using kava for as little as one to three months has resulted in the need for liver transplants and also death. There is some evidence that kava may worsen symptoms of Parkinson’s disease as well.

There are several interactions to be aware of with kava that can produce side effects. One of these is the interaction of alprazolam (Xanax) with kava. This can be a major interaction, and they shouldn’t be taken together. Kava shouldn’t be taken with sedatives either.

Medicines changed by the liver may interact with kava, as can something called Lovodpa, which increases dopamine in the brain.

Along with the potential adverse kava side effects, the following are some of the general effects of kava:

  • Slightly intoxicating
  • Impacts the brain’s GABA receptors
  • Can improve mood and lessen anxiety
  • Stimulates dopamine receptors in the brain

There are often questions about whether kava is legal in the U.S. and around the world. In the U.S. kava is legal, and is sold as a dietary supplement. It can be marketed as something that helps people relax and sleep better, but despite the legal status, the U.S. FDA has shown concern about the safety and effectiveness of kava.

In 2002 the FDA released an advisory saying that kava products were linked to potentially adverse effects on the liver. The FDA pointed out reports in other countries of hepatitis, cirrhosis and liver failure, and the reports about kava and liver problems led to new regulation in Germany, France, Canada, Switzerland and the UK.

The FDA released the consumer warning since that time, and there have been disputes as to whether or not kava causes liver injury.

Despite the fact that kava is legal in the U.S., there are advisements from the FDA about using it if you have liver issues already or take medicines that affect your liver.

Ground kava root

Kava For Anxiety

One of the primary reasons people take kava is for anxiety, and they often wonder if it’s safe for this. There have been some clinical studies which have shown kava may be able to treat anxiety symptoms, with it being more effective than placebos. Study participants showed improvement in their anxiety symptoms after a week of treatment, but there has been a decline in the research done using kava because of the potential for liver toxicity.

In 2013 there was a study published in the Journal of Clinical Psychopharmacology, and researchers looked at a group of people with generalized anxiety disorder over six weeks. Half the group took a placebo and half took kava. The findings showed that 37% of the kava group said their anxiety symptoms had been lessened, while only 23% of the placebo group said that. Around ¼ of the kava group said their anxiety symptoms had completely dissipated by the end of the trial, as compared to only 6% of the placebo group.

Despite the findings showing some promise for the use of kava and the treatment of anxiety, researchers said they need a larger replication study to confirm the findings. Also, the researchers were careful to point out that their study didn’t look at the potential long-term effects of using kava.

According to the National Institutes of Health, the pyrones contained in kava are believed to have anxiolytic, analgesic, muscle relaxant and anticonvulsant effects. NIH also highlights the therapeutic uses for kava include anxiety as well as insomnia and treating stress, and they say that it has a low potential for abuse. NIH names the most common potential kava side effects as:

  • Headache
  • Drowsiness
  • Diarrhea
  • Depression
  • Skin problems

Is Kava Safe?

So while kava for anxiety may show some promise at the clinical level, it still begs the question is kava safe?

One of the biggest potential side effects of kava for anxiety or any other purpose is liver toxicity. According to the NIH, the estimated frequency of liver injury because of kava is less than 1 per 1,000,000 doses, but it’s difficult to gather data on injuries resulting from the use of dietary supplements. There have been between 50 and 100 examples of liver injury that are believed to be related to kava, but people in favor of the use of kava have disputed the reality of these claims.

To sum up, kava may be safe for anxiety, and it may also be effective, but these are big maybes. There’s no clear way to say for sure whether kava for anxiety is safe or even if it works because much of the information about this supplement is purely anecdotal right now.

While kava has become more mainstream and some kava bars are even opening up in the U.S., doctors continue to advise people with liver problems or conditions, or people who have been drinking alcohol to avoid kava because of the risk of liver damage.

According to FDA warnings, kava can potentially pose a risk to anyone, but in particular, kava might not be safe for someone who doesn’t metabolize drugs well, and it may also be particularly dangerous for someone who combines kava with alcohol or other depressants of the central nervous system.

Combining Kava and Alcohol: Dangerous for Your Liver?

People will frequently compare the effects of kava to feeling a buzz from drinking alcohol, but there are numerous warnings about the use of kava and alcohol together. Is okay to combine kava and alcohol or can it cause liver problems?

While researchers are unsure of the exact reasons kava might cause liver damage, or even if it does, they do believe that combining kava with alcohol could put you and your liver at an undue risk. Some of the side effects although rare have included cirrhosis of the liver and liver failure, and the use of alcohol can make the risk of these effects higher.

Also along with considering whether or not kava and alcohol are dangerous for your liver is the fact that you can amplify the effects of kava when these substances are combined. Kava can already have a relaxing and somewhat sedative effect. If you add alcohol to the mix, it’s going to further slow your central nervous system, which can slow your reflexes and cause you to become very drowsy.

If you’re wondering whether or not it’s okay to take kava and alcohol at the same time, it would be a no. Doctors warn against it because of the increased risk of liver damage and dangerous side effects.

Summing up Kava: Risks vs. Benefits

So, to sum up, what is kava root?

Kava root is the root of a small bush that’s native to the Pacific island region. For thousands of years, it’s been used in religious and cultural ceremonies, and as a drink passed around in social environments. Kava has made its way to western culture, particularly as people who struggle with conditions like anxiety want to avoid pharmaceutical remedies and instead want natural options. Kava kava has become so popular that bars focusing on the use of it have been opening up around the country and the world.

Kava root can be taken in several different ways. You can use the ground up root to create a tea requiring steeping and kneading. You can also purchase kava teas, drinks and concentrates that are ready to go, or you can take it as a capsule supplement. There are varying levels of quality with kava root, and when people use it, they should try to source the best products available.

So, why do people use kava root?

It’s said to promote a sense of calm and relaxation, particularly among people who suffer from symptoms of anxiety. It’s believed to create a mild sense of euphoria or well-being, and other possible benefits of kava root include the ability to relieve pain, destroy fungus, prevent spasms, and it’s used as a diuretic in some cases.

Kava root primarily affects the limbic system, which controls everything from emotion to motivation.

While kava root can sound like an excellent alternative to anti-anxiety drugs or alcohol, it’s not without risks.

The FDA warns people to compare the risks vs. benefits of using kava. There are minor side effects that can occur with the use of kava root products including headache, dizziness or drowsiness, but some of the most severe potential side effects deal with liver toxicity. There have been some incidents of people experiencing liver injury and even failure following the use of kava root. For that reason, medical professionals advise people to be aware of the risks and also to avoid using it with alcohol or if you have an existing liver condition.

Do the benefits of kava outweigh the risks?

This is something to discuss with your health care provider. There are potential drug and supplement interactions that can occur with kava root and other possible risks, so before considering the use of kava for anxiety or any other purpose, speak with a doctor. Also recognize that all the risks might not be fully understood about kava because there is a limited amount of research on it right now.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.