From Drugwiki
Kava, Kava Kava or Piper methysticum is also know by ava, awa, awa pepper, intoxicating pepper, kava root or pepper, kawa, kew, rauschpfeffer, sakau, tonga, melo, ka ka, wurzelstock and yangona, kawa-kawa, and most commonly, simply "Kava."
Kava kava induces a pleasant sense of tranquility and sociability after it is consumed. Over the years many scientists have consumed kava kava in an attempt to describe its effects in more scientific terms. One of the first such descriptions of kava was offered by the noted phamacologist Louis Lewin in 1886. Lewin must have enjoyed studying kava kava, because what became his classic description of kava kava's effects was written in 1927, forty one years after his initial investigation. Here is Lewin's classic description: "When the mixture is not too strong, the subject attains a state of happy unconcern, well-being and contentment, free of physical or psychological excitement. At the beginning conversation comes in a gentle, easy flow and hearing and sight are honed, becoming able to perceive subtle shades of sound and vision. Kava soothes temperaments. The drinker never becomes angry, unpleasant, quarrelsome or noisy, as happens with alcohol. Both natives and whites consider kava as a means of easing moral discomfort. The drinker remains master of his conscious and his reason. When consumption is excessive, however, the limbs become tired, the muscles seem no longer to respond to the orders of control of the mind, walking becomes slow and unsteady and the drinker looks partially inebriated. He feels the need to lie down....He is overcome by somnolence and finally drifts off to sleep."
Introduction
Kava Kava is also known as "Awa" in Hawaii and "Yaqona" in Fiji. It is a legal herb with medicinal and mild narcotic properties. After his voyage to the South Seas in 1768, British explorer Captain James Cook first described for the Western world the ritual use of the intoxicating drink prepared from the Kava plant. The plant was named "Piper methysticum", or intoxicating pepper. Pacific islanders have used Kava for thousands of years. Although Kava was important for ceremonial occasions, the history of the South Pacific islands shows that the use of Kava was not limited to such gatherings. Kava was also taken before an ocean voyage and for ratification of agreements, and celebrations of marriages and births as well as deaths. It was considered a drink of the gods and was believed to cure illnesses and remove curses. In the 18th century Kava was used in almost all facets of life on the islands. Sharing a bowl of Kava fostered fellowship and socializing; it was unthinkable that Kava would not be a part of any significant event.
Research shows that the main active constituents in the root and rhizome (rootstock) are a group of resinous compounds called kava lactones. In the South Pacific today, Kava is served as a beverage, usually consumed at dusk before the evening meal because islanders feel a full stomach can inhibit its effects. After drinking, people typically eat smaller amounts of food because Kava tends to decrease the appetite. And while some islanders have described the taste of Kava as cool and refreshing, most who taste it find it has a bitter flavor with a temporary numbing effect on the tongue and inside of the mouth.
The Effects Kava Imparts Through Taste
One of the effects kava gives most users is its earthy taste. In my many years of kava drinking I have only come across about 2 dozen people who were not affected by the taste whatsoever. I have even seen a few people that have claimed to like the taste of kava. There are many varieties of kava in the world. Some yield beverage that is darker or worse tasting than others. Why this bad taste? As far as research has shown, botanists believe that the not so good taste of kava is a natural inhibitor inside the plant that prevents people from abusing it as a substance. Thus far, very few places on earth have ever reported kava abuse problems. In most places where it is consumed on a daily basis still, kava is a very sacred and respected plant. It is possible to put some type of flavoring in the kava to cover up the taste. In tribal cultures in Vanuatu and Fiji there is no record of trying to flavor the kava. People drink it as is. In all kava drinking cultures kava is drunk in the same manner: 1 shell at a time drank very rapidly.Yes, slam it! These cultures also have something else in common immediately after drinking kava, fruit or some other type of chaser is consumed. Try your favorite candy, hot chocolate, or other non decaffeinated drink. The taste is definitely not the worst thing ever and goes away quickly. On to the next effect...
The Effects Kava Imparts With Anesthetics
Immediately after drinking a shell of kava, most users report a slight numbness on their tongue and lips. This is totally normal and short lasting. The numbness is due to two local, topical anesthetics that are active ingredients inside of the kava root. They are kavain and dihydrokavain. These anesthetics can also make ones stomach feel numb. This is a very strange feeling to most users. It takes a little getting used to. Sometimes this feeling has been mistaken for nausea. Once your body gets used to it, the feeling is no longer bothersome. Now we will move on to the kava effects that everyone is looking for.
The Effects Kava Is Most Used For-Relaxing
Above all other things, kava is drunk for primarily one reason; to relax. Not only does kava seem to relax the mind, it also relaxes muscles. It does this without disrupting mental clarity,unlike alcohol. Kava can also make the user feel drowsy in some cases. If too much kava is consumed, almost all users will become sleepy. Kava has been proven by the German Commission E to be a cure for insomnia as a matter of fact. Please consult your doctor for further information about treating insomnia with kava .
The Effects Kava Has That Are Euphoric
Kava is quickly becoming the recreational beverage of choice in the south Pacific. Nakamals (kava bars) have been popular social havens in Vanuatu since the late 1980?s. In Noumea, New Caledonia over 200 Nakamals now exist in a city with a population of about 75,000. This popularity is most certainly related to the euphoric effects that kava drinkers get from drinking kava. This topic is very misunderstood and I wish to offer my experiences with it in order that they are clarified. First of all I would definitely not characterize the euphoric feeling as being high or drunk. It is definitely a feeling that is like no other. Kava is not like alcohol where the consumer feels the effects from drinking it the first time rather quickly. Kava is a substance that does not lend itself to abuse easily as I have said before. After many years of drinking kava and watching kava being consumed I have come to a simple conclusion. In order for the euphoric kava effects to be felt at a maximum, a period of time must pass in order that the kavalactones build up in the users body. This means that the first time kava is consumed, the effects may only be felt minimally. After three or four kava drinking sessions the effects should start to be felt. As more and more kava is consumed, the effects seem to become greater and greater with less and less consumed. So if this effect is what you are looking for, you must first pay your dues to the kava Gods. The Effects Kava Imparts Regarding Detoxification
Kava is a known detoxifier. This is another reason why it is recommended that you acclimate yourself slowly to it. This is also a reason why alcohol should not be consumed with any kava product. Alcohol is a toxin! The effects kava gives when it is mixed with alcohol are undersireable.Everyone acclimates to this kava effect of detoxification after a while and it seems to lessen.
Recommended Kava Usage
Kava is usually consumed after sunset in most cultures. Drinking kava during the day can be unproductive if the effects are felt too strongly.The bright light of day can also be uncomfortable on the eyes after drinking kava.
For your first kava session, I recommend only consuming 2-3 four ounce shells of it. Always space out each kava bowl fifteen minutes so that you do not consume too much. Even if? the kava effects are not felt fully it is best not to overdo it, especially the first try. It is best not to overload your body with foreign substances even if they are non toxic. It is best to drink 2-3 shells of kava per sitting at least the first 4 times that you drink kava. If more than that is desired, feel free. How much is too much? Don't worry, your body will let you know! In my opinion the kava drinkers that follow this regimen usually appreciate it more. Once you have been drinking kava for at least a month on a regular basis and have started to feel the effects more fully you can drink more than 2 or 3 shells and you will find out quickly about the kava effects we call euphoria. Be forewarned that drinking too much kava can impair motor skills and ability to drive. Kava affects the users ocular motor skills (eyes and ears). Balance can be affected if large amounts of kava are consumed. Never drink alcohol with kava! It is very unhealthy and will probably make you sick.
For best results, drink some kava and sit in a dark, quiet place. Your kava effects will be more pleasurable if an attempt to relax is made. It is great for in depth conversations among friends as kava tends to make people more social. Kava effects will not be felt as much when the user is up and moving around a lot. Loud music or flashing lights do not usually go good with kava either. Avoid them.
In short,give kava a fair shot before you decide if it is for you or not. Do not drink too much at once. Do not drink kava too quickly (unless you are trying to consume a single bowl) and space out shells by 15 minutes. Remember, the kava effects will come to you. You cannot go to them if that makes any sense? Before too long you will find out why so many people have been drinking kava for over 3000 years.
Uses of Kava Kava
- as a muscle relaxant and as a diuretic
- to provide relief for all kinds of pain, including headaches and migraines
- to relieving some of the discomfort of menopausal women, including hot flashes, insomnia and general nervousness.
- for the treatment of arthritic and rheumatic conditions, which is one of its traditional medicinal uses among South Sea Islanders.
- to treat anxiety, depression, insomnia, and asthma
- to relieve fatigue and to increase energy
- as part of a treatment for tobacco, alcohol and drug withdrawal.
Kava wakes you up, and, at the same time, it calms you down, allowing you to increase productivity while reducing stress. It causes a deep sleep with no hangover, and it leaves the mind clear. It can also be chewed and kept in the mouth for the temporary relief of toothaches. It is legal, safe, and truly a remedy for the stress filled world of today. Kava is available as a whole root and powder. Kava lactones are insoluble in water and are destroyed by heat. Ideally the herb should be first powdered and then mixed into COLD water for a few minutes. It must then be carefully squeezed through a cloth (cheesecloth works well) to release the active ingredients from the root stock fiber.
When using Kava for the first time, a teaspoon or two is used, mixed with a glass of your favorite juice or fruit smoothie (or prepare in the traditional method, stated above). It can be increased to up to one to two tablespoons, according to preference. Kava is a pure, natural root product, and its effect on you can depend on many things: your size, metabolism rate, and even your mood at the time. To promote a deep restful sleep one could take a small amount approximately 20 or 30 minutes before retiring.
Always check with your physician or pharmacist before combining with any prescription or over-the-counter drugs or medicines. It is not recommended to consume Kava if you are pregnant or nursing, or in combination with alcohol. Since it is a relaxant, do not use it while operating heavy machinery or driving a vehicle. Moderate use as described has not shown any harmful reactions. The only shown side effect is that a dry, scaliness of the skin may occur with overuse, over a long period of time (for instance, when the islanders drink several bowls of Kava a day, for years and years). And this condition disappears as soon as they stop drinking their Kava. It is also clear that when Fijians overdo their nightly Kava ritual, they can tend to be a bit sluggish in the morning. Recently there have been reports from Europe of possible liver complications when using Kava. These reports have not been substantiated, but for this reason we recommend that people with liver problems do not use Kava Kava.
R. J. Gregorys experience
"Kava seizes one's mind. This is not a literal seizure, but something does change in the processes by which information enters, is retrieved, or leads to actions as a result. Thinking is certainly affected by the kava experience, but not in the same ways as are found from caffeine, nicotine, alcohol, or marijuana. I would personally characterize the changes I experienced as going from lineal processing of information to a greater sense of "being" and contentment with being. Memory seemed to be enhanced, whereas restriction of data inputs was strongly desired, especially with regard to disturbances of light, movements, noise and so on. Peace and quiet were very important to maintain the inner sense of serenity. My senses seemed to be unusually sharpened, so that even whispers seemed to be loud while loud noises were extremely unpleasant." The difference between the effect noted by these pharmacologists consuming kava kava beverage and the effect of the kava extract that will be described here is a matter of dosage. During the traditional kava ceremony an individual will usually ingest much higher amounts of kava components compared with the levels commonly used in the treatment of depression and anxiety. The kava extract could produce the same type of effects as kava beverage if taken at high levels (not recommended).
"Until recently, kava has been regarded as a medicinal plant with a very favourable risk profile and a distinct efficacy. On first sight, the current discussion of potential deleterious effects of kava medication on liver metabolism seems to reverse the risk-benefit ratio, and calls for a closer look at the available data of the observed adverse effects on the liver in connection to kava intake. Within this analysis, we report background data on a total of 82 case reports dating from the years 1990 to 2002. This database consists of 38 case reports from the German "BfArM" (plus five duplicate/triplicate entries of otherwise identical case reports), five cases from the Swiss SWISSMEDIC" (formerly "IKS"), two case reports published in the German public press, five cases from the medicinal literature, 21 case reports from the US American FDA, four case reports from the British MCA, one from the Australian TGA, three from Canada, two from the French ADM and finally one case from the Pharmacovigilance Working Party of the EMEA. Twenty of these cases are obviously not connected to kava intake. In 21 case reports a potentially hepatotoxic concomitant treatment was identified. In seven cases there is considerable doubt concerning the causality of kava, whereas in 31 other cases the available data is too fragmentary for an assessment. This leaves three cases where some probability of hepatotoxic effects by kava can be established. In only one these case reports kava was taken according the dosage recommendations of the German commission E monograph. As a conclusion, hepatotoxic effects of kava intake cannot generally be ruled out. However, in comparison with alternative treatments for stress and anxiety disorders, respectively in comparison drug intake related hepatotoxicity in general, the risk of adverse liver effects seems to be very low."
As DNA molecules replicate themselves trillions of times in order to create all the cells in a person's body, alterations inevitably occur numerous times. These polymorphisms (literally, multiple shapes), of which there may be as many as 10 million in total (as many as 1 million per individual), are responsible for our biochemical individuality. Those involving only a single nucleotide (A, T, G or C), aptly named single-nucleotide polymorphisms (or SNPs), are the most prevalent variety, and are important because they modify the way the body functions in specific circumstances, and in some cases may make you more or less resistant to specific diseases, environmental toxins, drugs etc. Different ethnic groups have distinct SNPs. An example that relates to kava, and its potential for or lack of toxcicity in individuals, is known as Human Cytochrome P450 2D6 (abbreviated CYP2D6). This isoenzyme metabolizes many common prescription medications as well as kavalactones. Kava has been safely used for centuries by islanders in the South Pacific, yet when kava is taken by people of northern European ancestry, approximately 7-10% experience liver toxcicity due to a hereditary SNP that renders the CYP2D6 enzyme defective. This SNP is rarely found in individuals indigenous to the South Pacific. It is pertainent to note that there are a number of drugs that act as CYP2D6 inhibitors, temporarily inhibiting the function of the enzyme system responsible for detoxifying kava's active constituents in the liver. Taking any drug that functions as a CYP2D6 inhibitor with kava will render it toxic to anyone.
Kava Kava anti-cancer potential
On 15 February 2006, the Fiji Times and Fiji Live reported that researchers at the University of Aberdeen in Scotland and the Laboratoire de Biologie Moleculaire du Cancer in Luxembourg had discovered that kava may treat ovarian cancer and leukemia. Kava compounds inhibited the activation of a nuclear factor that led to the growth of cancer cells. The Aberdeen University researchers published in the journal The South Pacific Journal of Natural Science that kava methanol extracts had been shown to kill leukemia and ovarian cancer cells in test tubes. The kava compounds were shown to target only cancerous cells; no healthy cells were harmed. This may help explain why kava consumption is correlated with decreased incidence of cancer.
Side effects and safety
Skin rashes
Chronic and heavy use of kava for a period of three months or more has occasionally been reported to cause a scaly, yellow skin rash and an eye irritation that disappears after discontinuation of the herb. The rash resembles one brought on by a niacin (Vitamin B3) deficiency; however, a double-blind, placebo-controlled study showed no change in the rash after niacin supplementation. The 29 Tonga islanders who presented with the rash after heavy kava consumption--more than 900 g/week--were given either 100 mg of oral niacinamide or placebo. No statistically significant improvement was seen in the supplementing group, suggesting niacin deficiency may not cause the rash, which is more characteristic of an acquired ichthyosis. Until more is known, however, people taking kava regularly may also wish to take a multivitamin with at least 50 to 100 mg of niacin daily.
Liver damage incidents and regulation
In 2001 concerns were raised about the safety of commercial kava products. There have been allegations of severe liver toxicity, including liver failure in some people who had used dietary supplements containing kava extract (but not in anyone who had drunk kava the traditional way). Out of the 50 people worldwide taking kava pills and extracts that have had some type of problem, almost all of them had been mixing them with alcohol and pills that could have effects on the liver. The fact that different kava strains have slightly different chemical composition made testing for toxicity difficult as well.
The possibility of liver damage consequently prompted action of many regulatory agencies in European countries where the legal precautionary principle so mandated. In the UK, the Medicines for Human Use (Kava-kava) (Prohibition) Order 2002 prohibits the sale, supply or import of most derivative medicinal products. Kava is banned in Switzerland, France, Germany and The Netherlands. The health agency of Canada issued a stop-sale order for kava in 2002. But legislation in 2004 made the legal status of kava murky to many, especially since not everyone is aware that a stop-sale order does not constitute a ban such as that applies in several European countries. Kava is not illegal in Canada nor is it regulated since it doesn't fall under the Food and Drugs Act & Regulations. Many retailers have been ignoring the no-sale order without further consequence than having Health Canada issue warnings about the product's safety. At least one US manufacturer of kava products who had suspended export to Canada in 2002 has since lifted the restriction and resumed shipping kava to Canada after obtaining confirmation that it wasn't illegal for Canadians to import kava. IOt is likely that the no-sale order could be lifted if it were possible for Health Canada to have kava. The United States CDC has released a report expressing reservations about the use of kava and its possibly adverse side effects (specifically severe liver toxicity), as has the Food and Drug Administration (FDA).The Australian Therapeutic Goods Administration has recommended that no more than 250 mg of kavalactones be taken in a 24 hour period. According to the Medicines Control Agency in the U.K., there is no safe dose of kava, as there is no way to predict which individuals would have adverse reactions.
Toxicology of pill from kava extracts with stems and leaves
The legal intervention of several countries stimulated research, and hepatotoxic substances were found in the stems and leaves of the plant. Researchers from the University of Hawaii at Manoa found that an alkaloid called pipermethystine (formula 1), contained in stem peelings and leaves but not in the roots, had toxic effects on liver cells in vitro and in vivo. In rats fed with 10 mg/kg pipermethystine for two weeks, indications of hepatic toxicity were found. Comparable signs of toxicity were not detected with kava rhizome extracts (100 mg/kg, 2 weeks), (73 mg/kg, 3 months). Flavokavain B, found in the plant's rhizome (large horizontal underground stem), may also contribute to toxic effects. And, it is known that some of the kavapyrones block several subtypes of the enzyme cytochrome P450, which can result in adverse interactions with other drugs used concomitantly.
Hawaiian researchers learned from a trader in Fijian kava that European pharmaceutical companies eagerly bought up the stem and leaves peelings when demand for kava extract soared in Europe in 2000 and 2001. Before 2002, substantial amounts of aerial parts of the kava plant were being exported to North America and Europe and obviously used for the production of commercial pill extracts. For traditional use in the South Pacific, stem peelings and leaves are discarded, and only the rhizomes are used and extracted with water. This may explain why native populations that make heavy use of kava experience side effects that are mild, temporary, and confined to the skin, whereas industrialized countries that have newly adopted kava occasionally show severe, acute responses.
A medical conference in Fiji determined that the high concentrations of kava resins in pill form extracts alone could have been the culprit for the liver damage incidents.
Toxicity of traditional kava beverage preparations
Kava has been consumed heavily as a beverage in the south Pacific for around 3000 years with mixed reports on liver problems[citation needed]. One study has reported that when kava preparations are made with the root of the plant no toxicity is found. However, in two studies changes in liver function are noticed. The first claims that the effects are temporary and reversible when discontinuing kava use. There is evidence of health concerns among heavy drinkers, including poor nutrition and a rise in liver enzymes typically associated with liver damage.
The plant also contains glutathione. In extracts its concentration varies depending on the lipophilicity of the applied solvent; the amount is higher in aqueous extracts. Glutathione in kava beverage preparations is able to provide a certain protection of liver cells. However, kava extracts in pill form will not have the glutathione in it to help protect the liver.
Allergy
Literature suggests that <0.5% of people that take kava have an allergic reaction to it. Allergic reactions are usually mild and include itchy skin or itchy throat, and hives on the skin usually prevalent on the user's belly region. If someone has an allergy to any relative of the pepper family, such as black pepper, they have a higher chance of having a kava allergy.