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{{Taxobox
| color = lightgreen
| name = Kava
| image = Starrpipermethysticum.jpg
| image_width = 240px
| image_caption = Young ''Piper methysticum''
| regnum = [[Plant]]ae
| divisio = [[Flowering plant|Magnoliophyta]]
| classis = [[Dicotyledon|Magnoliopsida]]
| ordo = [[Piperales]]
| familia = [[Piperaceae]]
| genus = ''[[Piper (genus)|Piper]]''
| species = '''''P. methysticum'''''
| binomial = ''Piper methysticum''
| binomial_authority = [[Georg Forster|G.Forst.]]
}}

'''Kava''' (''Piper methysticum'') is an ancient crop of the western [[Pacific]]. Other names for kava include ''{{okina}}awa'' ([[Hawaii]]), '' 'ava'' ([[Samoa]]), ''yaqona'' ([[Fiji]]), and ''sakau'' ([[Pohnpei]]). The word kava is used to refer both to the plant and the beverage produced from it.

==Preparation and consumption==
[[Image:Kava_fiji.jpg|thumb|right|200px|Kava root drying in Lovoni village, [[Ovalau]], [[Fiji]]]]

Kava is consumed in various ways throughout the [[Pacific Ocean]] cultures of [[Polynesia]], [[Vanuatu]], [[Melanesia]] and some parts of [[Micronesia]] and [[Australia]]. Traditionally it is prepared by either chewing, grinding or pounding. Chewing is followed by depositing into a bowl, mixing with water and straining through the cloth-like fiber of a [[coconut tree]]. Grinding is done by hand against a cone-shaped block of dead [[coral]]; the hand forms a [[mortar]] and the coral a [[pestle]]. The ground root is combined with only a little water, as the fresh root releases moisture during grinding. Pounding is done in a large stone with a small log. The product is then added to cold water and consumed as quickly as possible.

The extract is an [[emulsion]] kavalactone droplets in starch. The taste is slightly pungent, while the distinctive aroma depends on whether it was prepared from dry or fresh plant, and on the variety. The colour is grey to tan to opaque greenish.

Kava prepared as described above is much more potent than unprocessed kava. Chewing produces the strongest effect because it produces the finest particles. Various sources incorrectly state that it is because saliva enzymes act on the plant. Fresh, undried kava produces a stronger beverage than old, dry kava. The strength also depends on the species and techniques of cultivation.

[[Fijians]] commonly share a drink called "grog", made by pounding sun-dried kava root into a fine powder and mixing it with cold water. Traditionally, grog is drunk from the shorn half-shell of a coconut, called a "bilo." Despite tasting very much like dirty water, grog is very popular in [[Fiji]], especially among young men, and often brings people together for storytelling and socializing. <ref>{{cite web | author=Kevin Cassell | year=2005| title=Fiji: A Visitor's Guide | url=http://kevincassell.com/FIJIARTC/KEVIN.HTM | accessdate=2007-04-25}}</ref>

Kava can also be combined with [[coffee]] to produce [[kavajava]], whose effects are said to combine the most pleasant qualities of each.

[[Image:Kava_vanuatu.jpg|thumb|right|200px|Kava root being prepared for consumption in Asanvari village on [[Maewo]] Island, [[Vanuatu]]]]

==Effects==
A moderately potent kava drink causes effects within 20-30 minutes that last for about two hours, but can be felt for up to eight hours.

The sensations, in order of appearance, are slight tongue and lip numbing caused by the contraction of the blood vessels in these areas (the lips and skin surrounding may appear unusually pale); mildly talkative and euphoric behavior; [[anxiolytic]] (calming) effects, sense of well-being, clear thinking; and relaxed muscles. Sleep is often restful and there are pronounced periods of sleepiness correlating to the amount and potency of kava consumed.

In Vanuatu, a strong kava drink is normally followed by a hot meal or tea. The meal traditionally follows some time after the drink so that the [[psychoactive]]s are absorbed into the bloodstream more quickly.

A potent drink results in a faster onset with a lack of stimulation, [[somnolence]], and then deep, dreamless sleep within 30 minutes. Unlike alcohol-induc
ed sleep, after wakening the drinker does not experience any [[hangover|mental or physical after effects]].

Heavy consumption can produce effects on the skin, ranging from light, red bumps; to heavy, scaly ulcers. This is an allergic response to [[antigens]] that form when lactones in kava bind to skin proteins. The effects disappear if consumption stops or decreases. Excessive drinking can also cause vomiting and [[nausea]] that usually subside within a day.

It is reported that many people experience rather vivid dreams after drinking kava. [http://www.erowid.org/experiences/subs/exp_Kava.shtml]

==Pharmacology==
[[Pharmacology|Pharmacologically]], kava is not [[Addiction|addictive]]. Its active principal ingredients are the [[kavalactone]]s, of which 15 have been identified and are all considered psychoactive. Only six of them produce noticeable effects, and their concentrations in kava plants vary. Different ratios can produce different effects.

Fresh kava root contains on average 80% [[water]]. Dried root contains approximately 43% [[starch]], 20% [[fibers]], 15% [[kavalactones]], 12% [[water]], 3.2% [[sugars]], 3.6% [[proteins]], and 3.2% [[minerals]]. Kavalactone content is greatest in the roots and decreases higher up the plant. Relative concentrations of 15%, 10% and 5% have been observed in the root, stump, and basal stems, respectively.

Kava has been considered relatively safe. Having been consumed for at least two thousand years, its safety record is very high. Yet, some kava herbal supplements have been accused of contributing to rare but severe hepatotoxic reactions, likely due to additives or the use of the wrong parts of the plant (see [[Kava#Safety|section on safety]]).

==Kava culture==
{{main|Kava culture}}
[[Image:Kava.jpg|thumb|A sign showing a "Kava license area" at [[Yirrkala]], in the [[Northern Territory]] of [[Australia]]]]

Kava is used for medicinal, religious, political, cultural and social purposes throughout the Pacific. These cultures have a great respect for the plant and place a high importance on it. It is used primarily at social gatherings to increase amiability and to relax after work. It has great religious significance, being used to obtain inspiration. In some Westernized Pacific peoples, the drink has been demonized and seen as a vice, and youth there often reject its traditional use. However, it has gained a cult following among the youth culture of caucasian people living on Pacific islands.

==Botany and agronomy==
There are several [[cultivar]]s of kava, with varying concentrations of primary and secondary psychoactive substances. The largest number are grown in the Republic of Vanuatu, and so it is recognised as the "home" of kava. Kava was historically grown only in the Pacific islands of Hawaii, Federated States of Micronesia, Vanuatu, Fiji, the Samoas and Tonga. Some is grown in the Solomon Islands since [[World war 2]], but most is imported. Kava is a cash crop in Vanuatu and Fiji.

The kava shrub thrives in loose, well-drained soils where plenty of air reaches the roots. It grows naturally where rainfall is plentiful (over 2,000mm/yr). Ideal growing conditions are 20-35 degrees Celsius (70-95 Fahrenheit), and 70-100% relative humidity. Too much sunlight is harmful, especially in early growth, so kava is an understory crop.

Kava cannot reproduce sexually. Female flowers are especially rare and do not produce fruit even when hand-pollinated. Its propagation is entirely due to human efforts by the method of [[Cutting (plant)|striking]].

Traditionally, plants are harvested around 4 years of age, as older plants have higher concentrations of kavalactones. But in the past two decades farmers have been harvesting younger and younger plants, as young as 18 months. After reaching about 2[[meter|m]] height, plants grow a wider stalk and additional stalks, but not much taller. The roots can reach 60[[cm]] depth.

==As medicine==
In [[the West]], kava is commonly marketed as [[herbal medicine]] against [[stress (medicine)|stress]] and [[anxiety]].

On [[15 Febru
ary]] [[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 leukaemia and ovarian cancer cells in [[test tube]]s. The kava compounds were shown to target only cancerous cells but not healthy cells.

[[Fiji Kava Council]] Chairman [[Ratu]] [[Josateki Nawalowalo]] welcomed the findings, saying that they would boost the kava industry. For his part, [[Minister for Agriculture (Fiji)|Agriculture Minister]] [[Ilaitia Tuisese]] called on the researchers to help persuade members of [[European Union]] to lift their ban on kava imports.

==Safety==
=== Incidents and regulation ===
In the year 2001 concerns were raised about the safety of commercial kava products.<ref>{{cite web | author=Mark Blumenthal | title=Kava safety questioned due to case reports of liver toxicity | publisher=HerbalGram | year=2002 | work=American Botanical Council | url=http://www.herbalgram.org/herbalgram/articleview.asp?a=2147| accessdate=2005-12-07}}</ref> There have been indications<ref>One case report from 2003: Gow PJ (2003): "Fatal fulminant hepatic failure induced by a natural therapy containing kava." MJA 178(9):442-443. [http://www.mja.com.au/public/issues/178_09_050503/gow10544_fm.html Fulltext]</ref><ref name "Boon 2003">{{cite journal | url=http://www.cmaj.ca/cgi/content/full/169/11/1163 | title=Kava: a test case for Canada's new approach to natural health products | author=Boon HS, Wong AHC | date=2003 | accessdate=2006-07-10 | journal=CMAJ | volume=169 (11) | id=PMID 14638650}}</ref>
of severe [[hepatotoxicity|liver toxicity]], including liver failure in some people who had used dietary supplements containing kava extract. The severity of liver damage consequently prompted action of many regulatory agencies in 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]] and [[The Netherlands]]{{Fact|date=February 2007}}. The health agency of [[Canada]] issued a stop-sale order for kava in 2002. But legislation in 2004 made the legal status of kava uncertain.<ref name "Boon 2003"/> The [[United States]] [[CDC]] has released a report<ref>{{cite journal | author=United States Centers for Disease Control and Prevention | title=Hepatic Toxicity Possibly Associated with Kava-Containing Products --- United States, Germany, and Switzerland, 1999—2002 | journal=Morbidity & Mortality Weekly Report | year=2002 | volume=51(47) | pages=1065–1067 | url=http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5147a1.htm | accessdate=2005-09-16}}</ref>
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).<ref>{{cite paper | author=Center for Food Safety and Applied Nutrition | title=Kava-Containing Dietary Supplements May Be Associated with Severe Liver Injury | publisher=United States Food and Drug Administration | date=2002 | url=http://www.cfsan.fda.gov/%7Edms/addskava.html | accessdate=2005-06-16}}</ref> The Australian [[Therapeutic Goods Administration]] has recommended that no more than 250mg of kavalactones be taken in a 24 hour period.<ref>{{cite web| url=http://www.tga.gov.au/cm/kavafs0504.htm | accessdate=2006-07-10 | title=Kava fact sheet | publisher=Therapeutic Goods Administration, Government of Australia | date=April 2005}} ([http://www.tga.gov.au/cm/kavafs0504.pdf Download PDF 44KB])</ref>

=== Toxicity ===
[[Image:Kava pyridine alkaloids.svg|thumb|200
px|[[Piperidine]] alkaloids from the kava plant]]
The legal intervention stimulated research, and hepatotoxic substances were found in the plant. Researchers from the [[University of Hawaii at Manoa]] found that an [[alkaloid]] called pipermethystine (formula 1), mostly contained in stem peelings and leaves, had toxic effects on liver cells ''[[in vitro]]''.<ref>a) Pratibha V. Nerurkar et al. (2004): "In Vitro Toxicity of Kava Alkaloid, Pipermethystine, in HepG2 Cells Compared to Kavalactones", Toxicological Sciences 79, 106-111. [http://toxsci.oxfordjournals.org/cgi/content/full/79/1/106 Fulltext]. <br/>b) Compare: Lim ST et al. (2007): "Effects of Kava Alkaloid, Pipermethystine, and Kavalactones on Oxidative Stress and Cytochrome P450 in F-344 Rats." Toxicol Sci. PMID 17329236</ref>
[[Flavokavain B]], found in the plant's [[rhizome]], may also contribute to toxic effects.<ref>Jhoo JW et al. (2006): "In vitro cytotoxicity of nonpolar constituents from different parts of kava plant (Piper methysticum)", J. Agric. Food Chem. 54(8):3157-62. PMID 16608246</ref>
And, it is known that some of the [[kavalactone|kavapyrones]] block several subtypes of the [[enzyme]] [[cytochrome P450]]<ref>a) J.M. Mathews et al. (2005): "Pharmacokinetics and disposition of the kavalactone kawain: interaction with kava extract and kavalactones ''in vivo'' and ''in vitro''", Drug. Metab. Dispos. 33(10):1555-63. PMID 16033948; [http://dmd.aspetjournals.org/cgi/content/full/33/10/1555 Fulltext]<br/>
b) J.M. Mathews et al. (2002): "Inhibition of Human Cytochrome P450 Activities by Kava Extract and Kavalactones", Drug Metab. Dispos. 30(11):1153-1157. [http://dmd.aspetjournals.org/cgi/content/full/30/11/1153?ijkey=b5f0eddf6ef6fdc8d812471d4fb0d07c64ddbc42 Fulltext]</ref>,
which can result in adverse interactions with other drugs used concomitantly.

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. Glutathion in kava preparations is able to provide a certain protection of liver cells.<ref>Whitton PA et al. (2003): “Kava lactones and the kava-kava controversy”, Phytochemistry 64(3):673-9. PMID 13679089</ref>

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 prepartions. 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.

===Outlook===
The issue has long been controversial and the debate fueled by economic interests of kava-exporting nations of the Pacific Islands as well as disagreements between the medical establishment and proponents of herbal and natural medicine. The German Federal Institute for Drugs and Medical Devices (BfArM), which in 2002 temporarily inactivated kava registrations, asked the producers to provide new clinical data by June 2007, in which case a reinstitution of the kava products on the market might again be possible.<ref>a) {{cite web | title=American Botanical Council | work=German Government Reconsiders Kava | url=http://www.herbalgram.org/default.asp?c=kava_overturn | accessdate=2006-05-12}} <br/>b) {{cite web | title=University of the South Pacific | work=USP plays a major role in the partial lifting of the Kava ban in Germany | url=http://www.usp.ac.fj/news/story.php?id=60 | accessdate=2006-05-12}}</ref>

A [[New Zealand]] committee that considered the issue commented in its summary: "A comparison with paracetamol-associated hepatotoxicity, results in the conclusion that these potential risks for kava are dramatically less than that of a popular non prescription drug widely sold through
grocery outlets."<ref>{{cite web | author= New Zealand association of medical herbalists | year=2005| title=Submission on proposed reclassification of kava as a prescription medicine | format=PDF | work= | url=http://nzamh.org.nz/downloads/kavamay05.pdf | accessdate=2006-05-12}}</ref>
The NZ government is currently only considering requiring a suitable warning label standard to go on kava products.

==See also==
* [[Alcohol and Drugs History Society]]

==References==
<div class="references-small">
<references />
</div>

==Literature==
*Lebot, Vincent et al. ''"Kava: The Pacific Drug"'', New Haven: Yale University Press, 1992. ISBN 0-300-05213-8

==External links==

{{Wikispecies|Piper methysticum}}

*[http://www.ctahr.hawaii.edu/fb Farmers Bookshelf - Information on Tropical Crop Production in Hawai{{okina}}i] (Site has javascript navigation and kava ({{okina}}awa) pages cannot be directly linked: click on "nutraceuticals", then "'Awa".)
*[http://www.andrewgray.com/pacific/kava.htm The Kava culture in Vanuatu]
*[http://www.spc.int/cis/kava.htm Kava Ban documents]
*[http://www.erowid.org/plants/kava/ Erowid's Kava vault]
*[http://www.erowid.org/experiences/exp.php?ID=1956 How to prepare Kava (Erowid)]
*[http://leda.lycaeum.org/?ID=428 Lycaeum: Includes list of isolated chemicals]
*[http://historyofalcoholanddrugs.typepad.com/alcohol_and_drugs_history/kava/index.html Kava news page]
*[http://kavafestival.org Hawai{{okina}}i Pacific Islands Kava Festival - An education, cultural event held in Hawaii sponsored by the nonprofit, {{okina}}Awa Development Council]
*[http://www.raysahelian.com/kava.html Kava Kava Research Information] Study by Ray Sahelian M.D. on Kava Kava Benefits and Side Effects

{{Herbal Sedatives}}

[[Category:Entheogens]]
[[Category:Fijian culture]]
[[Category:Vanuatuan culture]]
[[Category:Samoan culture]]
[[Category:Medicinal plants]]
[[Category:Piperaceae]]
[[Category:Oceanian cuisine]]

Kava - Revision history

MediaWiki default at 03:45, 14 June 2007