Kava: How to wind down without alcohol
Kava is a traditional drink from the South Pacific Islands, often described as producing a "body high" effect.
Did you know that excessive alcohol use is a leading cause of preventable death in the US? The CDC defines excessive alcohol use as:
Binge drinking, defined as consuming 4 or more drinks on an occasion for a woman or 5 or more drinks on an occasion for a man.
Heavy drinking, defined as 8 or more drinks per week for a woman or 15 or more drinks per week for a man.
Any alcohol use by pregnant women or anyone younger than 21.
Over time, excessive alcohol use can cause heart disease, liver disease, and cancer. Interestingly, most people who drink excessively are not alcoholics or alcohol dependent.
Since the pandemic, alcohol consumption shifted from social events to the privacy of homes, and with rising consumption came rising numbers of alcohol related deaths.
It is clear that many of us need to take a closer look at how our alcohol consumption has changed over the past few years and consider how we might change course. For myself, I've started replacing my evening glass or two of wine with mint tea or kava.
What is kava?
Kava is a medicinal plant endemic to Oceania, thought to originate in Vanuatu or New Guinea, and then spread throughout the region by seafarers. Its scientific name, Piper methysticum, refers to pepper (Piper) and intoxicating (methysticum). It is an important crop throughout the Pacific Islands, where it has different local names depending upon the region: kava (Tonga and Marquesa), ‘awa (Hawaii), sakau (Pohnpei), maolk (Vanuatu), and ‘ava (Samoa). It has been consumed for more than 2,000 years in traditional ceremonies (mostly by men) in Oceania.
Today, hundreds of kava cultivars are grown throughout the South Pacific Islands. The plant cannot reproduce sexually, so its cultivation is achieved through propagation from stem cuttings. The best kava, in terms of the concentration of active molecules (kavalactones), is harvested when it is about four to five years old.
What are the medicinal effects of kava?
Kava roots are rich in plant compounds known as kavalactones. The six major kavalactones are kawain, dihydrokawain, methysticin, dihydromethysticin, yangonin, and demethoxyyangonin, which vary in levels depending on the cultivar. The roots of the noble kava variety are prepared as a room-temperature, water-based suspension resembling muddy water. Drinking this kava root suspension, due to the presence of kavalactones, yields a sensation best described as a “body high.” The mind remains clear, but the body feels more relaxed. This sensation is different from that of alcohol, which has sedating effects on both body and mind.
Some of the main medicinal effects include:
Sedative: reducing irritability and excitement, yielding a relaxed state.
Anesthetic: reducing sensations of pain; his is first felt with a tingly sensation of the tongue as kava is consumed.
Euphoriant: eliciting a feeling of well-being and happiness.
Anxiolytic: reducing anxiety. A clinical study of patients with generalized anxiety disorder received 250 mg of kavalactones per day and experienced reductions in anxiety and depression.
Muscle relaxant: helps relax the body, and this also contributes to its pain relieving effects.
How safe is kava?
A WHO and FAO technical report on the safety of traditional and recreational beverage consumption rates the traditional preparation of kava in a water suspension to have an “acceptably low level of health risk.” Among South Pacific islander communities, “kava is considered to be a safe and enjoyable beverage, based on a long tradition of use and little evidence of harm. “
What to avoid?
There have been some health risks associated with alcohol (or organic solvent) extractions of kava root, including liver damage. Avoid use of kava tinctures.
There are kava “tea” products now available in the grocery aisle. While hot water preparations haven’t been tied to any adverse health effects that I could find in the literature, I don’t recommend these products for two other reasons:
The dose of kava root in a small tea bag is not enough to yield a decent pharmacological effect; and
This hot water preparation is counter to a method of preparation that has been used by Pacific Islanders for more than 2,000 years. Their method works, why change it?
Don’t consume alcohol with kava.
Many kava bars now also offer kratom products. There is no history of traditional use of these plants together and there are some concerns about the safety of kratom. Don’t consume these together. (Read more about kratom in my earlier post).
Potential Side Effects
The WHO and FAO technical report noted that heavy, regular consumption of kava (more than 435 grams of kava powder per week) may cause certain skin conditions known as “kava dermopathy.” Symptoms include dry, scaly, yellow skin and rashes on the palms, feet, and back. Symptoms are reversible with cessation of kava drinking.
Where to find kava?
There are a number of kava bars that have popped up across the USA. However, this herbal brew is simple to prepare at home. I have found numerous vendors online. When shopping, look for “Noble” kava varieties. You need to buy the loose powder, which typically comes in a 1 lb. bag. One of my favorite brands from Fiji is available on Amazon: Fijian Waka Kava.
How to make a kava suspension at home
The traditional preparation of kava involves grinding or pounding fresh or dry kava roots and then mixing this mass with water or coconut milk to create an emulsion. This is strained through a fiber mesh before consumption.
For home preparation, you'll need room temperature water, noble kava root powder, and a fine fiber mesh, such as a knee-high pantyhose stocking. To prepare a kava beverage for a social gathering or for yourself, follow these steps:
Place a large handful of kava powder into the stocking and tie a knot at the end.
Fill a water pitcher or large bowl with water. Submerge the kava-filled stocking in the water and massage the mass with your hands for at least three minutes. The water will change to a muddy or chocolate milk color.
The sediment will settle at the bottom of the container. It's important to mix the emulsion to redistribute this sediment throughout the water before serving. This sediment is where the pharmacologically active kavalactones are concentrated.
If it's your first time trying kava, expect an earthy, gritty texture in the beverage and a black pepper-like flavor, though not unpleasant. You may also experience a tingling sensation on your tongue, indicating the kavalactones are beginning to take effect. The relaxant effects of kava typically begin within 15 minutes and can last up to three hours.
Want to learn more?
Here is a great documentary on the traditional history, preparation, and use kava in Vanuatu. I use this video in my course on medicinal plants.
The Takeaway
We all need to wind down sometimes, and all too often, we turn to alcohol for this purpose. However, regular consumption of alcohol has many well-known side effects that are detrimental to our health. If you're looking for a different approach to relaxation using herbs, I would highly recommend kava. It has a history of over 2,000 years of safe use when prepared as a traditional water emulsion.
Yours in health, Dr. Quave
Cassandra L. Quave, Ph.D. is a scientist, author, speaker, podcast host, wife, mother, explorer, and professor at Emory University School of Medicine. She teaches college courses and leads a group of research scientists studying medicinal plants to find new life-saving drugs from nature. She hosts the Foodie Pharmacology podcast and writes the Nature’s Pharmacy newsletter to share the science behind natural medicines. To support her effort, consider a paid or founding subscription, with founding members receiving an autographed 1st edition hardcover copy of her book, The Plant Hunter.
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I’ve mostly considered kava in discussions of insomnia and anxiety, so this is very helpful thanks 😊. And there is a lot of overlap between symptoms that people drink alcohol to relieve and potential effects of kava.
And that pleasant burn we feel when swallowing alcohol? It’s actually a sensation of damage, but we’ve grown to associate it with the pleasure that comes next!
Love this. Can you discuss the side effects? In Fiji it’s called kani. The face swelling the next day. And after regular use, the scales skin. My family would love to find a way to enjoy yaqona again without these side effects.