Kava is a relaxing tea made from the root of a pepper plant Piper methysticum. This ceremonial tea has been safely consumed by the people of Polynesia, Micronesia, and Hawaii for 3,000 years. In these locales, kava tea is more than a beverage, it’s an integral part of the culture. It is consumed at milestone events like weddings and funerals, and also during healing and religious ceremonies to achieve a “higher level of consciousness.” Kava is also used traditionally for treating a wide variety of ailments including asthma, insomnia, fatigue, mood swings of menopause, and urinary infections.

Yet it’s been banned or restricted in some countries and labeled as a dangerous herb that can cause liver damage. Is the ban on kava justified or based on an unfounded fear? And beyond being a ceremonial drink, does kava have medicinal uses? Let’s take a look at how this scare has been perpetuated and the current status of kava around the world.

A Look At The Facts: Kava And Liver Damage

MedlinePlus, the National Institutes of Health (NIH) website for the general public, has published this warning:

“Kava is POSSIBLY UNSAFE when taken by mouth. Don’t use it. Serious illness, including liver damage, has occurred even with short-term use of normal doses. The use of kava for as little as one to three months has resulted in the need for liver transplants, and even death.”

That is a terrifying warning. But is kava as dangerous as it sounds?

According to the NIH, “Reports from health authorities in Germany, Switzerland, France, Canada, and the United Kingdom have linked kava supplement use to at least 25 cases of liver toxicity, including hepatitis, cirrhosis, and liver failure, prompting some of these countries to remove kava from the market.” The NIH liver toxicity database reports that number to be slightly higher, citing 50 to 100 cases of kava-related liver injuries mentioned in scientific literature.

If these don’t sound like very big numbers, you are right. The NIH concludes that the risk of liver damage from taking a kava supplement is less than one in one million. You are more likely to be struck by lightning! To put that in perspective, consider that prescription drugs cause over 100,000 deaths per year in the U.S. Kava or prescription drugs — which do you think has a better record of safety?

Kava Manufacturers To Blame?

It’s a widely accepted view that no one knows for sure what caused the liver problems. A review of 85 studies on kava safety concluded that there was no indisputable single cause of kava toxicity. So the status quo continues to label kava as toxic and to be avoided “just in case.” But let’s take look at what is known to see if this argument makes any sense.

It’s suspected that people who experienced kava toxicity already had compromised livers. A large portion of people who responded adversely to kava frequently consumed alcohol or took prescription drugs or herbs known to stress the liver. According to one study, 64 percent of the patients who experienced kava toxicity used up to 20 different drugs, supplements, and herbs, any of which could have reacted with kava. Another possibility is that these people had an immunoallergic response or were genetically unable to metabolize certain compounds in kava.

That may be part of the story, but it’s even more likely that the quality of the kava supplements was to blame. It’s known that supplement manufacturers took a lot of shortcuts and did not use traditional extraction methods.

Traditionally, kava is prepared by soaking only the root of the kava plant in water, but manufacturers used alcohol or acetone instead to extract the kavalactones, kava’s active ingredients. And manufacturers weren’t just using roots, they were using the leaves, stems and bark peelings — all plant parts known to contain alkaloids toxic to the liver. According to one Fijian kava dealer, stem peelings, which are considered a waste product, were purchased by pharmaceutical companies as a cheap source of kava extract. There’s also speculation that some manufacturers weren’t even using the correct kava species!

Chris Kilham is a world renowned educator, proponent of herbal remedies, and the author of Kava: Medicine Hunting in Paradise. On his website MedicineHunter.com, he writes, “It took several years, and the dedicated efforts of many medical research teams to establish that the kava liver toxicity report was shoddy and baseless. But the damage to kava was done. To this day, despite absolutely no evidence of liver toxicity among kava drinkers, and despite liver safety demonstrated in medical studies, kava still carries the taint of concerns over liver toxicity.”

Kava’s Current Legal Status

Restrictions on kava and its legal status are constantly changing and are different from country to country.

Here in the United States, kava is readily available. You can buy kava supplements in the form of capsules, tablets, liquid extracts, sprays and tea bags as an herbal remedy to aid relaxation and to combat stress, anxiety, and insomnia. You can easily buy kava supplements at any health food store or online.

Studies consistently find kava as effective as prescription medications for treating anxiety, generalized anxiety disorder, and depression — without the side effects. Kava also shows potential for treating substance abuse of all kinds, from tobacco to heroin. Recently, kava bars have been springing up in some cities where kava tea can be shared communally with friends, thus replicating the traditional experience.

The U.S. government and kava have a checkered past, however. In 2002, the Food and Drug Administration initiated a ban on the selling of kava supplements upon hearing about liver toxicity reports in Europe. In 2005, they conducted their own research and ultimately decided that kava was safe and lifted the ban in 2008. Even though kava was given the go-ahead for sale, all government-funded studies on kava were suspended.

European countries are not united in their stance against kava. Kava is regulated in France, Switzerland, and the Netherlands. Germany recently lifted a 15-year ban, while restrictions in the United Kingdom grew tighter. Poland is the only European country where the possession of kava can result in a prison sentence.

One unfortunate casualty of the kava ban has been its negative impact on the economies of Pacific Island nations like Fiji and Vanuatu that depend on kava as a significant export.

Taking Kava Safely

Stress, anxiety and insomnia are at epidemic levels and kava offers a natural alternative to prescription anti-anxiety medications and sleeping pills which have significant side effects. Kava in the form of a supplement is not the same as traditional kava tea, so use common sense when taking a kava supplement. The American Botanical Council offers these common sense precautions:

Don’t use kava if you have liver problems.

Don’t take kava if you regularly use alcohol.

Don’t mix kava with any drug that adversely effects the liver — this includes both prescription and over-the-counter medications. You can check if kava has any known interaction with any medication in this drug interaction checker.

Don’t use kava for more than four weeks at a time.

Discontinue kava use if you develop signs of jaundice or hepatitis.

Don’t take kava with other anti-anxiety remedies such as 5-HTP, melatonin or St. John’s wort.

As with many other herbal remedies, kava’s safety has not been established for pregnant or nursing women.

When buying a kava supplement, remember that quality matters. It’s always a good idea to buy kava or any herbal supplement from a reputable company that adheres to GMP (Good Manufacturing Practices) and has an established reputation of caring about the safety and effectiveness of their products.

You can also brew your own kava tea. The easy way is to use kava tea bags. But for the full kava experience, make your tea the traditional way. Start with kava powder, put it in a cloth bag, add water, then knead and squeeze the bag until your tea has reached the desired consistency.