Kava

Kava, also called kava kava, is a plant native to the South Pacific and belongs to the pepper family. Its scientific name is Piper methysticum. The word “Kava” may refer to the plant itself, its root, or the traditional beverage made by preparing the root with water.

Key Takeaways

• Kava comes from the root/rootstock of Piper methysticum, a South Pacific plant in the pepper family
• Its main active compounds are kavalactones
• Kava may produce calming, sedating, or mildly psychoactive effects
• Research is strongest for anxiety, but findings remain mixed
• Kava has been linked to rare but sometimes serious liver injury
• Kava should not be mixed with alcohol or sedative medicines

Kava At A Glance

Common Names: Kava, Kava Kava, awa, ava pepper, Kawa ava root, Yaqona or Yagona, Sakau, Seka, and Malok or Malogu

Origin & History

• Kava is native to the South Pacific: Kava comes from the Pacific Islands and belongs to the pepper family. Its scientific name is Piper methysticum.
• It has been used for thousands of years: Pacific Island communities have prepared Kava beverages for ceremonial, social, and traditional purposes for a very long time.
• The word “Kava” has Pacific linguistic roots: According to Lynch (2002), the reconstructed Proto-Polynesian term for the plant, Kava, comes from the Proto-Oceanic term kawaR, understood as a “bitter root” or a “potent root,” including one associated with fish-poison use.
• Kava is closely tied to Oceania: Its traditional use is especially associated with island communities across Polynesia, Micronesia, and Melanesia.
• Vanuatu is often linked to Kava’s early history: Kava is widely discussed as having important historical roots in Vanuatu, with its spread later extending across other Pacific Island regions.
• Traditional Kava is root-based: Historically, kava was prepared by grinding, crushing, or pounding fresh or dried kava root, mixing it with water, and straining the liquid before serving.
• Kava carried cultural importance beyond the drink itself: In many Pacific communities, kava became part of ceremonies, gatherings, hospitality practices, and shared social customs.
• Its use has expanded outside the Pacific Islands: Kava beverages have become more common in other parts of the world, including kava bars in many locations across the United States.
• Modern kava appears in many forms: Along with traditional beverages, kava is now sold as dietary supplements, powders, extracts, teas, prepared drinks, and other commercial products.

Cultural Background

• Ceremonial value: Kava has long been used by Pacific Islanders for ceremonial purposes, with NCCIH noting that kava beverages have been used for thousands of years. (NCCIH)
• Social role: Kava is also a traditional recreational drink in Polynesia, Micronesia, and Melanesia, often shared in community and social settings. (Wikipedia)
• Regional customs: Kava traditions vary across Western Oceania; different islands and communities have their own cultural practices around kava. (Wikipedia)
• Cultural meaning: Kava rituals have been associated with strengthening group ties, reaffirming status, and supporting spiritual or ceremonial communication. (Alcohol and Drug Foundation)
• Modern presence: Kava culture now extends beyond the South Pacific through diaspora communities and kava bars, including many locations in the United States. (NCCIH)

Forms of Kava

• Traditional kava beverage: Kava is commonly prepared as a non-fermented drink made from the plant’s rootstock. Traditional preparation may involve chewing or pounding the rootstock, soaking it in water, and filtering the liquid before drinking. (Drug Enforcement Administration)
• Kava root and powdered root: Dried kava root that has been ground into powder. It is different from an extract because it contains ground root material rather than a concentrated kavalactone preparation.
• Kava capsules and tablets: Oral supplements typically filled with powdered kava root or kava extract. In the United States, kava is sold as a dietary supplement, including capsule and tablet forms. However, these products are often promoted for anxiety and other health-related purposes, although they are not FDA-approved medicines.
• Kava extracts: Concentrated preparations made to contain kavalactones, the main active compounds in kava. Extracts may appear as powders, pastes, or liquids. Some liver-injury reports have involved products extracted with alcohol or acetone, although cases have also involved water-prepared beverages. 
• Kava teas and drink mixes: Commercial kava may appear as tea bags, instant powdered drink mixes, and other prepared beverage formats. 
• Ready-to-drink kava beverages: Kava beverages are now sold outside the Pacific Islands, including at kava bars in many U.S. locations. 
• Kava gummies and other products: Chewable products that contain kava powder or kava extract.

Pharmacology: How Does Kava Work?

Kava contains a group of compounds known as kavalactones or kavapyrones. About 18 kavalactones have been identified, and at least 15 are considered active. However, most of kava’s pharmacological activity is linked to six major kavalactones: “kavain,” “dihydrokavain,” “methysticin,” “dihydromethysticin,” “yangonin,” and “desmethoxyyangonin.” These six are often described as responsible for about 96% of the plant’s pharmacological activity.

Kava also contains minor constituents such as the chalcones “flavokavain A,” “flavokavain B,” and “flavokavain C.” A toxic alkaloid called “pipermethystine” has also been identified, although that is not present in the consumable parts of the plant.

Kava mainly affects the central nervous system: Pharmacologically, kava is linked with central nervous system activity, which helps explain why it is associated with relaxation, calmness, drowsiness, and mild psychoactive effects. Its compounds do not appear to act through a single pathway only.

GABA activity is one major pathway: Kavalactones are often discussed for their effect on GABA-A receptor activity, a pathway involved in slowing nerve signaling in the brain. Reported actions include potentiation of GABA-A receptor activity by “kavain,” “dihydrokavain,” “methysticin,” “dihydromethysticin,” and “yangonin.”

Kava may also influence other signaling systems: Reported pharmacological actions include effects on dopamine and norepinephrine reuptake, CB1 receptor binding, voltage-gated sodium and calcium channels, and reversible monoamine oxidase-B inhibition. These combined actions may contribute to kava’s relaxing, mood-related, and sedating profile.

The exact mechanism is still not fully established: Although kavalactones are known to be central to kava’s effects, researchers continue to study exactly how these compounds act in the brain and body. Evidence suggests multiple pathways may be involved rather than one simple mechanism.

Kava Effects On The Body

A PubMed-indexed review suggests several body effects: A PubMed-indexed review by Singh states that kava’s biological effects are linked to kavalactones and may include sedative, anxiolytic, antistress, analgesic, local anesthetic, and neuroprotective effects.

Common effects may feel relaxing or calming: ADF reports that people may experience feeling happy and relaxed, mild sleepiness, numbness in the mouth and throat, and a reduced or loss of appetite.

Smaller amounts may affect muscles and alertness: The Better Health Channel report suggests that smaller amounts of kava may cause relaxed muscles, sleepiness, feelings of well-being and relaxation, mild loss of feeling in the throat and mouth, and appetite loss. 

A PubMed-indexed review titled Kava as a Clinical Nutrient: Promises and Challenges suggests that kava’s potential benefits are mainly linked to neurological effects, especially stress and anxiety, while newer research is also examining its anti-inflammatory and anticancer properties.

Kava is a central nervous system depressant and can produce alcohol-like symptoms such as balance issues and slurred speech.

Effects depend on body size, general condition, previous experience, strength, amount, and other substances taken around the same time. 

Larger amounts may cause drowsiness, nausea, loss of muscle control, mild fever, pupil dilation, and red eyes.

Kava effects on anxiety

Research suggests kava may have short-term anxiety-related effects, especially in some placebo-controlled studies and reviews. However, the evidence is not consistent enough to present kava as a confirmed treatment for generalized anxiety disorder. 

A Cochrane review found that kava extract showed a small but significant benefit over placebo for symptomatic anxiety, while NCCIH states that kava may help anxiety after several weeks but does not appear helpful for generalized anxiety disorder. (PMC, NCCIH)

Kava and sleep or insomnia

Kava is sometimes discussed for sleep because of its calming and sedating effects, but the evidence is limited. One PubMed-indexed clinical study on kava extract WS 1490 suggested that it may help sleep disturbances linked with non-psychotic anxiety disorders. However, this does not prove that kava is effective for general insomnia. (PubMed)

Another randomized placebo-controlled trial found that kava did not improve insomnia more than placebo, and that there is not enough evidence to show whether kava helps conditions other than anxiety.

Kava and PTSD

A Frontiers in Psychology review explores kava-talanoa, a culturally grounded approach that combines kava with talanoa, a Pacific form of open group discussion. The authors describe it as a possible culturally aligned medico-behavioral approach for reducing PTSD symptoms, but they also note that planned clinical trials are still needed.

Kava Side Effects

• Headache
• Dizziness
• Sleepiness
• Digestive upset
• Nausea or vomiting
• Numbness or tingling in the mouth/throat
• Reduced appetite
• Slowed coordination
• Skin changes with heavy long-term intake
• Possible liver injury in rare cases

Kava Effects On The Liver

Kava has been associated with potential liver toxicity (hepatotoxicity), but the evidence remains debated. Some kava extracts have shown hepatotoxic effects, and these concerns led health authorities in the United States, Australia, and Canada to issue warnings.

Possible factors include toxic alkaloids from leaves and stems, contamination, commercial extraction methods, drug interactions, and genetic differences in metabolism.

Is Kava Legal?

Yes, kava is legal in the USA.

• In the United States, kava is not controlled under the Controlled Substances Act.
• It is sold as a dietary supplement, but the FDA has not approved kava products for any medical indication.
• Rules differ by country, and some regions have restricted or previously banned kava products because of liver-related concerns.

Is Kava An Alcohol Alternative?

Kava is often marketed as an alcohol alternative because it may create calming, relaxing, or mildly psychoactive effects. However, experts do not consider it a simple or risk-free replacement for alcohol. 

According to Dr. Jarratt Pytell, MD, MHS, an internal medicine and addiction medicine physician and assistant professor in the University of Colorado Department of Medicine, kava may be a potentially less harmful option for some people trying to reduce alcohol intake, but it still carries risks and should not be mixed with alcohol. 

He also notes that kava is not regulated like alcohol or prescription medicines; its effects can vary by product, and concerns remain around liver toxicity, sedation, and unknown long-term impact.

What’s unknown about kava?

Many questions about kava remain unanswered. Researchers do not yet know whether kava can help reduce alcohol-related harm, how widespread kava access would affect public health, or whether people would replace alcohol with kava instead of using both. 

How much kava one must consume to start feeling its effects?

There is no fixed amount of kava that works the same for everyone. Effects depend on the product form, kavalactone content, preparation method, amount consumed, individual response, and whether alcohol or other substances are involved. 

“I think it’s almost impossible to say how much has to be consumed to feel the effects, and that’s the problem with unregulated substances.” As Dr. Jarratt Pytell quotes. It is generally better to start with a low amount if you are a beginner. 

Are kava drinks a good substitute for alcohol for Dry January?

Kava drinks may work as an alcohol alternative for some people trying to reduce or stop drinking, but they are not the safest or lowest-risk substitute. Compared with water, non-alcoholic beer, or other alcohol-free beverages, kava carries more uncertainty because it is not a zero-risk substance. 

Kava may be reasonable for someone replacing daily alcohol intake, but its potential risks, unregulated nature, liver concerns, and unknown long-term effects should still be considered. It should not be presented as a broadly endorsed public health solution for Dry January.

What to consider before consuming kava?

Before consuming kava, consider why you want to try it, where you are getting it from, and whether the setting is appropriate. If you are trying kava for anxiety, sleep, or alcohol replacement, it is especially important to understand that kava is not risk-free and may not be suitable for everyone. Choose a trusted source, avoid mixing it with alcohol or sedative substances, and do not plan to drive afterward. For first-time users, starting with a low amount rather than finishing a whole drink at once is better.

Who should avoid kava?

Kava is not suitable for everyone. People with liver conditions, pregnant or breastfeeding women, children, people taking sedatives or certain prescription medicines, people drinking alcohol, and anyone who needs to drive or stay alert should avoid kava or consult a healthcare professional first.

Does kava help with generalized anxiety disorder (GAD)?

Kava does not appear to be helpful for symptoms of generalized anxiety disorder. While some evidence supports short-term anxiety symptom relief in general, clinical trials specifically targeting GAD have not shown kava to be more effective than placebo.

Can you mix Kava and alcohol?

No. Combining kava with alcohol can increase how intoxicated you feel and raises the risk of liver damage. The combination is considered unsafe by health authorities and addiction medicine physicians.

Is Kava FDA-approved?

No. Kava products sold in the United States are generally marketed as dietary supplements, not FDA-approved medicines. This means they should not be presented as approved treatments for anxiety, insomnia, PTSD, or any other medical condition.

References

1. National Center for Complementary and Integrative Health. “Kava: Usefulness and Safety.” National Institutes of Health. Last updated April 2025. (NCCIH)
2. Wikipedia contributors. “Kava.” Wikipedia, The Free Encyclopedia. (Wikipedia)
3. Better Health Channel. “Kava.” State Government of Victoria, Australia. (Better Health Channel)
4. U.S. Drug Enforcement Administration, Diversion Control Division. “Kava.” Drug & Chemical Evaluation Section. (DEA Diversion Control Division)
5. UCLA Health. “Ask the Doctors: What Are the Risks and Benefits of Kava?” UCLA Health. (UCLA Health)
6. Alcohol and Drug Foundation. “Kava.” Alcohol and Drug Foundation. (Alcohol and Drug Foundation)
7. Bian, T., Corral, P., Wang, Y., et al. “Kava as a Clinical Nutrient: Promises and Challenges.” Nutrients, 2020. (PMC)
8. Health.mil. “Kava for Generalized Anxiety Disorder.” Military Health System. (Military Health System)
9. University of Colorado Anschutz Medical Campus. “Is Kava a Good Alcohol Substitute for Dry January?” Department of Medicine. (CU Anschutz News)
10. GoodRx Health. “What Is Kava? Uses, Benefits, Side Effects, and More.” GoodRx. (GoodRx)
11. Pittler, M. H., and Ernst, E. “Kava Extract Versus Placebo for Treating Anxiety.” Cochrane Database of Systematic Reviews, 2003. (PMC)
12. Sarris, J., Stough, C., Bousman, C. A., et al. “Kava in the Treatment of Generalized Anxiety Disorder: A Double-Blind, Randomized, Placebo-Controlled Study.” 2013. (PubMed)
13. Lehrl, S. “Clinical Efficacy of Kava Extract WS 1490 in Sleep Disturbances Associated With Anxiety Disorders.” 2004. (PubMed)
14. Jacobs, B. P., Bent, S., Tice, J. A., Blackwell, T., and Cummings, S. R. “An Internet-Based Randomized, Placebo-Controlled Trial of Kava and Valerian for Anxiety and Insomnia.” Medicine, 2005. (PubMed)
15. LiverTox. “Kava Kava.” Clinical and Research Information on Drug-Induced Liver Injury, National Institute of Diabetes and Digestive and Kidney Diseases. Last updated April 10, 2018. (NCBI)
16. Aporosa, S. A., et al. “Innovating Through Tradition: Kava-Talanoa as a Culturally Aligned Medico-Behavioral Therapeutic Approach to Amelioration of PTSD Symptoms.” 2025. (PMC)