Recently the Australian Government sought input from the community on a proposed pilot program to ease restrictions on the importation of kava in to Australia. The proposal is to increase the quantity of kava that may be imported for personal use from two kilograms to four kilograms. Questions have been raised about potential harms to Aboriginal and Torres Strait Islander communities if the amount of kava that can be imported is increased.
Kava is a drink made from the roots of a type of pepper plant that grows in the Pacific Islands. As part of the culture of the Pacific Islands, it has traditionally been prepared using water or coconut milk and used in ceremonial events and social occasions and for medicinal purposes.
In Australia, kava was introduced to Aboriginal communities, primarily Arnhem Land communities, in the 1980s as an alternative to alcohol. Community members, who had visited the Pacific Islands, had witnessed the calming effects kava produced and thought that if kava replaced alcohol as the drink of preference, it would reduce the number of harmful alcohol related incidents.
The short term effects of kava intoxication include feeling relaxed and sociable, and having a positive mood. While the risks to health of moderate use of kava are considered low, long term and heavy use of kava can lead to malnutrition, scaly rash and more frequent infections.
The most serious health concern linked with long term or heavy kava use (more than 400 grams per week) is damage to liver function. Reports of liver function damage from kava use have been linked predominantly with herbal kava preparations, however the traditionally prepared kava drink has also been associated with raised liver enzymes (which can indicate inflammation or damage to the liver). It is recommended that drinking kava should not be combined with alcohol and that anyone with a pre-existing liver condition, such as hepatitis, should avoid drinking kava altogether. Prescription drugs also interact with kava to change the way the liver processes these substances, which can result in serious side effects.
According to research conducted in the early 2000s, the use of kava is not widespread in Australia, but is largely confined to communities in North East Arnhem Land. Since the 2000s there has been little published research related to kava consumption, so it is difficult to know the extent of kava use and related harms. Aboriginal Elders in North East Arnhem Land have expressed concern about the effects of kava use on the social wellbeing of specific communities, such as disengagement from the community and cultural practices and financial strain on families (current estimates are that kava sells for around $1,000 per kilogram). Northern Territory police have also stated that there are significant social harms associated with activities linked to the trafficking of kava in these communities, such as car accidents at night.
The recently published Review of kava use among Aboriginal and Torres Strait Islander people published by the Australian Indigenous HealthInfoNet, charts the complex history around the regulation of kava and outlines the available evidence on the effects of kava use on the health of individuals and communities.
The review highlights that effective actions to address problematic kava use need to engage communities and to address the social conditions which underpin problematic kava use as well as other drug use. Changes to regulating kava have the potential to increase harms from kava use but could also be an opportunity to engage with communities to develop community-based strategies to address problematic kava use.
The review is free to download from the Australian Indigenous HealthInfoNet Alcohol and other Drugs Knowledge Centre.