The complex presence of kava in the Western World: A fascinating perspective of Dr Huffman

A kiwi journalist trying kava for the first time at the University of Auckland  (photo by Todd Henry) 

A couple of weeks ago we went to one of the Pacific islands that lost its kava culture 150 years ago with the arrival of the European missionaries. But while nobody drinks kava there today, we have good reasons to believe that their forests still have some of the ancient local cultivars and hence we wanted to try to find them. We weren't very successful (i.e. didn't manage to find the actual plants), but found people who might be able to assist us with future searches and/or even send us some samples. On the way back to Auckland I had a bit of time so I finally managed to read a series of articles by Kirk Huffman, a prominent anthropologist and a respected expert on kava's history, culture and modern use. Kirk presents a very interesting overview of kava's history and effects as well as a thought-provoking account of the developments that led to kava's increasing popularity and the so-called "ban" in Europe (now lifted).

I thought you might find some of his observations interesting, so I've collected a few longer quotes: 

"Kava is the name for a plant, for its root, for a drink made from its root, and now for tablets and extract from that root sold in the West. The plant grows only in the Pacific. It first came to the attention of the English-speaking world after Captain Cook’s first visit to Tahiti in 1769, when he and his scientists were invited to drink it ceremonially. They were suitably impressed, but slightly put off by the taste. It had a rather pleasing effect, and Cook’s scientists originally dubbed the plant it was made from as piper inebrians, then changed that piper methysticum, it being a distant relative of the pepper plant. Early European explorers found that a drink made from the roots of this plant was drunk ritually throughout much of Polynesia, from Tonga to Samoa to the Cook Islands and back to Fiji. In Hawai’i it is called Awa, in Tonga Kava, in Fiji Yaqona (pronounced ‘yanggona’). The root of these terms comes from an early proto-Polynesian term meaning ‘bitter’. ‘Kava’ is the name that has stuck and spread worldwide, rather like the origin of our word ‘coffee’ or even ‘tea’. Historians, explorers, writers and academics for long assumed that it was essentially a purely Polynesian drink..

Little did they know: back in a hidden corner of the southwestern Pacific lay the real homeland of kava; the volcanic archipelago of Vanuatu, keeper of so many of the Pacific’s secrets.  (...) There, possibly over two thousand years ago, ancestors of still-surviving clans discovered how to artificially ‘clone’ a drinkable variety of the kava plant from a wild, non-drinkable, parent plant. This wild source is a variety of pepper plant known by scientists as piper wichmannii, and this grows only in western Melanesia (that area comprised by West Papua, Papua New Guinea, the Solomon Islands, and Vanuatu). Extracts from the roots of this wild plant are undrinkable, but modified forms are sometimes used in traditional medicines. Through generations of observation and experimentation, those wise men in northern Vanuatu managed to develop from this plant another variety – and then more – whose roots provided a drinkable extract whose effects are remarkable.

These roots contain no alcoholic substances, but an extremely complex array of 12 to 14 chemicals (* that was the known situation in 2002; it is now known that there are over 40 chemicals, 19 of which are psychoactive) – mostly analgesics and anaesthetics – that are linked in such a complex interrelationship that it is almost impossible to reproduce by modern methods. It is also extremely difficult to tell which are the absolutely essential ingredients for the effect the root extract gives when drunk. The psychoactive ingredients have been dubbed ‘kavalactones’ by modern scientists. The ingredients, when drunk, work on the central nervous system, through a reduction of activity in the spinal area, reducing cardiac rhythmn and then stimulating and relaxing respiration. The whole effect is one of extremely pleasurable relaxation, with the mind remaining clear, with a sometimes-increased focus. It is an extremely effective soporific, and a mild narcotic, but non-addictive. Effects last only a few hours and the drinker wakes the next morning feeling fresh and revived. Medicinally, it cleanses the kidneys through its diuretic action, flushes out minor illnesses of the urino-genitary system (and a good practical note for certain readers: if you happen to be in the first stages of a bout of gonorrhoea, it will get rid of that as well), removes aches and pains, gets rid of headaches, can assist in getting rid of skin pimples, and so on – the list is almost endless. On a practical note for European readers, it is also one of the most effective slimming aids known (and you don’t have to waste hours running or jogging, waiting for that ‘joggers high’) and you can say goodbye to constipation problems (although this is not a topic of great concern for Pacific Islanders!). But each subspecies of kava – and there are over 80 of them in Vanuatu – has its own special effects and use. Some are better for ritual/spiritual purposes, some better for medicinal use. (...) Sounds too good to be true? Well, like anything – coffee, tea, doughnuts, Smarties, streak, whatever – if one overdoes it over an extended period of time one can slow down a bit. But as soon as one stops drinking for a couple of days one is as right as rain.

(...)

"For nearly a decade, many health food shops in the UK have stocked bottles of tablets labelled ‘Kava’ or ‘Kavakava’: ‘To be taken to Alleviate Stress or Anxiety’. In Germany, medicinal ‘kava extract’ has been used as an ingredient in anti-stress medicines for decades, and in fact German medical scientists have been working with kava extracts since 1860. Kava tablets have also been available in the US since the mid-1980s and became the ‘in thing’ in New York in 1998, drug stores and pharmacies there displaying big posters indicating ‘Yes, we have KavaKava !’, etc. In 1999 certain Spanish Health Food and Alternative Living magazines announced that kava would soon be coming to Spain. I remember thinking periodically over the last decade how long it often takes our modern cultures to really accept something new from the so-called ‘Third World’ (I should point out here that I consider this term rather derogatory and that it is really our own ‘modern’ world that should be called by that term, it being so removed by many steps from its real roots). In late January (2002) my wife and I visited one of the major Farmacias in the Calle de las Farmacias of Vila (Eivissa/Ibiza Town), and I asked if they sold any kava extract medecines. I was told they had been selling them, but had recently taken them off the shelves as they had, earlier that month, received a circular from the Spanish National Farmacias Institute in Madrid to withdraw stocks until further notice. In a nearby health food shop there was a gap on the shelves where bottles of kava tablets should have been. No explanations. Nobody really knew why, just that they had received an official circular. As often happens, it is quite possible that those responsible for the circular did not really know either: they were merely copying others.

(...)

In early November 2001 the German Bf ArM – the Federal Institute of Drugs and Medical Devices (in Bonn) – announced that it had received from German doctors reports that there had been 24 cases of individuals with various levels of liver damage in which it was suspected that there was a possible connection with the intake of medicinal kava extract/tablets as an anxiety/stress reliever. The Bf ArM (Germany’s equivalent of the US Food and Drug Administration, the FDA) then requested information and ‘pro’ and ‘con’ kava views from the pharmaceutical, health food and medical professions to enable them to try and make some formal decision about the safety of kava in medicinal extract form. They gave a deadline of 21st December 2001 for reports to reach their offices and they were expected to make a decision by the end of January 2002. They began their decision-making meetings on 6th January and, as a result...it seems that the press around the world has announced a German ‘ban’ on the use of kava extract in natural medicines used to combat stress, anxiety, tension and other such ills of the modern world. Possibly not to be outdone by their German colleagues, the French government announced a pre-emptive ban on all medicinal kava products on 14th January (2002) and their medicinal registration within France was withdrawn that day. Certain Pacific Island states, the world’s major kava exporters, were puzzled, shocked and, to put it mildly, angry, And rightly so! A Kanak (indigenous Melanesian New Caledonian) academic friend and colleague wrote to me on 17th January, ‘The French and German prohibition on the use of kava is big news in Vanuatu and here. Just when an island product could permit our small economies to survive, the big countries put a stop to it...PS One should hint to the French and Germans that it would be better to ban alcohol and tobacco, which are a lot more dangerous than kava!’ (trans. from the French). Import orders for South Pacific kava were rapidly cancelled by companies in the US and Europe and by early March kava exports from the Pacific had almost juddered to a halt.

(...)

This is a disaster for certain Pacific island economies, particularly for Fiji, Vanuatu, Tonga and Samoa. Overseas countries, and foreign entities such as the World Bank, the IMF and foreign economic advisors to these Pacific nations have perpetually been telling them that they must develop exports that will cut down on their needs for overseas financial aid. Kava seemed like the ideal answer: it was local, traditional, and did not require backbreaking labour to prepare for export. It looked like parts of the Pacific had finally found one of their own products that would enable them to achieve some form of economic independence. Then the European press fanned the flames, announced the German ‘ban’ and stopped the whole export industry in its tracks. It is said there is nearly AUD $200 million worth of kava, growing in Pacific Island nations, ready for export within the next couple of years. The whole situation is extremely depressing and Pacific governments and indigenous inhabitants relying on kava exports have a right to be absolutely furious. The kava-exporting nations called urgent meetings in January and February 2002 to try and deal with the rather hysterical accusations regarding kava and liver damage that were appearing in the European press. As the drinking of kava by Pacific males is an extremely ancient and respected practice, it goes without saying that more is known about the properties of kava by Pacific Islanders than by European (or American) scientists – and liver damage in traditional kava drinkers is not a known side-effect.

(...)

The already-planned Pacific herbs business forum meeting took place in the capital of Vanuatu 18th- 20th February (2002). Sponsored by the Brussels-based Centre for Development of Enterprise in association with the Commonwealth Secretariat and the (Netherlands) Technical Centre for Agriculture and Rural Cooperation, it brought together nearly 100 professionals involved in the production and consumption of Pacific medicinal plants and related products. Because of recent events in Europe, kava was the main topic of discussion. What were the reasons for the kava ban and what should Pacific Island nations do?
But wait a minute. The main ‘problem’ seems to lie in Germany, and with France and Britain (and now Spain – and with warnings at the beginning of this month in Australia) and other nations recommending the withdrawal from sale of kava-based medicines based purely upon the German announcements and German press-generated statements circulated around the world. Has anyone really followed up what is going on in Germany? Seemingly not. My wife and I spent three weeks in Germany from late December (2001) and I used the opportunity to telephone widely and try and get to the bottom of all this. Readers may be interested to know – and Pacific Islanders rather shocked and angered to hear – that medicinal kava extracts to combat stress and anxiety are still openly on sale in German pharmacies (I rang a colleague in Germany on 18th March to get this confirmed) and there is (as yet) no official ban on medicinal kava products announced by the relevant German government Ministry. The Bf ArM in Bonn has not yet announced any decision – although everyone was expecting one at the end of January. This seems to be a situation where a media-inspired frenzy regarding the possibility of a ban has in fact created a de facto ban, to the detriment of the long- suffering Pacific Islanders who have had long experience with the inconsistencies, irrationalities, irrelevances and, to put it bluntly, idiocies, of the ‘White Man’s World’. What would be rather nice poetic justice, in a way, would be to see a group of traditional Pacific chiefs, or a group of Pacific nations, get together and bring a legal court case against certain European nations and certain European media concerns for sheer stupidity, cultural incomprehension and lack of respect (and, just for good measure, include a whopping financial fine to cover loss of kava export revenue).

Innumerable thousands of men from the kava-drinking areas of the Pacific have been regularly using the sacred drink for untold generations and no-one has any stories of liver damage caused by properly-prepared kava of the drinkable varieties – and in fact in certain areas of northern Vanuatu, where a mild form of hepatitis is almost hereditary, kava-drinking seems in no way to aggravate it. Then the White Man comes. His missionaries try to prohibit kava-drinking as being associated with ‘heathenism and devil-worship’. Colonial governments demean it as ‘unhygienic’. Tourists don’t like the taste and some call it ‘Pacific mud’. Then what happens? The White Man suddenly finds out there is money to be made from it, it can be made into a relaxing medicine to treat one of the West’s major illnesses, stress. Everyone now tells Pacific islanders ‘Plant lots of this wonderful bush and we will buy its roots from you and you will make lots of money’. Over nearly the last couple of decades there has been a rather frenzied rush amongst European and US pharmacological specialists to experiment with the plant’s roots, to decipher its chemical secrets, to take a bit from here and a bit from there, concentrate it to get a stronger effect, and so on and so forth. You know the game."

[Today the scientific consensus appears to confirm these concerns - The problem with many kava products sold outside the South Pacific isn't kava itself, but the widespread use of cheaper, but never traditionally consumed non-noble varieties and the aerial parts of the plant.]

"All of this rather reminds one of the 1986-7 hysterical anti-kava press campaign in Australia which had lurid headlines such as ‘Kava takes hold on Aborigines’; ‘Kava a Danger to Aborigines says Senator’; ‘A New Sinister Scourge’; ‘Kava: New Poison for Aborigines’; ‘Darkness descends on Milingimbi...and kava flows’; ‘Inquiry into Kava’; ‘Kava Crisis’; ‘Aborigines seek ban on ‘killer’ kava’, and so on.

A short aside here is merited. Australian Aborigines were neither traditional kava growers nor drinkers. Kava-drinking was first introduced to certain aboriginal groups in Australia’s Northern Territory in the early 1980s by two Fijian Methodist missionaries working there who saw it as a safe alternative to alcohol. As with American Indians, alcohol has been a veritable scourge for Australian
aboriginals: neither population group possess the essential stomach enzyme (* Alcohol Dehydrogenase) necessary for alcohol processing, so they literally poison themselves with it. Approximately 50% of Japanese lack this enzyme as well, as do approximately 4% of women of European origin. For those lacking this enzyme, alcohol can literally kill, and the slightest amount of alcohol in the system can initiate liver dysfunction and raise liver enzymes in liver function tests. Medical tests carried out by the Menzies School of Health Research (Darwin) on chronic heavy kava- drinking aborigines in Arnhem Land over an 8-month period in 1987-8 did indicate a slight increase in biochemical indicators of liver dysfunction, but these returned quickly to normal amongst those who ceased drinking and the report here states ‘...there is no evidence of any chronic effects of kava use on health’ after cessation of drinking. Most of the aborigines involved in the tests were rather severely undernourished (not as a result of the kava-drinking; it unfortunately seemed to be a part of life at that time in that particular area). This may have had an effect on the results, and a certain amount of alcohol intake cannot be discounted (although there was supposed to be none). I should here point out that consuming large amounts of coffee could produce liver problems amongst susceptible individuals back here in the West. Kava-drinking amongst certain aboriginal communities certainly eradicated alcohol-induced violence and fighting: one cannot even feel angry when drinking kava. Kava and anger are completely incompatible. The frenzy of the Australian press campaign was stunning in the extreme. Aboriginal groups can consume vast quantities of alcohol and its effect is devastating. Alcohol sales to aboriginal groups in certain outback areas of Australia can be of a regular sizeable amount. Small wonder that some Australians suspected a certain amount of instigation of the anti-kava press campaigns by ‘elements of the alcohol industry’.

(...)

"The US does certainly have a rather schizophrenic attitude to certain substances, and these attitudes go in and out of fashion. By 1998 kava was the new ‘In Thing’ in New York, its position cemented by the front page of the popular colourful US ‘Sun’ Magazine for 4th August (1998): ‘Bible Cures Revealed! Doctors’ new guide to Healing Herbs in Sacred Scriptures’, underneath which was the headline ‘Kava Kava: Daily dose at night relieves anxiety’. Readers avidly rushed to find the part in the Bible mentioning kava. What had swung US medical opinion behind kava were the results of an extensive and extremely detailed 1997 experimental study on kava using 101 patients suffering from anxiety and tension. The work was carried out over a 25-week period by German scientists and the positive results (nothing new, of course, to regular Pacific kava-drinkers) hit the American medical profession with an almost audible slap. At last something really good and harmless had been found! I should here point out that liver enzymes were regularly checked during the experiments and nothing untoward was found. News circulated of certain Californian doctors taking some of their patients off of Prozac and putting them onto kava tablets, with commendable results. I remember an academic colleague laughingly telling me at the time (1998), ‘The kava producers better be a little bit careful: if it becomes too successful, it will start bothering the big companies and you begin to see indications that the police suddenly start to take an untoward interest in it!’.

Strangely enough, they did (although one is sure this had nothing to do with the ‘big’ companies selling other medicines), resulting in the famous Californian ‘kava trials’ of September 2000. There is a rather large Tongan community living in San Mateo County in California and, as in Tonga, the men will often have a lengthy kava-drinking session in the church grounds after the church service. One Tongan was arrested by the police for apparent ‘drunken driving’, but as the police found no alcohol in him, the local public prosecutor changed the accusation to ‘driving under the influence of drugs’. The police lay in wait outside the Tongan church in San Mateo County and arrested another Tongan. A trial date was set and the DA (District Attorney) wanted to prosecute for use of ‘an hallucinogenic substance’. By this time I was a Visiting Fellow at the Australian Museum in Sydney, but an old school friend from England, then living in California, put me in touch with the defence lawyer before the trial. Anyone who knows about kava knows that it is not a hallucinogen, but the prosecution did not know that: it seems they knew almost nothing. Kava is neither an hallucinogen nor a stupefacient, although it is a (mild, non-addictive) narcotic, soporific, analgesic, diuretic, muscle-relaxant, a ‘mood leveller’, and much more. The trial was critical as, if kava had been shown to be a hallucinogen, then it could be legally banned. Unfortunately, I do not have my complete ‘kava trials’ file here at hand, but I remember that a total of 11 Tongans eventually went on trial; that 10 were declared ‘innocent’, and one was declared ‘guilty’. But ‘guilty’ of what, no-one seemed to know. ‘Guilty of being Tongan’, one colleague laughingly told me. Nothing more was heard after that, and ‘hallucinogenic kava’ faded from the press.

Back to the ‘Europe-kava-liver’ problem. Many of the cases seem to involve individuals with possibly already-existing liver damage who were then taking kava tablets (sometimes 2-5 times the recommended doses) often at the same time as alcohol - and in certain cases ‘other substances’ as well. The sad but famous case of the one German ‘death from kava-induced liver failure’ turned out to be that of an 81-year-old German woman with a long history of alcohol abuse problems. These examples are taken from what sort of numbers range? If only a few thousand people were taking these kava medicines, then maybe things were not as they should be if there was any possibility that kava was involved. I decided to find out. On 14th January (2002) I spoke with one of the representatives of a small German pharmaceutical company (employing 300 people) that produces and sells three kava extract medicinal products. I was amazed at the size of the sales market! The company had been producing medicinal kava extract for over 30 years. During the period 1990 to October 2001 they had sold 40 million daily doses of their major kava product and 23 million daily doses of their other two kava brands – with no reports whatsoever of serious adverse side effects. I
was stunned, and said so. I was then told that the biggest share of the market in kava extract sales in Germany was held by another small German company, which had sold 100 million daily doses over the same period.

So with sales of that magnitude (and that is only two small companies amongst a larger number) and, if one believed the press reports, then just about everyone in Germany – and further afield in Europe – should now be suffering from liver problems. This is obviously not the case, so there are other factors that are involved in these kava bans.

(...)

I discussed this with a number of German pharmaceutical people during the three weeks my wife and I spent there in January. They agreed that the number of cases was infinitesimal. The doctors, though, were of course only doing their correct duty in reporting anything. My German brother-in-law, a respected economist and statistician, did say, though, that whoever had done up the reports and press releases had very little idea of statistics. Other pharmacists told me the same, but not in such polite academic terms. One wondered why there was so much fuss about medicinal kava extract and the liver when, for example, it was known that the aspirin-type painkiller Paracetemol could possibly damage the liver and yet was still easily available. Another said ‘What about Viagra?: that is already responsible for 70-80 deaths’, but whose registration has not been withdrawn (at which point I said ‘This just goes to show that sex and money are more important than death’, a comment that was met with a meaningful silence). It was not until recently that I came across a report indicating that by September 2001 a total of 616 people worldwide had died from using Viagra (many, it is said, by using it incorrectly). Bear in mind that Viagra has really only been in use for about five years, not 2000 years or more like kava possibly has been. Most of these things are probably pretty good and safe, though, if used in the proper way and with the proper supervision.

(...)

But if Euro-America (and Australia) want to ban kava products on whatever basis, what about...FAVISM? ‘Favism?’, you ask? Well, I had never heard of it either until a Swiss friend and colleague – a respected botanist and environmentalist who has been known to have a half coconut shell or two of Vanuatu kava – put me on to it recently. Favism is an inherited condition, an hereditary (and sometimes fatal) intolerance to beans, specifically beans from the variety vicia faba. These beans are a common element in Euro-American nutrition. Certain Mediterranean populations, especially those in southern Italy and particularly Sardinia, possess an hereditary enzyme deficiency that triggers a severe reaction to an intake of fava beans, and sometimes even to fava pollen. Intake can result in acute haemolytic anaemia and even death. Those affected by favism can be up to as much as 4% of certain Mediterranean populations who may be deficient in the necessary enzyme. In Sardinia, though, this can be as high as 35% of the population. For over a century, schoolteachers in Sardinia had noted a strange annual occurrence, mostly amongst their male students: with the arrival of Spring each February a high percentage of their students seemed drained of energy. This situation lasted for three months each year. Most just felt lethargic: others died, urinating blood. It was the time when fava pollen was in the air. There are many individuals of southern Italian descent in the US (*and in Australia). Those suffering from favism should not only refrain from eating (fava) beans, but should not take aspirin, vitamin C, certain anti-malarial tablets, nor certain anti-bacterials or certain heart drugs. Has one ever heard any suggestion that (fava) beans should be banned? No, of course not – it is part of our accepted Euro-American lifestyle, along with other potential killers such as alcohol, tobacco, and so much of the other paraphernalia of our polluted side of the world.

These things come from the Western World and the West has become unconsciously inured to their potential dangers: it looks upon the level of risk as acceptable. Kava, with no real known risk in the Pacific over millennia (except for possible temporary symptoms if overdone for long periods, or if one drinks a non-drinkable variety) is not from ‘our’ Western World, it is a gift to ‘us’ from a more ancient corner of the globe, and ‘we’ seem to have messed it up. The traditional drink of kava is associated with some of the world’s oldest religions, with the bridging of that gap between the material and spirit worlds. That is why so many early (and some even today) missionaries in the Pacific were/are so against it. For Pacific islanders, this recent ‘ban’ is just a continuation of those early bigoted views. It is almost as if this recent ban is a continuation of a certain type of Western attitude that was so succinctly put once by John Foster Dulles, one of the most important planners of so much of US foreign policy since World War II: ‘For us there are two sorts of people in the world; there are those who are Christian and support Free Enterprise and there are the others’. Most Pacific islanders are now, though, devoted Christians (which does not mean, however, that older traditional religions are no longer relevant) and Christianity now plays a larger part in their lives than in those of most of Western Europe’s inhabitants.

(...)

In spite of the fact that kava is thought by many to be possibly the most effective and safe natural medication to relieve anxiety, stress and tension (at least the milder types) – possibly the most widespread illness (besides obesity and cancer) of the ‘modern’ world – this modern world has seemingly rejected it. We have gone through some of the reasons for this and have also had a look at the very shaky (and minuscule amount of) medical information upon which a de facto ban seems to have been based. Some have suggested that if certain of the major pharmaceutical companies had been able to patent various elements of the complex chemistry of kava, then this might never have happened. Since particularly the late 1990s, the booming sales of kava tablets in Europe were actually beginning to cut into the sales of the more expensive (and often less effective) patented synthetic medicines for stress relief produced by some of the bigger drug companies. One should note that the kava extract medicines have always been produced by the smaller less well-known companies of the ‘natural remedies’ type. However, I would not necessarily want readers to leap to the conclusion that there exists an ‘Axis of Evil’ type of conspiracy on behalf of some of the large companies to just get rid of the competition (kava). It may be slightly more subtle than that. As a rather distinguished Swiss friend and colleague – well-versed in the machinations of the botanical and medicinal worlds – told me on 31st January this year regarding the situation in general, this ‘...may not necessarily be the big pharmaceuticals trying to block kava, it may just be the medical profession in general against ‘alternative medicine’...’."

Source: http://www.liveibiza.com/ibiza_anthropology/ibiza_anthropology_index.htm