Substance Relative Safety Landscape Analyses
The graphs below offer a comprehensive view of the substance landscape, highlighting the safety of kava in comparison to other commonly used substances.
Download the below charts as a PDF here.
Google search results from 2004 to now put into perspective the public’s concern over so-called “kava addiction” versus that of other popular substances.
PUBLIC INTEREST IN ADDICTION
Source: Google
CALLS PER SUBSTANCE
Reviewing the call data from the American Association of Poison Control Centers for commonly used substances in the US between 2017 and 2021 normalized per 100,000 users of each substance, kava calls barely register comparing most closely with energy drinks.
Source: American Association of Poison Control Centers & CDC & SAMHSA user data
Normalizing the call data from the American Association of Poison Control Centers per 100,000 users for each substance, kava calls barely register.
CALLS PER 100K USERS
Source: American Association of Poison Control Centers
CDC, FAERS, AND CAERS DATA ANALYSES
When reviewing the FDA Adverse Event Reporting System (FAERS), the CFSAN Adverse Event Reporting System (CAERS), and the Centers for Disease Control and Prevention databases in the context of overall substance use in the U.S., normalized per 100,00 users, the data illustrates that kava presents a much lower risk than alcohol, tobacco, sugar, and opioids.
Source: Nutrasource independent review of FAERS, CAERS, & CDC data, 2023
Kava Consumption & Liver Health
Overwhelmingly, kava is said to cause damage to the liver based on case reports from the early 2000s, but more recent scientific evidence and historical use data challenge those assertions.
Does kava damage your liver?
In the late 1990s and early 2000s several case reports of hepatoxicity and liver failure were causally linked to using kava supplements in Germany. In response to these reports, the World Health Organization (WHO) designated a committee in 2007 to assess the risk of hepatoxicity associated with kava products. This investigation concluded that “the condemnation of kava extracts appears unwarrantable”. [1] An additional study on the safety of both traditional and recreational use of kava was undertaken in 2016 by the WHO. This study found that heavy kava consumption's most significant health effects were a scaly skin rash (kava dermopathy) and elevated gamma-glutamyl transferase (GGT; a liver enzyme) levels. Both conditions reversed upon cessation of kava use. Overall, this study concluded that “it is possible for kava beverage to be consumed with an acceptably low level of health risk; however, further studies are needed to define the parameters necessary to ensure safe use of the beverage”. [2]
How does kava compare to other substances?
To put the risk of liver damage due to kava in perspective, it is helpful to describe it versus other commonly prescribed and/or over-the-counter alternatives. The kava toxicity rate has been calculated as 0.23 cases per 1 million daily doses. In contrast, diazepam, a benzodiazepine widely prescribed for anxiety, has a toxicity rate of 2.12 cases per 1 million daily doses. [3] And acetaminophen, the active ingredient in many over-the-counter pain-relieving and cold/flu drugs, is the leading cause of acute liver failure in the United States, whereas kava taken alone has no reported incidences of acute liver failure in the Food and Drug Administration’s Adverse Events Reporting System Public Dashboard. In 2021, there were no incidents of death related to kava use.
How can you safely consume kava?
As with any plant-derived ingredient, the quality of the raw material is of utmost importance when selecting a product. Any product derived from the kava root should be tested for trace contaminants, pesticides, and mycotoxins. Consultation with a healthcare professional and in- depth examination of any preexisting conditions or comedications is necessary to ensure no additional risk is presented by kava consumption.
Download a PDF version of this overview on kava consumption and liver health here.