Contemporary Pacific and Western perspectives on `awa (Piper methysticum) toxicology

Showman, Angelique; Baker, Jonathan D.; Linares, Cristina; Naeole, Chrystie; Borris, Robert P.; Johnston, Edward F.; Konanui, Jerry; Turner, Helen

doi:10.1016/j.fitote.2014.11.012

Cited by 35 publications

(32 citation statements)

References 81 publications

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“…Kava is a traditional Pacific beverage made from the roots and stems of Piper methysticum Forst. f. (“ awa ” meaning bitter in Hawaiian) plant, which belongs to the pepper family [ 6 , 7 , 8 ] ( Figure 1 ). In 2002, the Vanuatu government approved the Kava Act [ 9 ], in which kava is identified in different cultivars and categorized: noble cultivars (long history of safe use for traditional purposes), medicinal (ancient and confirmed history of useful properties amongst traditional herbalists for therapeutic properties), two days cultivars (able to intoxicate for two days and banned from export) and wichmannii cultivars ( Piper wichmannii , ancestor of P. methysticum , wild variety banned from export).…”

Section: Introductionmentioning

confidence: 99%

Hepatotoxicity Induced by “the 3Ks”: Kava, Kratom and Khat

Pantano

Tittarelli

Mannocchi

et al. 2016

IJMS

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The 3Ks (kava, kratom and khat) are herbals that can potentially induce liver injuries. On the one hand, growing controversial data have been reported about the hepatotoxicity of kratom, while, on the other hand, even though kava and khat hepatotoxicity has been investigated, the hepatotoxic effects are still not clear. Chronic recreational use of kratom has been associated with rare instances of acute liver injury. Several studies and case reports have suggested that khat is hepatotoxic, leading to deranged liver enzymes and also histopathological evidence of acute hepatocellular degeneration. Numerous reports of severe hepatotoxicity potentially induced by kava have also been highlighted, both in the USA and Europe. The aim of this review is to focus on the different patterns and the mechanisms of hepatotoxicity induced by “the 3Ks”, while trying to clarify the numerous aspects that still need to be addressed.

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Section: Introductionmentioning

confidence: 99%

Hepatotoxicity Induced by “the 3Ks”: Kava, Kratom and Khat

Pantano

Tittarelli

Mannocchi

et al. 2016

IJMS

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“…[30,31] Due to its sedative properties [32] kava has been also widely used in the treatment of anxiety [33,34] but reports of hepatotoxicity [35,36] led to restrictions in many countries. [30,31] Due to its sedative properties [32] kava has been also widely used in the treatment of anxiety [33,34] but reports of hepatotoxicity [35,36] led to restrictions in many countries.…”

Section: Kava (Piper Methysticum)mentioning

confidence: 99%

“…[30,31] Due to its sedative properties [32] kava has been also widely used in the treatment of anxiety [33,34] but reports of hepatotoxicity [35,36] led to restrictions in many countries. [37] Contemporary use has extended beyond traditional and medicinal settings [38] to recreational use, [31,39] with 6.3% New Zealanders (aged 16-64 years) reporting ever using kava recreationally. [40] In response to growing concerns about the influence of the PSA on ceremonial practices of Pacific communities in New Zealand, [41] the government clarified that kava products would remain widely available on the legal market.…”

Section: Kava (Piper Methysticum)mentioning

confidence: 99%

What products are considered psychoactive under New Zealand's legal market for new psychoactive substances (NPS, ‘legal highs’)? Implications for law enforcement and penalties

Rychert

Wilkins

2016

Drug Testing and Analysis

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The problem of defining what psychoactive products and substances should be covered by legislation aimed at controlling new psychoactive substances (NPS; 'legal highs') is central to the current debate on designing new legislative responses to NPS. In New Zealand, implementation of the Psychoactive Substances Act 2013 (PSA) revealed uncertainties about which psychoactive products are covered by the new regime, with important implications for legal penalties. We reviewed five pieces of legislation which can cover substances with psychoactive properties: PSA, Misuse of Drugs Act (MODA), Food Act, Dietary Supplements Regulations and Medicines Act. Our analysis revealed that a number of psychoactive substances which are not MODA-scheduled may potentially fall under more than one regulatory regime, including kava, Salvia divinorum, nitrous oxide, 25I-NBOMe, and 1,3-dimethylbutylamine (DMBA). For example, kava may be classified as a food, a dietary supplement, a herbal remedy, or a psychoactive substance, depending on how it is presented (including advertising and labelling). There are considerable differences in penalties and regulatory requirements between the different legislative regimes and these may result in unnecessary prosecutions or 'gaming' of the system. We discuss a number of ways to more clearly categorize products, including a public schedule of psychoactive substances and products, demarcation criteria based on the quantity of the active ingredient, and demarcation based on 'discernible intoxication'. Routine use of forensic testing is essential to ensure appropriate prosecutions and penalties. Robust safety standards are also required in legislative regimes exempted from psychoactive substances regime to prevent 'creative compliance'. Copyright © 2016 John Wiley & Sons, Ltd.

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“…Although this figure may appear small in a country of 4.6 million people of which 7% identified as Pacific people (Ministry of Health, ), this excludes the increasing number of non‐Pacificans, many who have taken up kava as an alternative to alcohol (Aporosa, ). The increase in kava's popularity is also evident in the United States, with the growth of dedicated kava bars (Showman et al, ; Wolinski, ). This contradicts a popular belief that kava is a novelty drug used by only small section of the Pacific community.…”

Section: Introductionmentioning

confidence: 99%

Kava drinking in traditional settings: Towards understanding effects on cognitive function

Aporosa

Atkins

Brunton

2020

Human Psychopharmacology

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Background Kava drinking is a tradition among Pacific Island people, although growing in popularity with other ethnicities. However, drinking substantial quantities of kava has raised concerns regarding physical manifestations of slow response and lack of precision in bodily control. These impairments can have significant consequences when after consuming large volumes of kava an individual makes a choice to drive. Aims The objective of this study was to measure selected cognitive functions following high traditionally consumed kava volumes (greater than 2,000 mg of kavalactones) aimed at identifying potential risks for kava drink‐drivers. Methods The reaction and divided attention of 20 control participants was assessed against 20 active kava‐drinking participants during and following a 6‐hr kava session in a “naturalised” setting. Assessment measures were drawn from Vienna Test System—Traffic's test battery. Results/Outcomes Results showed no statistical significant difference between control and active participants at any measurement point over a 6‐hr testing period regardless that the movements and speech of the active participants were observed to slow as the test session and kava consumption progressed. Conclusion Inconsistencies between test results and observations during testing and by road policing officers demonstrate an urgent need for more research in this field.

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Contemporary Pacific and Western perspectives on `awa (Piper methysticum) toxicology

Cited by 35 publications

References 81 publications

Hepatotoxicity Induced by “the 3Ks”: Kava, Kratom and Khat

Hepatotoxicity Induced by “the 3Ks”: Kava, Kratom and Khat

What products are considered psychoactive under New Zealand's legal market for new psychoactive substances (NPS, ‘legal highs’)? Implications for law enforcement and penalties

Kava drinking in traditional settings: Towards understanding effects on cognitive function

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