I am a recovering addict. I abused different drugs for eighteen years before trying to get help in October of 2016. So far my journey as a recovering addict has not been easy. Almost two years and several treatment centers later I only have seventy four days clean as of this writing. As I continually learn more about how my disease works and what being in recovery means, the more I see that I have much more to learn. I am constantly realizing more truths about myself and what I have to do to remain clean. One thing that I know for certain is that, although my drugs of choice are heroin and benzos, I have to abstain from all drugs. Any substance I do will ignite that little fire in my brain that burns for my drug of choice and I won’t be satisfied until I get it. My sponsor in Narcotics Anonymous says if he goes out and drinks one night, he’ll test positive for meth and heroin the next day. For an addict, taking any kind of mind or mood altering substance is a slippery slope.
Total abstinence from these substances is a common goal shared among recovering addicts and is a principle of different anonymous fellowships that many of us belong to. While recovery comprises many things, the program of NA or AA is the crux for most recovery programs. And while NA members are suggested to practice total abstinence from any and all mind or mood altering substances, the organization itself does not take a stance on what those substances are. On the surface it may seem like total abstinence is a cut and dry issue but it isn’t. Among individual addicts, fellowship members or not, it’s a pretty contentious topic. Not so much with hard drugs like heroin or cocaine but with something that has become socially acceptable in a lot of circles. Something that many people would consider an herbal supplement rather than a drug. Something like kava.
Kava is a perennial shrub in the pepper family and is grown throughout several islands in the Pacific like Fiji, Vanuatu, and Tonga. The natives of these islands have been cultivating and using kava for different cultural purposes for thousands of years. Traditions vary from culture to culture but include welcoming ceremonies, weddings, funerals, social gatherings, and religious rituals. Medicinally it has been used as a sedative, muscle relaxant, diuretic, anesthetic, to treat digestive and respiratory ailments, and to reduce anxiety. Most often it is made into a drink by grinding, chewing, or pounding the root of the plant into a powder then adding it to cold water or coconut milk. Users can drink kava at kava bars. It is also available as a dietary supplement in the forms of capsules, whole root, powdered root, tea, and instant drink mix.
The number of kava bars has been increasing in a lot of American cities, especially Austin, San Francisco, and New York. People talk about the relaxed, coffee-house like atmosphere and the ease of social interaction. Some patrons go before work or on the lunch break and say that it helps them focus more when they go back to the office. Others choose to go in the evenings instead of going to traditional bars. People like being able to go out and have something that helps them unwind and socialize without the downside of a hangover the next day. What used to be considered a staple of alternative medicine and new age culture is now being more widely accepted by different social groups and professionals.
The desirable psychoactive effects of kava come from compounds called kavalactones. As the plants get older the concentration of these compounds increases and plants are usually harvested after about four years. There are many different strains but experts make a distinction separating them into two categories; noble and non-noble. Noble strains usually take about five years to mature and have more kavalactones than non-noble varieties. Non-noble strains are cheaper and easier to produce and can be harvested after one year but they have higher levels of potentially harmful chemical compounds that are not significantly present in noble varieties. There are regulations on exportation and production of kava out of many of the islands where it is grown but they are not always enforced.
Proponents of kava tout it as a safer and better way to relax than drinking alcohol, smoking marijuana, or taking benzodiazepines like Xanax or Valium. Users report feeling a mild “buzz” that can feel similar to ones attained with those other substances but without any of the cognitive impairment or lowered inhibitions that come with them. Some users even say that it helps them think more clearly. Researchers are looking into kava as an alternative to benzodiazepines to treat anxiety. They work in the same way, by increasing GABA levels in the brain, but benzos are extremely addictive and withdrawals can be fatal.
Kava has been controversial not just at the personal level but in government as well. In the 1990’s supplement pills and extracts became widely available on the market and they were often potent and unregulated as to strength and composition. There were a small number of isolated reports of liver toxicity and damage which led to doubt over the safety of the products and more regulations across different countries. In 2002 the European Union temporarily banned the importation of pharmaceutical kava products. Also in that year, Canada banned the sale of any products containing kava. In the United States the FDA announced a consumer advisory stating “kava-containing dietary supplements may be associated with severe liver injury.” Around this time Western Australia also posed a ban. In Poland, possession of kava can result in a prison sentence and in England it is illegal to sell or import any kava product for human consumption.
More research has been done since the early 2000’s and has led to changes in policy in many of these countries. In 2012 Canada lifted its ban on kava products, as did Germany in 2014. Western Australia lifted its ban in 2017. No action was ever taken by the FDA on its consumer advisory and it has since been archived. Most of the bans and regulations came out of the concern for liver toxicity from kava use but scientists have found different reasons why the cause for concern was not as serious as it seemed. Older studies conducted in Australia were criticized for focusing on populations where alcohol abuse was prevalent with kava use and overall poor health was a problem. It has also been pointed out that many of the reported cases of serious liver injury involved people who had a history of alcohol and prescription drug abuse. Other research has shown noble kava strains to be safe and that adverse effects are probably related to allergic reactions to poor quality non-noble strains. In 2007, the World Health Organization published a review on kava based on individual case reports, clinical trials, literature, and studies dealing specifically with kava and liver toxicity. It states that “most experimental studies have not shown that kava has a tendency to have a toxic effect on the liver … most clinical reviews of case reports cast doubt on a causal association between kava products and liver problems.”
In another review published in 2016 by the World Health Organization and the Food and Agriculture Organization it states that excessive consumption of kava can result in skin rash, weight loss, nausea, sore red eyes, and loss of appetite. However these are all reversible by stopping kava use. It points to over a millennium of use in the Pacific Islands with hardly any evidence of harm to those populations. The review goes on to say: “There is little documented evidence of adverse health effects associated with traditional moderate levels of consumption of kava beverage, with only anecdotal reports of general symptoms of lethargy and headaches.”
The National Institute of Health didn’t have much information on kava. In relation to safety concerns, their webpage on it reiterated what I had already found: that it can cause liver damage when used with alcohol, long term use can cause dry and yellowish skin and heavy use can cause eye irritation and heart problems. The studies listed on other sites said that most of these conditions are reversible with cessation of use.
It was easy to find all this information but I couldn’t find any information to answer the question is kava addictive?
It’s not as clear cut as something like opioids. According to the CDC, “overdose deaths from opioids, including prescription opioids and heroin, have increased by more than five times since 1999. Overdoses involving opioids killed more than 42,000 people in 2016.” The addictive nature of things like opioids and crack cocaine is also plain to see by the illegal, degrading, and self-destructive things that people do to get more when they are strung out. Addicts will do almost anything to avoid the excruciating withdrawal symptoms. You don’t need to do a study to confirm that. Just ask anyone at a Narcotics Anonymous meeting or in a rehab facility to share what they’ve been through.
The studies, publications, and government statements that I found mentioned nothing about potential kava addiction. The NIH, WHO, FAO and the DEA didn’t have anything written about it. The research had to do with the chemistry of the plant, the psychoactive effects, and possible dangers of use. The US National Library of Medicine had a brief article about exploratory and preliminary research into kava as an anti-craving agent. It states “The preliminary findings suggest that kava may reduce the craving associated with addiction.” That sounds cool in terms of recovery but I’m skeptical. Using any drug to treat addiction to another drug does not have a good track record. Heroin was first refined in 1874 by a chemist named Alder Wright and then in the 1890’s Bayer marketed it as a morphine substitute. I’ve spoken with a lot of people who were put on Suboxone to try to get off of heroin. Every single one of them said that withdrawals from Suboxone were worse than heroin and when tapering off the Suboxone treatment, they ended up doing heroin again to relieve the withdrawal symptoms.
I also think that there are probably a lot of misconceptions and misinformation within the general public about kava. I found an article on a news website about a lawsuit brought against a kava bar by a couple in Florida. The couple said that the kava they drank was “nearly as addicting as heroin”. The article didn’t say that the couple had ever done heroin so how would they know? The article also has one Dr. Robert Moran, a psychiatrist in Florida with multiple board certifications and who received his education at prestigious schools, as saying that kratom is the main ingredient in kava, which is just not true. Maybe the article misquoted him. Kratom is a plant in the coffee family, a completely different species of plant than kava. That’s just one example but it’s a good example of how misinformation can be spread. Whether the doctor said it or it was a mistake by the writer of the article, readers may take the false information as truth.
I did a Google search on “kava addiction” and almost every link and website that popped up belonged to recovery programs and kava retailers. Most of them listed similar information to what I found in the research about where it’s from, how it’s made, what it’s used for, and potential health risks. They referenced the bans and warnings of different countries in the early 2000’s but didn’t reference the subsequent reversals of those bans. They talked about the reported cases of liver damage related to kava usage but not any of the research that showed most of those cases were related to other external factors. Only one site had any kind of reference to where their information came from and it was a broken link with an error message.
So how does this all relate to recovery?
The legality and safety of kava isn’t really the issue. When I was in my active addiction, it didn’t matter if my Xanax was prescribed by a doctor, bought from my dealer, or stolen; I just wanted it. I definitely didn’t care if heroin was good for me or not. In fact I equated less safety with more fun and a better high.
Most addicts have a drug of choice but in any given situation, if that choice doesn’t exist then we’re usually down for whatever. Drugs aren’t the root problem. As addicts they are our solution to our root problems and eventually that solution leads to a whole host of other problems that overshadow the original ones. It isn’t so much about what the drug is as much as it is about what we think that drug does for us. Since we don’t want to look at ourselves and deal with our issues, we escape them temporarily through drugs and eventually use them so much that we are mentally and physically addicted. Over time it gets to the point where you’re fully aware of all the bad things that will most likely happen from using again but the perceived dangers of not being able to get high seem worse than the actual dangers of getting high and you go and get high again.
I spoke with a few other addicts in recovery whose opinions I respect and who have a lot more clean time than I do about what they thought of kava. They all consider using kava a relapse. I really like how one of them explained it. He said that when he first heard about kava he got really excited as it was legal, was natural, and seemed harmless. Then he realized that the fact that he got as excited as he did was a clear indicator that he shouldn’t use it. It came back to wanting to use something outside himself to enhance a good time, relieve anxiety, make his depression go away, whatever the reason, to try and find a loophole in his program of abstinence from drugs. Kava is probably fine for normal people but addicts cannot use any kind of substances responsibly like normal people. It just doesn’t happen like that. There’s no beating the game. It comes back to what my sponsor said about drinking leading to heroin and meth. The fact that beer or weed or kava seem fairly innocuous in comparison to drugs like those makes the situation even more dicey. In the end they always lead back to the drug of choice.
I’ve learned something in recovery from my own personal experience and the experiences of hundreds of other addicts that have been shared with me. Riding out a drug addiction until the wheels fall off leads to jail, an institution of some kind, or an early death. So the best possible outcome is a hospital or rehab. Since we know how the story will end, it’s more important to look at how it begins if we want to write a new ending. With my life and freedom dependent on my ability to stay clean, avoiding another relapse is one of the most important things I can do. Preventing a relapse is so important because it’s not always the first or second or tenth or even fiftieth use that kills or incarcerates. Whatever number it ends up being, it started with that first one.
I didn’t find a concrete answer as to whether or not kava is addictive. I think more research is needed on that one. Based on all the information I looked at, it seems safe for normal people to use in moderation. However it is considered an intoxicating substance and it doesn’t really matter if it’s addicting or not. It’s an addict’s reaction to any given substance that matters. Anything that changes our brain chemistry is trouble. After doing all this research I still have the same thoughts on kava as when I started writing this. Using any kind of substance no matter how socially acceptable or seemingly harmless is a slippery slope for addicts. I’m not going to try to tell anyone else how to run their recovery or whether or not they should use kava. I can only speak for myself and I don’t want to put my own recovery in jeopardy. The only kind of research I wasn’t willing to do on this topic was trying kava myself.