Kava: herbal panacea or liver poison?
EMBARGOED UNTIL 12.00 NOON SUNDAY 4 MAY 2003
Kava, the drug traditionally used for ceremonial purposes in the Pacific Islands, has become popular in the West for its calming effect.
In response, the drug was produced commercially in the Pacific Islands for the Western market, but was banned by many countries, including Australia, after reports of liver toxicity. The ban has caused significant damage to Pacific Island economies.
Debate in the current edition of the Medical Journal of Australia by Dr Robert Moulds, Professor of Medicine at the Fiji School of Medicine, suggests more research is needed to make safer kava extracts available in Western countries and to identify sub-populations who should not consume kava.
"The kava used in Western countries is a dried ethanol or acetone extract of kava made up as capsules. Traditional kava from the Pacific Islands is a watered extract of powdered roots," Dr Moulds said.
"Pacific Islanders have used kava extensively for centuries, without recognised liver toxicity. But the population is small and there has been no systematic evaluation of possible liver damage," he said.
"For both economic and public health reasons, it is important to determine if kava is toxic and why.
"Issues for consideration should include the impact of the use of the drug on Australian Indigenous people, extraction procedures, genetic differences in liver metabolism, co-ingestion of other agents, comparative doses from different extraction processes and the harm-benefit ratio for kava," Dr Moulds said.
Also included in this edition of the MJA is a discussion of a death from liver failure associated with kava use, by Dr Paul Gow and colleagues from the Austin and Repatriation Hospital in Melbourne, and editorial comment by Dr Bart Currie, from the Menzies School of Health Research and Flinders University in Darwin.
The Medical Journal of Australia is a publication of the Australian Medical Association.
CONTACT: Professor Robert Moulds, 0011 979 3303 561 (H), 0011 679 3311 700
Judith Tokley, AMA, 0408 824 306