Experts propose global guidelines for safe use of Kava

Leading world Kava experts Dr Jerome Sarris from the University of Melbourne, Australia; Professor Rolf Teschke from Wolfgang Goethe-University, Frankfurt, Germany; and Dr Vincent Lebot from CIRAD, Port-Vila, Vanuatu, have proposed a six-point plan that is intended to become the framework to assist in the re-introduction of Kava to restricted countries. The framework will ensure only high quality Kava to be consumed throughout the Pacific and the rest of the world.

The framework was recently published in the international journals Phytomedicine and The British Journal of Clinical Pharmacology.

"Kava can potentially be used safely if this framework for production and use is adopted," Dr Jerome Sarris said.

Kava was restricted for use in 2002 in Europe, United Kingdom and Canada over concerns it may cause liver problems (on average one case per every 50 million doses). This was considered to be potentially due, in part, to companies using chemical extracts from poor quality material using an incorrect type of Kava.

Dr Sarris said the future regulatory and commercial strategies should focus not only on the standardisation of medicinal Kava products and traditional Kava extracts, but also on thorough surveillance during the manufacturing process to improve Kava quality for safe human use.

"It is intended now that these recommendations be taken up by Kava producing Pacific Island countries in order to reinvigorate the Kava industry and provide a pathway back to safe global use of the plant," Dr Sarris said.

The use of the plant as a treatment for generalised anxiety is part of two human trials currently being conducted by Dr Sarris in Melbourne Australia, where it is available over the counter.

In Australia in 2005, the Australian Therapeutics Goods Administration allowed for water soluble extracts of Kava to be used for medicinal purposes.

He said preliminary results with the Mediherb extract showed the kava extract used was safe and effective in reducing anxiety.

"We do however, need a larger study to validate this result," Dr Sarris said.

The six-point framework for the safe production of Kava is as follows:

1) Use of Kava plants at least five years old ("noble" type of Kava cultivar is preferred, as it is traditionally considered safe)

2) Use of the peeled rhizome (root) of Kava plant (not leaves or aerial parts)

3) Water-soluble extract for Kava (not alcohol or chemical solution to extract constituents)

4) Dosage recommendations of less than 250 mg of kavalactones (the active chemicals) per day for medicinal use

5) Systematic rigorous future research investigating safety issues (potentially from poorly stored and manufactured Kava material, and/or incorrect cultivar and plant material), and human clinical trials using noble cultivars prepared via good pharmaceutical manufacturing practice

6) A Pan-Pacific quality control system enforced by strict policing.