Date: Fri, 25 Jan 2002 01:21:59 -0500 Subject: Kava ban in Europe <fwd>
KAVA BANNED - FRANCE, SWITZERLAND, UK *************************************** A ProMED-mail post <http://www.promedmail.org> Date: 20 Jan 2002 From: Nancy J Pollock <[email protected]> I wish to draw your attention to some of my publications which could be relevant to those dealing with concerns about kava extract on the body. I published an article on kava in the 2-volume Cambridge History of Food (2001), which could be used to provide more accurate information on the history and use of kava in Pacific societies. I also published an article examining kava as a drug in the Viennese Ethnomedical Newsletter (vol III, no. 3, pp 3-6) which addressed concerns raised at a civil court case against a driver who had been drinking kava, and provided background references used in that case [Dr Pollock was kind enough to provide ProMED-mail with the following information]. [Regarding evidence of hepatotoxicity,] I found none in the 72 references I consulted. The overall conclusion was that kavalactones are benign and a relaxant similar to St John's wort, gingko, etc. S Reeder and MJ Cupp's book on Toxicology and Clinical Pharmacology of Herbal Products cites kava as having few side effects other than the dermatological ones widely noted in Pacific island heavy drinkers. Pittler's column in Am J Health-Syst Pharm of 15 May l999 discusses kava in detail. He states that "Kava is an herb that is rapidly gaining popularity for its purported anxiolytic and sedative properties" (p.957) Toxic dosages, he suggests, "greater than 300g of the dried kava root per week for several months can cause kava dermopathy and fish-scale like lesions. These symptoms resolve several weeks after discontinuation of the kava extract." It is my opinion that a person taking kava as a herbal remedy for anxiety or relaxation would have to take several boxes of 20 pills to get up to 300g of kavalactones per week. I argued in the court case [against a driver who had been drinking kava] that a clear distinction must be drawn between the social setting in which kava has been consumed in Pacific societies and (1) its modern commercialisation as a herbal medicine, readily available for individuals to purchase, or (2) where it is a prescribed medication. Kava cannot be labelled a drug within the system of Polynesian societies' usage because its usage is heavily controlled, and it is drunk only in social settings, such as Faikava, men's meetings, or at ceremonies. Ni-Vanuatu today drink kava in kava bars known as nakamel, but that is a very recent innovation where the bars mimic Australian and New Zealand bars for beer and spirits. The judge acquitted the accused Tongan, as there is nothing in our Land Transport Act that includes kava in the 4 categories of banned substances. In his written summary of the case, he stated that there is not enough evidence available to consider kava a drug. Records of Australian Aborigines being persuaded to drink kava in an attempt to reduce the amount of beer and other intoxicating substances have not included any toxicological side effects. That they drink kava as a "chaser" to beer may have parallels with those with liver problems in Europe who may try kava as an antidote to alcohol -- such a myth is forming! - -- Dr Nancy J Pollock Acting Director of Development Studies Victoria University PO Box 600 Wellington, New Zealand <[email protected]> ProMED-mail <[email protected]> [In Germany, where kava is regulated as a drug, there is a program of pharmacovigilance or reporting of adverse drug reactions. Such mandatory reporting led to the detection of about 68 cases of liver failure among kava users. Hence the pharmaceutical agent was moved against by the government. One possible problem with the pharmacovigilance approach is the extreme narrowness of the reporting system, which does not acknowledge the concomitant use of other pharmacologically active substances [I cannot speak for the German system, but the "yellow card" used in the United Kingdom certainly asks for concomitant drugs to be listed when reports are made. Mod.SH]. There are a couple of noteworthy caveats. About 79 per cent also used alcohol regularly. Also there was a large percentage known to use/abuse paracetamol (acetaminophen, hepatotoxic in overdosage). Only 5 or 6 cases (about 8 per cent) experienced liver problems unrelated to other pharmaceutical agents or alcohol use. Secondly, as the use of Kava gained popularity, a second variety of the plant was used in production of the drug. Some suspect this second variety to be the cause of the problem. An overdose of Kava [from the original plant] is known to depress and produce sound sleep for 5 to 6 hours (without alcohol or other agents). An overdose of the new variety (appropriately enough called tuday) puts a person into essentially a comatose state for 2 days. The original variety of Kava is less potent than any of the benzodiazepines approved as pharmacological agents. Likewise, in heavy users of the product, the original variety is known to produce insignificant but transitory spikes in some liver enzymes. Cessation of intake of the original variety for 12-24 hours returned liver enzymes to normal. All the above also applies to the kavalactones available in pill form. The tea extract of the kava plant is so mild it does not produce any liver spikes, even transiently. Although the tea form may have some sedative properties, they are only slightly stronger than a glass of warm milk. - Mod.TG] -- The silver-list is a moderated forum for discussion of colloidal silver. 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