Last Saturday I went for lunch with friends
over to C'an Sort near San Joan, the best place (at least
on Saturdays) on Eivissa/Ibiza for absolutely superb vegetarian/organic
food (and Carol's chocolate brownies, over which wars could
be fought). Saturday lunches there are sort of a gathering
of the 'alternative elite' of the island - a multi-cultural
and multi-linguistic meeting in which there are so many people
to talk to about so many things that sometimes there can often
be little time to eat. Bel Fogelberg was there. Bel, originally
from Australia, is the last person on the island to weave
a particular type of traditional eivissenc thick blue-black
cloth necessary for certain types of women's' costumes. She
learned the process over 30 years ago, when there were still
weavers of this cloth on the island. Now these weavers are
dead and the traditional island black-haired sheep that provides
the wool almost non-existent. Ibicenco women who need this
cloth now place orders with Bel. But when the last black-haired
sheep is gone from the island, what will happen then? I had
seen Bel a couple of weeks ago at a dinner and she had said
that she had been suffering from a painful stiff neck for
quite some time. I suggested she try taking kava tablets.
Medicinal kava extract, from the South Pacific kava plant,
piper methysticum, along with its other wonderful properties,
can be a very effective natural pain-killer and is particularly
useful for stiffness and aches along the neck and spine as
it works through the central nervous system along the spine.
I told her that because of recent events neither kava tablets
nor medicinal extract were available since January on Eivissa
(strange, in an island where just about anything else is available
- one colleague has joked that recent European attempts to
ban kava are probably just about the best way to eventually
guarantee that it sells well on the island!). Bel said she
would order it from a mail service in Guernsey/Jersey that
supplies a large segment of the English-speaking population
of the island with quality vitamin/mineral and herbal supplements
at prices much lower than anything on the island. But when
I saw Bel at C'an Sort she told me even these suppliers had
told her they no longer provided kava tablets, even though
they were advertised in their catalogue.
This is just another example of the spreading
cancer of 'a ban that does not yet officially exist' but in
fact prohibits people who would benefit from taking extracts
of this amazing plant from doing so. It seems the problem
does not lie in the Pacific, where the kava plant grows, but
in Europe - and now the US. According to (often rather lurid)
press reports in Europe and the US, some medical professionals
have hinted there may possibly be a connection between the
taking of medicinal kava extract to relieve anxiety and stress
and liver damage. Nothing like this is known in the traditional
kava-drinking cultures of the Pacific, so if there is some
such connection, then it seems possible that it may not be
anything to do with the traditional drink from the plant at
all but more to do with the medicinal extraction/production
process for kava tablets and extracts in 'the modern world'.
This would not be the first time that a perfectly good and
useful natural product has been damned by 'modernization'
- and it won't be the last, either. The European and US press-reading
public must already be convinced that kava is 'no good', particularly
with such headlines as 'Out for Kava-Kava' (in Germany, 19th
November 2001) and even recent Pacific (particularly Fijian)
press reports - copying the European ones - relating news
on '30 cases of hepatitis in Germany and Switzerland', '24
cases of serious liver disorder in Germany and Switzerland',
etc, etc, etc. The latter certainly puzzled people in Fiji
(reaction would be similar in England if the Daily Mirror
came out with a 'Tea found to be responsible for Senile Dementia'
headline), but many of the articles said the news was based
upon medical reports. All of this rather reminds one of the
hysterical anti-kava press campaign in Australia in 1986-7
which had lurid headlines such as Kava takes hold on
Aborigines'; 'Kava a Danger to Aborigines says Senator'; 'A
New Sinister Scourge'; 'Kava: New Poison for Aborigines';
'Darkness descends on Milingimbi...and kava flows'; 'Inquiry
into Kava'; 'Kava Crisis'; 'Aborigines seek ban on 'killer'
kava' and so on.
A short aside here is merited. Australian
Aborigines were neither traditional kava growers nor drinkers.
Kava drinking was first introduced to certain aboriginal groups
in Australia's Northern Territory in the early 1980s by Fijian
Methodist missionaries there who saw it as a safe alternative
to alcohol. As with the American Indians, alcohol has been
a veritable scourge for Australian aboriginal - neither population
group possess the stomach enzyme necessary for alcohol processing,
so they literally poison themselves with it (approximately
50% of Japanese lack this enzyme as well and...approximately
4% of European women). For those lacking this essential enzyme,
alcohol can literally kill, and the slightest amount of alcohol
in the system can initiate liver dysfunction and raise liver
enzymes in liver function tests. Medical tests carried out
by the Menzies School of Health Research (Darwin) on chronic
heavy-kava drinking aboriginal in Arnhem Land over an 8 month
period in 1987-8 did indicate a slight increase in biochemical
indicators of liver dysfunction, but these returned to normal
amongst those who ceased drinking and the report here states
'there is no evidence of any chronic effects of kava use on
health' after cessation of drinking. Most of the aboriginal
involved in the tests were rather severely undernourished
(not as a result of the kava drinking, it unfortunately seems
to be a part of life for aboriginal in that particular area),
which of course may have produced an effect on the results,
and a certain amount of alcohol intake cannot be discounted
(although there was supposed to be none). I should here point
out that consuming large amounts of coffee could produce liver
problems amongst susceptible individuals back here in 'our'
side of the world! Kava drinking amongst certain aboriginal
communities certainly eradicated alcohol-induced fighting
and violence - one cannot even feel angry when drinking kava.
Kava and anger are completely incompatible. The frenzy of
the Australian press campaign was stunning in the extreme.
Aboriginal groups can consume vast quantities of alcohol and
its effect is devastating. Alcohol sales to aboriginal in
certain outback areas of Australia can be of a regular sizeable
amount. Small wonder that some Australians suspected a certain
amount of instigation in the anti-kava press campaigns by
'elements of the alcohol industry'.
The present series of press reports is certainly
milder than the Australian one of 1986-7, but rather flawed
in a different way. Various figures of reported cases of medicinal
kava extract associated with liver damage in Europe vary from
article to article: 24 cases, 30 cases, 60 cases (US), and
so on. So one sort of gets the impression that it's a 'tip
of the iceberg' type of problem. There is usually the mention
of one associated death from liver failure, and several liver
transplants. No wonder some people (journalists included)
jumped for their writing pens (or computers, nowadays, I guess).
It seems very few have actually bothered to really dig around
to get to the bottom of all this. I have. Things fall into
perspective.
If one digs back through all the material
one keeps coming up against the same two or three short medical
reports, all recent, all brief, and all saying that there
is as yet no proven connection between the medicinal kava
intake and the liver problems. It seems there may possibly
be one known case in Germany/Switzerland and one known case
in the U.S where kava seems to be the only causal factor.
The other cases seem quite possibly to be of individuals who
may already have had a damaged liver from other causes but
who had taken medicinal kava tablets to relax sometime along
the way (and maybe extremely heavy doses at that). As the
kava intake was the 'unknown factor', it is the one that tends
to be pinpointed. This is only correct procedure, though,
as medical doctors must be aware of every possibility and
they did the correct thing by noting it.
However, sometimes things can get a bit
out of hand and reach the heights of insanity. A classic example
is an article in the New York Times of 3rd January 1997, "FDA
Warns That Herb Drinks May Cause Health Problems: Dozens of
Partygoers Fall Ill in California". The report deals
with sudden illnesses of 50 teenage and early 20s (42 were
hospitalized) New Year's Eve revellers in one concert hall
who had taken vials of a herbal liquid product known variously
as Lemon fX Drop, Orange fX Rush and Cherry fX Bomb. The vials
had labels saying only one vial was to be taken every four
hours and that it was not to be combined with alcohol or with
illegal or over-the-counter drugs. One of the many ingredients
in the vial was kava. When the police were called in they
confiscated 10,000 tablets (must have been some party!) and
were stoned by the partygoers. Lieutenant John Weaver of the
Los Angeles Police Department said (and I quote from the report)"people
who ingested the substance probably fell victim to one of
its legal and natural ingredients, kava..." Well, surprise,
surprise, as he then goes on to say that some of the revellers
had taken as many as six vials over a short period of time
and some had combined it with Ecstasy, LSD and GBH (a legal
intoxicant known as Liquid X). That may sound like a rather
normal night in Ibiza during the summer (from what I hear,
residents don't go much to the nightclubs as they are really
for the tourists) but nobody here would be stupid enough to
blame any such upsets on kava!
The US does certainly have a rather schizophrenic
attitude to certain substances, and these attitudes go in
and out of fashion. By 1998 kava was the new 'in thing' in
New York, and whilst I was then a Visiting Fellow at the Metropolitan
Museum of Art there, I noted its progress. I knew it was really
'in' when I saw the colourful front page of the US 'Sun' magazine
for 4th August 1998: "Bible Cures Revealed! Doctors'
new guide to Healing Herbs in Sacred Scriptures" and
just underneath this headline: "Kava Kava: Daily dose
at night relieves anxiety". Believe it or not! But I
still haven't found the part in the Bible that mentions kava.
What had swung US medical opinion behind kava were the results
of an extensive and extremely detailed 1997 experimental study
on kava using 101 patients suffering from anxiety and tension.
The work was carried out over a 25 week period by German scientists
and the positive results (nothing new, of course, to regular
Pacific kava drinkers) hit the American medical profession
with an almost audible noise. At last something really good
and harmless has been found! I should here point out that
liver enzymes were regularly checked during the experiments
and nothing untoward was found. News circulated of certain
Californian doctors taking some of their patients off of Prozac
and putting them on to kava tablets, with commendable results.
I remember an academic colleague at the Metropolitan Museum
laughingly telling me (in regard to the previous statement)
"The kava producers better be a little bit careful, if
it becomes too successful it will start bothering the big
companies and you begin to see indications that the police
suddenly start to take an untoward interest in it!"
Strangely enough, they did (although I am
sure this had nothing to do with the 'big' companies selling
other medicines), resulting in the famous Californian 'kava
trials' of September 2000. There is a rather large Tongan
South Pacific community living in San Mateo county in California
and, as in Tonga, the men will often have a lengthy kava-drinking
session in the church grounds after the church service. One
Tongan was arrested by the police for seeming 'drunken driving'
but as the police found no alcohol in him the local public
defender got it changed to 'driving under the influence of
drugs'. The police lay in wait outside the Tongan church in
San Mateo county and arrested another Tongan. A trial date
was set and the DA (District Attorney) wanted to prosecute
for use 'of an hallucinogenic substance'. By this time I was
a Visiting Fellow at the Australian Museum in Sydney, but
an old school friend in California put me in touch with the
defence lawyer before the trial. Anyone who knows about kava
knows that it is not a hallucinogen (but the prosecution didn't
know that, it seems they knew almost nothing). Kava is neither
a hallucinogen nor a stupefacient, although it is a (mild,
non-addictive) narcotic, soporific, analgesic, diuretic, muscle
relaxant, a 'mood leveller', and much, much more. This trial
was critical, as if kava had been shown to be a hallucinogen,
then it could be legally banned. Unfortunately, I do not have
my complete 'kava trials' file here at hand, but I seem to
remember that a total of 11 Tongans eventually went on trial
and that 10 were declared 'innocent' and one was declared
'guilty'. But 'guilty' of what, no one seemed to know. 'Guilty
of being Tongan', one colleague laughingly told me. Nothing
more was heard after that, and 'hallucinogenic kava' faded
from the press.
Back to the 'Europe-kava-liver' problem.
Many of the actual cases seem to involve individuals with
possibly already-existing liver damage who were then taking
kava tablets (sometimes 2-5 times the recommended doses) sometimes
at the same time as alcohol and in some cases 'other substances'
possibly as well. The sad but famous case of the one German
'death from kava-induced liver failure' turns out to be an
81-year-old woman with a long history of alcohol abuse problems.
These examples are taken from what sort of numbers range?
If only a few thousand people were taking these kava medicines
then maybe things were not as they should be if there was
any possibility that kava was involved. I decided to find
out. On 14th January I spoke with one of the representatives
of a small German pharmaceutical company (employing 300 people)
that produces and sells three kava extract medicinal products.
I was amazed at the size of the sales market! The company
has been producing medicinal kava extract for over 30 years.
During the period 1990 to October 2001 they had sold 40 million
daily doses of their major kava product and 23 million daily
doses of their other two kava brands - with no reports whatsoever
of serious adverse side effects. I was stunned, and said so.
I was then told that the biggest share of the market in kava
extract sales in Germany was held by another small company,
which had sold 100 million daily doses over the same period!
So with sales of that magnitude (and that
is only two small companies amongst a larger number) and if
one believed the press reports then just about everyone in
Germany and almost the whole of Europe should now be suffering
liver problems. This is obviously not the case, so there are
other factors that are involved in these 'kava bans'. We will
look at these next week. If at times you have laughed or scratched
your head or have become angry at certain points in this article,
wait until next week, this is nothing!
Kirk W Huffman
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