Kava: more than an alternative to alcohol
· 5 min read
The phrase "kava as an alternative to alcohol" is used in two entirely different contexts. The first is simple: some people are looking for a way to unwind in the evening or relax socially without losing mental clarity and without a hangover the next day. The second context is far more complex and controversial: the question of whether kava can support, in any way, people struggling with alcohol dependence. It is worth keeping the two apart, because mixing them leads to oversimplification.
This first, practical dimension is relatively easy to understand. Kava, prepared as an infusion, gives a mild feeling of relaxation and ease that some people compare to the first phase of alcohol's effect, but without the accompanying impairment of cognitive function, without dehydration and without a hangover the next day. It is precisely this aspect that leads kava to be served in alcohol-free bars and treated as an option for people who, for one reason or another, are cutting down or removing alcohol from their lives, not necessarily because of dependence.
Why kava works differently from alcohol
Kava and alcohol affect the same neurotransmitter system, GABA, but they do so differently. A study published in 2016 in PLOS ONE showed that kavain, one of the main kavalactones, strengthens the action of GABA-A receptors, but does so independently of the classic benzodiazepine binding site, which is targeted both by anxiolytic drugs of that class and, indirectly, by alcohol. In practice this means that kava's mechanism of action differs from the mechanism responsible for the development of dependence on alcohol and benzodiazepines, which at least partly explains why the classic literature describes kava as well tolerated, without the cognitive dulling typical of alcohol. This does not mean, however, that kava is entirely free of risk: cases of growing tolerance and mild withdrawal symptoms have been reported with long-term, intensive use, which we discuss further in the article how kava works.
Kava in addiction treatment programmes: a contested subject
Kava's potential in the context of addiction has long interested both scientists and treatment practitioners. As early as 2001, the researcher Steiner published in the journal Pacific Health Dialog preliminary data from a pilot study testing kava as an agent for reducing cravings for addictive substances, including alcohol, tobacco, cocaine and heroin. The results were exploratory: some participants reported a reduced urge to reach for their substance of choice, but the author himself stressed that this was preliminary data requiring further, larger-scale research.
Two decades later, the researcher Apo Aporosa, in an article published in 2019 in the journal Drug Science, Policy and Law, described how kava is sometimes incorporated into treatment programmes in New Zealand, citing, among others, a programme for people with alcohol problems run by a local health board in the Bay of Plenty region, and a smoking-cessation programme in Marlborough called Kava-cation, for which an informally reported success rate of 90 percent is cited. It is worth noting that this particular figure comes from personal communication cited in the review article, not from a published, peer-reviewed clinical trial, so it should be treated with appropriate caution.
Aporosa also describes a real dispute within the addiction treatment field: some specialists regard drinking kava during treatment for alcohol or other substance dependence as a potential relapse, since it still means reaching for a mind-altering substance, while the recovery process is built on learning to cope with emotions without chemical support. Other practitioners see kava as a tool that eases withdrawal symptoms and cravings, something that can help rather than harm. Science has not yet settled this dispute clearly, because large, controlled clinical trials on the subject are lacking. This shows clearly how far it is from a single, promising observation from two decades ago to a practical clinical recommendation: that path requires replicated studies in large groups, not just pilot data and reports from individual treatment programmes.
Sober curious and mocktail bars
Regardless of the controversy around addiction treatment, kava increasingly appears in a broader cultural context as part of the sober curious movement, the conscious cutting down of alcohol consumption without needing total abstinence for medical reasons. In this framing, kava sits alongside mocktails and other non-alcoholic drinks as an alternative to a drink that still provides a sense of ritual and sociability, but without alcohol's typical side effects. It is worth remembering, though, that kava's popularity in this context stems largely from social observation and user accounts, rather than from scientific studies directly comparing its effect on social life with that of alcohol.
What kava certainly does not do
Kava is not a cure for alcohol dependence and does not replace therapy or addiction treatment. It does not repair the damage caused by years of alcohol misuse and should not be treated as a stand-alone way of dealing with the illness of dependence. What is more, kava and alcohol should never be combined: both are metabolised in the liver, so consuming them together increases the load on that organ, and combining kava with medications processed in the liver, including those used in addiction treatment, requires medical advice.
People struggling with alcohol dependence should first consult a specialist before deciding to take any mood-altering supplement, kava included. It is also worth remembering the legal status: in Poland, kava is banned for sale as a food under a Ministry of Health regulation on designer substances; in Germany it is available only on prescription; and in the European Union it formally has no novel food status.
You can read more about the mechanisms behind kava's effect on the nervous system in the article kava and GABA, and about kava's role in building alcohol-free evening rituals in kava instead of alcohol. We write more about how kava affects the liver in the article kava and the liver.
Sources
- Chua HC, Christensen ETH, Hoestgaard-Jensen K, et al. Kavain, the Major Constituent of the Anxiolytic Kava Extract, Potentiates GABAA Receptors: Functional Characteristics and Molecular Mechanism. PLOS ONE, 2016
- Steiner GG. Kava as an anticraving agent: preliminary data. Pacific Health Dialog, 2001
- Aporosa SA. De-mythologizing and re-branding of kava as the new 'world drug' of choice. Drug Science, Policy and Law, 2019