Kava
- Depressant substance made from kava shrub
- Made into a drink used in Top End communities. Less commonly ingested as a processed powder, in capsules or an extract
- Causes a type of drunkenness and can cause health problems
- 1–2 months after stopping kava use
- Skin and liver problems usually return to normal
- Underweight people tend to regain lost weight if nutrition and oral intake is adequate
Intoxication (being drunk on kava)
- Usually relaxed, calm without violent feelings
- Pupil dilation, red eyes
- Numbness in mouth/throat at first, sleepiness after drinking more
- Causes muscle relaxation so person may not walk properly
Acute problems from kava
- Injuries due to severe drowsiness
- Unconscious
Long-term problems from kava
- Malnutrition and weight loss from lack of appetite/interest in food
- Kava dermatitis (dry scaly skin) — ‘crocodile skin’, ‘like dried seaweed’
- Liver damage, raised liver enzymes (GGT, ALP), low white blood cell count
- Increased risk of melioidosis, infections, complications of heart disease — see Melioidosis
May worsen mental health illness — symptoms of depression
Ask
- How often is kava used
- How many people is it shared with
Check
- Calculate age-appropriate REWS
- Adult — AVPU, RR, O2 sats, pulse, BP, Temp
- Child (less than 13 years) — AVPU, respiratory distress, RR, O2 sats, pulse, central capillary refill time, Temp
- Weight, BGL
- Blood for FBC, LFT
- Adult Health Check and immunisations status
- Head-to-toe exam — attention to skin
Do
- Talk with kava drinkers about
- If heart disease or pregnant — cut down or stop drinking kava
- Increased risk of infections
- Mixing kava with alcohol (grog), benzodiazepines, other depressant drugs can be dangerous
- Advise to cut down or stop
- Give moisturiser for dermatitis ('crocodile skin')