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')