Kava is trending. The science is still catching up

Kava drinks are gaining popularity, and researchers say so are the unknowns.

Kava is a plant native to the Pacific Islands, where its root has traditionally been used in beverages consumed at social and cultural gatherings. Today, kava is sold in the United States in drinks, powders, extracts and supplements. 

A new UVA Health study released in April 2026 found poison center calls involving kava rose 383% between 2011 and 2025, increasing from 57 reports to 203. 

Dr. Christopher Holstege, director of UVA Health's Blue Ridge Poison Center and a co-author of the study, said one of the biggest unanswered questions is whether reported health effects are being caused by kava itself, by ingredients mixed into products, or by combinations of substances such as kava and kratom.

“You have a product that promotes sleep and relaxation and has some effects on a specific receptor called the GABA receptor, which is where Valium and other drugs work,” Holstege explained. “That product is now being combined with one that has opiate effects, and that's what's being marketed either as kava by itself or kava with kratom as an alternative to alcohol.”

Kratom comes from a plant native to Southeast Asia and is part of the coffee family. In the United States, it is commonly marketed as a dietary supplement and sold in powders, capsules, extracts and beverages, despite not being approved by the FDA for any medical use. Researchers say its active compounds can produce opioid-like effects. 

WRAL previously reported that mitragynine, kratom’s primary active compound, appeared in more than 350 toxicology reports tied to overdose deaths in North Carolina.

The UVA Health study also found nearly one-third of kava-related calls to poison control centers in 2025 involved kratom. However, Holstege says it’s not immediately clear what is driving the increase.

"Is it the kava itself? Is it changed? In other words, are the kavalactones in it more concentrated, or is it the combination with kratom or other substances that are actually causing the problem?" Holstege said. “It’s a great question.”

The findings come as kava products become more visible in North Carolina. As part of WRAL Investigates' ongoing coverage, Enterprise Reporter Destinee Patterson recently visited a Triangle kava bar and spoke with customers who described using the products as an alternative to alcohol.

Holstege said researchers still have questions about potential drug interactions, effects on cognition and impairment, appropriate dosing, and how these products may affect different people over time. 

“How do we do post-marketing surveillance on the impacts of these and I'm not sure we fully know right now, right?” Holstege asked. “It may be a number of years before we really know: Is there an impact? Is it no impact at all? Is there a positive impact? The question is, ‘How do we track that a little bit better than just the voluntary calls of the poison centers?’”

Health concerns regarding kava aren’t new. Holstege pointed to Food and Drug Administration warnings dating back to 2002 that warned of possible liver damage tied to kava use. The FDA advisory noted “kava-containing products have been associated with liver-related injuries, including hepatitis, cirrhosis, and liver failure.”

Holstege told WRAL he is not "anti-kava," but said consumers need to know more about what they're purchasing and consuming.

"The public needs to be aware of this and be thinking through what they're purchasing at the stores. It's a question of quality control and what exactly consumers are getting," Holstege said.

He also said he hopes to see more research into kava products, potentially supported by companies that manufacture and sell them.

"Hopefully some of the companies who are making money on this will put some of the money back into studies to show that it is safe," he said.