Promoted as a natural, hangover-free alternative to alcohol, kava, a plant-based drink, is becoming increasingly popular at stylish cafes and vape shops. However, its rising popularity is linked to a significant increase in poisoning incidents across the United States.

A study conducted by the University of Virginia Health’s Blue Ridge Poison Center highlighted a 256 percent surge in poison center calls related to kava, escalating from 57 cases in 2011 to 2023 cases by 2025.

Kava, originating from the Pacific Islands, has been traditionally used in ceremonial practices for centuries. In the United States, it is available in various forms, including unregulated concentrated extracts, capsules, and trendy ready-to-drink beverages, often marketed as a healthier alternative to alcohol for relaxation.

The concern among experts centers around the potency of commercial kava products. These products can contain kavalactones, the active ingredients, at concentrations two to ten times higher than traditional preparations, significantly amplifying the risk of side effects such as rapid heartbeat, severe vomiting, neurological issues, and liver damage.

The study also noted a change in the demographic profile of those affected by kava poisoning. In the early 2000s, the majority of calls involved young children and women.

Currently, the majority of poisoning cases involve men aged 20 and older. This shift reflects the aggressive marketing strategies targeting men, particularly near college campuses and in vape shops, as reported by the CDC.

Researchers also reported that kava is increasingly being combined with kratom, a psychoactive plant with opioid-like effects. 

By 2025, kratom was involved in 30 percent of kava-related poison center calls, driving severe outcomes like seizures, hypertension, and tremors.

Touted as a healthy alternative to alcohol with no hangover, kava is now sold everywhere from hip cafes to vape shops (stock)

Poison center data acts as an early alert system for dangers linked to new or reemerging substances.

Following a steep drop in kava-related reports after the FDA’s 2002 warning about the substance being linked to liver injury, cases have climbed sharply again since 2011.

Dr Chris Holstege, director of the Blue Ridge Poison Center, said: ‘We are now experiencing an increase in calls again as new kava products enter the market, including products mixed with other substances such as kratom that can cause adverse interactions.’

The report, published in the CDC’s Morbidity and Mortality Weekly Report, relied on data from the National Poison Data System, which collects information from all 53 US poison centers.

Whenever someone called a poison center about a possible kava exposure, whether the person was a child who accidentally swallowed something or an adult who took too much, that call was logged in the database.

The team looked at every kava-related call made between January 2000 and December 2025, a total of 25 years.

For each call, they recorded the person’s age and sex, whether kava was taken alone or with other substances, what symptoms occurred, how serious the outcome was and whether the person needed hospitalization.

They then tracked how the number of calls changed year by year, who was calling and whether outcomes were getting more or less severe. 

A traditional kava drink is prepared from the ground root of the kava plant, producing a muddy, earthy-looking beverage

After the FDA advisory, kava exposure reports plunged 87 percent from 331 in 2001 to a low of 42 in 2010. They then began rising in 2011, surging 383 percent 2025

Serious outcomes included life-threatening effects, hospitalization or significant disability.

Between 2000 and 2025, poison centers logged 3,101 kava-related calls. Before the FDA’s 2002 liver warning, calls were high — 331 in 2001 — then plunged 87 percent to a low of 42 in 2010.

The following year, reports began to tick up. The market rebounded around with new product formats, aggressive wellness marketing and wider availability, leading directly to the resurgence in poison center calls.

The types of people calling also shifted. While women and young children made up most cases in the 2000s, women had dropped to 40 percent of calls and children under 12 to just seven percent of calls in 2025.

Adults 20 and older consistently accounted for about two-thirds of all reports.

Serious outcomes have become much more common. In 2000, only 12 percent of kava exposures led to severe medical problems. 

By 2024, that figure had jumped to 39 percent. Eight deaths were reported over the 25-year period.

Single-substance kava exposures typically caused vomiting, drowsiness, dizziness and rapid heartbeat. But when kava was combined with kratom, which happened in 128 cases, the effects were more dangerous, including seizures, tremors and high blood pressure.

Between 2000 and 2025, an average of 20 percent of kava exposures led to hospitalization each year, with no clear trend. But serious medical outcomes more than tripled, rising from 12 percent in 2000 to 39 percent in 2024. Eight deaths were reported over the 25-year period

Of all kava-related calls, 43 percent involved multiple substances. Alcohol and benzodiazepines were the most common co-ingredients for years, but in 2017, kratom emerged. By 2025, kratom was involved in 30 percent of multiple-substance kava exposures

Liver enzyme elevations were also more common with kava-kratom combinations than with kava alone.

The rise in kava-related poison center calls mirrors the broader boom in nonalcoholic beverages, as more people look for alcohol-free alternatives.

These products are often sold online and in vape shops and are marketed as a way to feel social without the hangover, which helps explain why young adults now make up the majority of exposure reports.

Holstege said: ‘These new kava products are found in stores throughout our area.

‘The public needs to be aware of potential complications associated with the consumption of these products.’ 

Unlike other countries that cap kava doses — Australia, for example, limits daily intake to 250 mg of kavalactones — the US has no such regulations.

Kava and kava-kratom products are completely unregulated in the US yet some manufacturers advertise more than 250 mg of active ingredients per single 30 ml serving, often with multiple servings per container.

Because there is no standardized manufacturing or content verification, the actual potency could be even higher.

Health experts warn that chronic use of these high-potency products has been linked to liver damage, seizures, rapid heartbeat and high blood pressure.

According to the researchers: ‘Continued promotion of these products without adequate verification of product content, consumer education regarding potential adverse health effects, and clinical awareness of evolving exposure patterns represents an ongoing public health concern.’