Recent data emerging from the University of Virginia Health System reveals a striking 383% increase in calls to poison control centers concerning kava-related exposures from 2011 through 2025. This alarming trend has drawn significant attention from toxicologists and public health experts, particularly due to the association of kava with adverse neurological and cardiovascular outcomes. The study was spearheaded by researchers at UVA’s Blue Ridge Poison Center, with Dr. Chris Holstege, MD, among the lead authors. Their in-depth analysis quantifies the shifting landscape of kava use in the United States, spotlighting potential public health risks tied to these popular but largely unregulated products.
Kava, a psychoactive plant native to the South Pacific Islands, has been traditionally consumed in its native regions as a mild sedative and anxiolytic beverage. Its principal active compounds, known as kavalactones, exert their effects by modulating neurotransmitter systems in the brain, particularly influencing GABAergic and dopaminergic pathways which underpin its calming and muscle-relaxant properties. While culturally significant in Pacific societies, the recent commercialization of kava in Western markets has resulted in substantial alterations in its potency and mode of consumption, escalating the risk profile for adverse events.
The Blue Ridge Poison Center documented 203 kava-related calls in 2025, a significant increase from 57 calls in 2011. Demographically, men older than 20 years represent the majority of these exposure reports, suggesting targeted usage trends possibly linked to cultural consumption patterns or availability. More concerningly, concurrent use of kava and kratom—a separate plant-based substance frequently sold in gas stations and vape shops—has surged, constituting 30% of kava exposures in 2025. This synergy raises important questions about the pharmacodynamic interactions between these two substances, both of which influence central nervous system activity but via distinct mechanisms.
The pathophysiology underlying the combined consumption of kava and kratom is complex. Kratom, rich in mitragynine and other alkaloids, acts primarily on opioid receptors, whereas kavalactones modulate ion channels and neurotransmitter function. Co-ingestion may potentiate neurotoxicity, culminating in seizures, tremors, and severe cardiovascular disturbances. Poison center data reflect a worrisome rise in serious health outcomes; in 2025 alone, 32% of exposures involved severe clinical manifestations, with the previous year peaking at 39%. Such statistics underscore the pressing need for medical professionals and consumers to recognize the potential for life-threatening interactions.
Historically, kava consumption in the United States saw a marked decline following a 2002 advisory from the Food and Drug Administration that linked kava to instances of acute liver failure. The FDA warning precipitated a near decade-long decrease in poison center calls, reaching a nadir of 42 reports in 2010. However, the resurgence of kava’s popularity in the past decade corresponds with the introduction of highly concentrated commercial products, often two to ten times more potent than traditional kava preparations. These potent formulations pose heightened risks, particularly for hepatic injury, a serious adverse effect that initially sparked regulatory concern.
The pharmacological variability inherent in commercial kava products is of particular concern. Unlike traditional root infusions, these commercial forms include extracts and pills with standardized—or sometimes exaggerated—kavalactone content. This lack of regulation and quality control results in unpredictable dosing and exposure levels, elevating the possibility of toxicity. Liver damage remains a notable complication, with isolated reports indicating hepatotoxic responses. The mechanism is thought to involve both direct toxic effects on hepatocytes and idiosyncratic immune-mediated injury, demanding further investigation into safe usage parameters.
In addition to hepatotoxicity, kava has been implicated in adverse neurological outcomes such as sedation, ataxia, and cognitive impairment. Combined with kratom, these effects can cascade into more severe neurotoxic events, potentially linked to excitotoxicity or neurotransmitter dysregulation. Cardiovascular reactions, including tachycardia and elevated blood pressure, have also been recorded. These findings highlight the complexity of kava’s pharmacodynamics and the necessity for enhanced clinical surveillance and patient education regarding risks.
The UVA research team, including Dr. Rita Farah, PhD, MPH, conducted a comprehensive temporal analysis of kava-related poison control center data spanning nearly a quarter-century. Their meticulous study revealed eight fatalities linked to kava exposure between 2000 and 2025, emphasizing the substance’s potential lethality under certain conditions. Their longitudinal work also contextualizes the ebb and flow of kava use in relation to regulatory actions and market trends, offering vital epidemiological insights to inform public health strategies.
This upward trend in toxic exposures coincides with the expanding market availability of novel kava-containing products. Retail outlets across regions increasingly stock beverages, tinctures, and dietary supplements bearing kava, sometimes alongside kratom, without standardized labeling or adequate health warnings. This commercialization, coupled with the allure of “natural” or “herbal” remedies, may foster a false perception of safety among consumers, inadvertently contributing to increased misuse and adverse events.
Public health experts warn that enhancing public awareness is crucial to mitigating the risks posed by these substances. Dr. Holstege and colleagues advocate for targeted educational campaigns that inform individuals about the potential complications attributable to kava consumption, especially when paired with other psychoactive agents like kratom. Healthcare providers must also remain vigilant, incorporating detailed substance use histories in clinical assessments and providing clear guidance on the dangers of these emerging recreational drugs.
The UVA research findings were published in the Morbidity and Mortality Weekly Report (MMWR), a key publication by the Centers for Disease Control and Prevention. This peer-reviewed venue ensures that the data and interpretations reach a broad spectrum of public health officials, clinicians, and researchers, facilitating informed policymaking and clinical practice adjustments. The study’s robust methodology and alarming conclusions underscore the urgent need for regulatory scrutiny and further scientific inquiry into kava’s safety profile.
The steady rise in kava-related adverse events documented by this research signals a critical public health challenge amid the backdrop of evolving drug consumption trends. As products become more potent and widely available without adequate oversight, healthcare systems can anticipate increasing burdens related to intoxication, morbidity, and mortality. Proactive responses grounded in rigorous scientific understanding and community engagement will be essential in addressing this multifaceted issue.
Subject of Research: Toxicological analysis and epidemiology of kava-related exposures in the United States
Article Title: Not explicitly specified; related to kava poison center calls increase and health outcomes
News Publication Date: Not explicitly specified (context suggests 2025 or soon thereafter)
Web References: https://www.uvahealth.com/news/kratom-calls-skyrocket-to-nation-s-poison-centers, https://makingofmedicine.virginia.edu
References: Researchers’ published findings in Morbidity and Mortality Weekly Report (MMWR)
Image Credits: UVA Health
Keywords: Kava, kavalactones, poison center calls, kratom, neurotoxicity, hepatotoxicity, cardiovascular effects, drug interactions, public health, epidemiology, MMWR
