Cases of Kava Impairment in Iowa Drivers

Abstract

Kava is an Oceanic plant in which the root is consumed as a beverage and is becoming increasingly popular. The effects of kava consumption may include sedation, euphoria, and impairment of motor coordination. This article demonstrates kava impairment through four cases of self‐reported kava use supported with Drug Recognition Expert (DRE) evaluations of each subject. Subject's urines screened negative for common drugs of abuse by immunoassay analysis. Urine from cases 3 and 4 were analyzed by liquid chromatography–tandem mass spectrometry, and gas chromatography–mass spectrometry, which yielded the presence of kavalactones. Subjects exhibited poor driving behavior and signs of intoxication. Indicators of impairment from multiple drug categories, central nervous system (CNS) depressants, CNS stimulants, and cannabis were observed, which may be consistent with the presence of multiple kavalactones and their diverse array of mechanisms of action. The consumption of kava can hinder one's ability to operate a vehicle safely.

Kava as a Clinical Nutrient: Promises and Challenges

“…During the past 15 years, there have been a number of case reports in the literature about the potential adverse effects of kava where the product used was not reported or characterized. Berry et al reported four cases of drivers in Iowa unable to safely operate a motor vehicle, potentially due to kava use, between 2011 and 2018 [ 180 ]. There was no detailed information on the kava products or dosages (the amount of kavalactones) used.…”

Risk Associated with the Use of Selected Ingredients in Food Supplements

“…Hepatotoxic effects of Kava‐Kava have been reported, which are directly related to the raw material parts used, including mainly aerial parts (leaves and bark) of P. methysticum [81–83] . The consumption of kava‐kava has been shown to impair the ability to drive vehicles [84] …”

Kava drinking in traditional settings: Towards understanding effects on cognitive function

“…To date, there has only been one successful kava‐driving prosecution in NZ (District Court of New Zealand, ) and a small number overseas (Jolly, ; Swenson, ). Although this subject is of concern to road safety commentators (Berry, Gilbert, & Grodnitzky, ; Fu, Perl, Jennings, & Hepburn, ; Wainiqolo, Kool, Nosa, & Ameratunga, ), law enforcement, and land transport agencies in NZ and the Pacific Islands, the reality is that very little is known about the effects of kava at traditionally consumed volumes, on cognitive faculties related to driver safety. Additionally, when the comments of LaPorte et al's () and Sarris et al (2013) as discussed above are combined with Bwarenaba et al () concerns about kava psychopharmacology and neurophysiology following small pharmacologically administered doses of kava, this points to the urgency to undertake research in this field.…”

“…To date, there has only been one successful kava-driving prosecution in NZ (District Court of New Zealand, 2000) and a small number overseas (Jolly, 2009;Swenson, 1996). Although this subject is of concern to road safety commentators (Berry, Gilbert, & Grodnitzky, 2019; Fu, Perl, Jennings, & Hepburn, 2019; Wainiqolo, Kool, Nosa, & F I G U R E 2 Chemical structure of the six major kavalactones present in kava beverage made from the roots and basal stump. Me = methyl group.…”