A study published on April 2 found that the number of calls to U.S. poison centers about kava, a drug found in drinks marketed as an alternative to alcohol, rose sharply over the past 15 years or so.
Poison centers received 203 calls related to kava in 2025, up from about 57 calls in 2011, according to a research paper from the University of Virginia’s Blue Ridge Poison Center. Men aged 20 and older accounted for the largest number of kava-related calls, it found.
The combined use of kava and kratom, a drug that is commonly found for sale at smoke shops and gas stations around the United States, also increased in recent years. In 2025, the combination accounted for 30 percent of the kava-related calls, the researchers said.
The increase was linked to kava- and kratom-containing products being sold more frequently, according to the university, which published its results via the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report journal.
“The number of kava-related calls to poison centers decreased after the 2002 Food and Drug Administration public warning associating liver failure with kava ingestion,” Dr. Chris Holstege, director of the Blue Ridge Poison Center, said in a statement.
“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.”
Kava, sometimes called kava kava, is a plant in the pepper family that is native to several Pacific Islands and historically used by local people for its sedative effects. The plant’s root was usually crushed and combined with water for consumption.
Health officials and poison control centers have long warned of adverse effects associated with the plant. Notably, long-term usage of kava could lead to liver damage, according to the National Capital Poison Center and the National Library of Medicine.
The study published by the Centers for Disease Control and Prevention on April 2 stated that “after reports of acute liver failure and liver transplantation temporally associated with kava use,” the Food and Drug Administration issued a warning that kava-containing supplements could be linked to severe liver injury, adding in 2020 that “indiscriminate kava use is not safe for use as a recreational or relaxation beverage for human consumption.”
Usage of the plant emerged in the United States in the late 1990s and grew significantly in the 2010s, according to the Centers for Disease Control and Prevention report. And despite the Food and Drug Administration’s warnings, the commercial market for kava has continued to expand in recent years, it added.
The most commonly reported symptoms or signs of kava exposure in the study included vomiting and nausea, drowsiness or lethargy, dizziness, agitation, and tachycardia. Signs of kratom and kava exposure, the researchers said, included similar symptoms but also seizures, tremors, and cardiovascular effects such as hypertension.
Meanwhile, the paper found that “liver injury was less common for both exposure types.”
The researchers said that they hope that the publication of the study will raise awareness of the possible toxicity related to kava consumption.
“These new kava products are found in stores throughout our area,” Holstege said. “The public needs to be aware of potential complications associated with the consumption of these products.”