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Possible toxicity and withdrawal seizures in Aboriginal kava drinkers in Arnhem Land, (Australia)

Published online by Cambridge University Press:  05 May 2015

Alan R Clough*
Affiliation:
Menzies School of Health Research/Northern Territory University, Darwin, Northern Territory, Australia
Sheree Cairney
Affiliation:
School of Psychological Sciences, La Trobe University, Victoria, Australia
Paul Maruff
Affiliation:
School of Psychological Sciences, La Trobe University, Victoria, Australia
Chris B Burns
Affiliation:
Menzies School of Health Research, Darwin, Northern Territory, Australia
Bart J Currie
Affiliation:
Menzies School of Health Research/NT Clinical School, Darwin, Northern Territory, Australia
*
PO Box 1479, Nhulunbuy, NT, 0881, Email: [email protected]

Abstract

Background: In the 1990s, heavy kava use in Aboriginal communities was linked to reports of unusual neurological events which were often described as ‘fits’ or ‘seizures’. Kava use has also been associated with extra-pyramidal movements. We now raise the possibility that kava toxicity and kava withdrawal may be associated with grand mal seizures. This paper describes some of ’these “seizure” episodes’ in kava drinkers. Nine communities and associated homelands in the eastern Arnhem Land (Miwatj) region (Northern Territory, NT) including 7001 Aboriginal people of whom 4217 were over 15 years. Twenty-one kava users experienced 32 “seizure” episodes for which the date of occurrence and other data was recorded in notes in community health clinic files dating from the 1980s up to 1999 in a sample of the Miwatj population. Kava, alcohol, tobacco, cannabis use and petrol sniffing, year in which “seizure” occurred, notes of kava toxicity or withdrawal. Kava toxicity effects were suspected in 15 and withdrawal effects in six of 32 “seizure” episodes. In seven episodes impaired consciousness and abnormal movements were adequately documented to suggest grand mal seizures. The maximum number of “seizures” experienced was three and three individuals experienced this number between 1990 and 1999. One was a heavy kava user. Six other individuals experienced two “seizures” each and five of these were heavy users. Sixteen individuals experienced 19 “seizures” during 1994-1997 when kava supply may have reached its peak. Fifteen of the 21 individuals experiencing “seizures” were heavy users described locally as dja[aw'marama. The clinical data and the coincidence of peak supply with records of “seizures” suggest kava toxicity and withdrawal seizures may both occur with heavy kava use. Further systematic analysis is warranted to confirm this and to assess kava's effects with respect to possible confounders such as alcohol.

Type
Articles
Copyright
Copyright © University of Papua New Guinea and Massey University, New Zealand/Aotearoa 2001

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References

Alexander, K. (1985). Kava in the North: a study of kava in Arnhem Land Aboriginal Communities Monograph, Darwin: Australian National University North Australia Research Unit.Google Scholar
Almeida, JC, & Grimsley, EW. (1996). Coma from the health food store: interaction between kava and alprazolam. Ann Intern Medicine, 125(11), 940–41.CrossRefGoogle ScholarPubMed
Brunton, R. (1988). A harmless substance? Anthropological aspects of kava in the South Pacific. Kava: use and abuse in Australia and the South Pacific, University of New South Wales, Monograph No. 5. National Drug and Alcohol Research Centre.Google Scholar
Cairney, S, Maruff, P, & Clough, AR. The neurobehavioural effects of kava. Aust NZ J Psychiatry, (in press).Google Scholar
Cawte, J. (1985). Psychoactive substances of the South Seas: betel, kava, and pituri. Aust NZ J Psychiatry, 19, 83–7.CrossRefGoogle ScholarPubMed
Clough, AR. (2000). Response to issues paper, National Competition Policy Review of the Kava Management Act. NT Department of Industries and Business, Darwin.Google Scholar
Clough, AR, Bailie, R, Burns, CB. Guyula, T, Wunungmurra, R, & Wanybarrnga, SR. (2002). Validity and utility of community health workers' estimation of illicit substance use. Aust NZ J Public Health, 26(1). 52–7CrossRefGoogle Scholar
Clough, AR, Burns, CB, & Mununggurr, N. (2000). Kava in Arnhem Land: a review of consumption and its social correlates. Drug Alcohol Rev, 19(3). 319–28.CrossRefGoogle Scholar
d'Abbs, P. (1993). A review of kava control measures in the Northern Territory (3/95). Darwin: Menzies School of Health Research.Google Scholar
d'Abbs, P, & Burns, CB. (1997). Draft report on inquiry into the issue of kava regulation [online]. Darwin: Menzies School of Health Research.Google Scholar
d'Abbs, P, & Maclean, S. (2000). Petrol sniffing in Aboriginal communities: a review of interventions. Darwin: Cooperative Research Centre for Aboriginal and Tropical Health.Google Scholar
Dunlop, I. (1996). We believe it, we know it's true [Video]. Lindfield, NSW: Film Australia.Google Scholar
Gordon, E, & Devinsky, O. (2001). Alcohol and marijuana: effects on epilepsy and use by patients with epilepsy. Epilepsia, 42(10), 1266–72.CrossRefGoogle ScholarPubMed
Herkes, GK. (2001). Epilepsy. Med J Aust, 174(10), 534–49.CrossRefGoogle ScholarPubMed
Kalant, H. (2001). The pharmacology and toxicology of “ecstasy” (MDMA) and related drugs. CMAJ, 165(7), 917–28.Google ScholarPubMed
Lebot, V., Merlin, M., & Lindstrom, L. (1997). Kava, the Pacific Elixir: The definitive guide to its ethnobotany, history and chemistry. (2nd ed.). Rochester, Vermont: Healing Arts Press.Google Scholar
Mathews, J., Riley, M., Fejo, L., Munoz, E., Milns, N.. Gardner, I., Powers, J., Ganygulpa, E., & Gununuwawuy, B. (1988). Effects of the heavy usage of kava on physical health: summary of a pilot survey in an Aboriginal community. Med J Aust, 148, 548–55.CrossRefGoogle Scholar
Neiman, J, Haapaniemi, HM, & Hillborn, M. (2000). Neurological complications of drug abuse: pathophysiological mechanisms. Eur J Neurol, 7(6), 595606.CrossRefGoogle ScholarPubMed
Northern Territory of Australia. (1998). Kava Management Act. Darwin: Legislative Assembly of the NT.Google Scholar
Pfeiffer, C., Murphree, H., & Goldstein, L. (1967). Effect of kava in normal subjects and patients. Psychopharmacol Bulletin, 4(3), 12.Google ScholarPubMed
Pittler, MH, & Ernst, E. (2000). Efficacy of kava extract for treating anxiety: systematic review and meta-analysis. J. Clin Psychopharmacol., 20(02), 84–9.CrossRefGoogle ScholarPubMed
Ruze, P. (1990). Kava-induced dermopathy: a niacin deficiency? Lancet, 335(06 16), 1442–5.CrossRefGoogle ScholarPubMed
Sacks, O. (1996). Island of the colour blind. Sydney: Picador.Google Scholar
Schelosky, L., Raffauf, C., Jendroska, K.. & Poewe, W. (1995). Kava and dopamine antagonism. J Neurol, Neurosurg Psychiatry, 58, 639–40.CrossRefGoogle ScholarPubMed
Schuckit, MA. (1995). Drug and alcohol abuse: a clinical guide to diagnosis and treatment. (4 ed.). New York: Plenum Medical Book Company.CrossRefGoogle Scholar
Spillane, P., Fisher, D., & Currie, B. (1997). Neurological manifestations of kava intoxication [letter]. Med J Aust, 167, 172–3.CrossRefGoogle Scholar