Kava in the Pacific Islands: a contemporary drug of abuse?

Notes from the Editor This Harm Reduction Digest discusses kava, a beverage consumed in some of the Pacific Islands nations. In the past, while traditional use of the drug was widespread, custom determined who could use kava and for what purposes, and negative impacts were minimized. However, in recent years, as part of the processes of modernization, major changes have occurred with regard to who uses kava, where and how it is consumed. Community leaders, health workers and ordinary members of Pacific Island nations are increasingly identifying harms they believe are being caused by kava, including physical health problems; dependence; impacts on family life and the work-place; and the linking of kava consumption to that of alcohol and cigarettes. David McDonald and Anita Jowit present new data from a recent survey of kava drinkers and non-drinkers in Port Vila, Vanuatu, describe the extent and nature of the harms, and suggest some harm reduction approaches that have potential for preventing kava-related problems.