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basal stump of the Piper methysticum plant in water <br />(Figure 1). The resultant slightly peppery earthy fla- <br />voured drink produces a mild relaxant soporific effect <br />(Aporosa and Tomlinson, 2014). Six key psychoactive <br />compounds called kavalaetones have been identified as <br />responsible for kava's pharmacological effect. These act <br />on receptors in the central nervous system, causing a <br />slight numbing and slowing in the response time in <br />muscles, limbs and the brain (Singh, 2009). <br />Kava also plays a significant role in traditional medi- <br />ans This is best summarized by Lebot and Cabamm <br />(1988) who present a valuable table unnamed from <br />across the Pacific in which they list symptoms and the <br />appropriate kava preparation method for each condition <br />(23-29). These include mild local anaesthetic and analgesic <br />efYects, and antifungal and antibacterial action (Singh, <br />2009). Kava's efficacy as an anxiolytic, used in the treat- <br />ment of generalized anxiety disorder, has been recognized <br />by contemporary pharmacology (Blades, 2016; Starts <br />et al., 2013), as has its use as an alternative to hormone <br />replacement therapy (HRT) for women (Braun and <br />Cohen, 2010; Cagnacei et al., 2003). More recently kava <br />has been used in cancer research, specifically ovarian, <br />bladder, colon, lung cancer and leukaemia (Lim, 2016). <br />While the medicinal benefits of kava have been widely <br />reported, them is also increased interest in kava as a roc- <br />reational drink and alternative to alcohol, to the point that <br />it is now being consumed in franchized bar settings in the <br />USA (Showman et al., 2015; Wofir i, 2018) In some <br />bars, kava is mixed with other substances to potentiate <br />effects, a practice several medical professionals <br />have voiced concern over due to risks associated <br />with `drug interaction' (Addiction Resource, 2019). <br />However, kava's increased popularity has been matched <br />by kava suspicion, myth and misreporting, to the point <br />that the Pasifika Medical Association (PMA) was obliged <br />to make this a theme within their 2016 annual conference. <br />'+.ova drink codu:4 <br />Archaeologists, linguists and botanists believe kava on- <br />ginated in northern Vanuatu approximately 3000 years <br />Science, Policy and Low <br />ago (Lebot et al., 1992). It is thought that the spread of <br />kava followed early migrational trade mutes as far west <br />as Papua New Guinea, to Hawaii in the east, and <br />Amearoa New Zealand in the south where it failed to <br />grow (Crowley, 1994). As Lebot and Levesque (1989) <br />explain: `for kava, dispersal of vegetative propagules by <br />wind or bird is impossible, [and] the plant therefore <br />owes its survival entirely to human distribution of <br />stem cuttings' (234). Together with kava's use in indi- <br />genous medicine (Lebot and Cabalion, 1988), the plant <br />in both its raw and drinkable form play significant roles <br />in traditional practice, being widely used to mark life <br />events from birth to death (Aporosa, 20196). In a <br />number of the Island nations such as Pohnpei <br />(Micronesia), Vanuatu, Fiji, Tonga and Samoa, much <br />of that traditional use remains, whereas in other areas <br />such as Te An Maohi (the greater Rarotongan island <br />group), French Polynesia and Hawaii, colonial contact <br />and missionizetion saw kava use reduced and in some <br />cases eliminated altogether (Aporosa, 2014). <br />Today kava has shifted to the Pacific diaspora. As <br />Pasifikanst have continued to use kava in their now <br />home environments, they have introduced new user <br />groups to this iconic drink. In most cases, these new <br />non-Pasifika kava users employ kava purely for recre- <br />ation, for the purpose of relaxation and/or as a medi- <br />cine, namely to reduce anxiety and facilitate sleep. <br />However, there are others who have drawn on kava's <br />traditional meanings and sociocultural function to both <br />enhance and expand their sense of identity through the <br />practice of kava drinking (Aporosa, 2015). <br />Change has also occurred among indigenous users. <br />For instance, extremes between traditional and urban <br />contemporary styles of kava consumption can be found <br />(Corcoran and Brynjolffssen, 2008). Whereas urban <br />contemporary niVarmatu kava drinkers tend to stand <br />and drink, urban Fijian and Tongan kava users, includ- <br />ing those in diaspora, tend to mix and serve the bever- <br />age from a designated bowl to drinkers sitting on <br />woven mats on the floor (Figure 2). The latter is <br />argued to have greater adherence with Pasifika cultural <br />values, in which some believe it is disrespectful to stand <br />Dr, pounded kava root being mix for drinking (photographer: Todd Henry, 2019). <br />