There isn’t an affirmative “yes” or “no” answer to this question. Will it kill you to combine alcohol and kava kava? No – unless of course you ingest more than you should of either kava or alcohol. However, there is a body of scientifically backed information that would suggest that you should never combine alcohol and kava. Furthermore, many people prefer kava kava to alcohol, and it is used quite widely as a complete alternative to drinking alcohol.
Now for some lengthier Kava Guru wisdom on the topic of combining alcohol and kava kava (Piper Methysticum):
Many people enjoy drinking alcohol and kava at the same time because of the heightened effect of each and the quicker onset of their sought-after effects. Of course quantity is of key importance here – it would never be recommended that one drink either kava kava or alcohol in high quantities, either alone or in combination with each other. It would be no different than the recommendation not to combine anything else that is mind-altering or medicinal with each other, or specifically with alcohol.
Additionally, some traditional ceremonial procedures involving kava kava actually include the ingestion of alcoholic beverages before or after the process. There has also been a recent development of “kava bars” in the Western world and some of these kava bars serve alcohol along with kava kava drinks. For example, some people enjoy sipping on kava kava beverages while taking a shot of alcohol at various points in between . Furthermore, ethanol is used in the process of commercial kava kava extraction at percentages upwards of 60% and Western herbal medicine traditionally uses 25% ethanol to 75% water as the solvent base for tinctures [6, p.674]. However, just because many people choose to combine alcohol and kava kava does not mean that it is the wisest thing to do.
True to my Guru nature, I would like to bring to your attention all relevant bits of knowledge I am privy to, and would like to tell you a bit about the evidence that suggests the combination of alcohol with kava kava could increase the risk of liver damage or toxicity.
Many of the cases that have surfaced regarding kava kava and liver damage have been proven to be unsubstantiated, strictly because it was proven that alcohol could have played a role. The kava kava used in these studies was commercially extracted and, as noted above, commercial extracts often carry ethanol in their solvent bases. Whereas studies conducted with the use of pure kava kava (with no alcohol) have not surfaced any evidence of liver toxicity. Although there is some indication to suggest that the addition of glutathione (an organic chemical that helps with the metabolization of kavalactones) may have a levelling effect that prevents hepatotoxicity [6, p. 676]. This could then suggest that the alcohol may have been the variable responsible for liver damage, or that the combination of kava kava and alcohol was responsible.
This brings us to a discussion of what actually happens to the liver when kava kava and alcohol are used in combination. The liver makes use of the enzyme CYP 2E1 for the metabolizing of alcohol. There have been studies that suggest CYP 2E1 is also used in the metabolizing of kavalactones (kava kava compounds) [3, p.476]. If both substances are metabolized by the same enzyme or altogether have a similar enzymatic pathway – then it is quite possible that when used in combination, the metabolic pathways become stressed and hepatotoxicity (toxic liver damage) may be more likely to occur.
Furthermore, kavalactones do temporarily alter the functioning of various liver enzymes, including gamma-glutamyl transferase and alkaline phosphatase . Some of the affected enzymes may be used during the metabolic processes of breaking down ethanol (alcohol) [3, p. 475-477]. As a result, it is possible that enzymes used in the metabolization of alcohol are temporarily affected while the liver processes kava kava. If this is the case, then it is likely that when kava kava is in the system, the liver may not be able to properly metabolize alcohol and could then experience hepatotoxicity if the substances are combined.
In an entirely different vein of discussion with regard to the combination of alcohol and kava kava – kava kava is actually widely used as a preferred alternative to drinking alcohol and has been recommended by physicians to patients with alcoholic substance abuse problems . Given the many similar side effects that kava kava and alcohol share – relaxation, mood elevation, release of inhibition, anesthesia, muscle relaxation, and more – many people enjoy kava kava as a valuable alternative to drinking alcohol . Kava kava is not a central nervous system depressant, and in this way varies from alcohol. Furthermore, kava kava is not physically addictive, like alcohol  – which would explain its use in the therapeutic treatment of alcoholism .
Kava Guru thinks it breaks down to this: no, it won’t kill you to combine alcohol with kava kava, nor will your system be greatly damaged with small doses of the combined substances. However, given the studies discussed above – it is perhaps best to avoid the combination as much as possible. Additionally, kava kava provides all of the pleasant effects of alcohol consumption with the added benefit of nonaddiction. So really, it’s no wonder that kava kava is growing in popularity as a complete alternative to alcohol!
1. Cassileth, Barrie, PHD. “Oncology”. United Business Media LLC, San Francisco: April 15, 2011. Vol. 25-4 p. 384-385.
2. Craig, Winston J. “Kava kava: Antidote for Anxiety”. Vibrant Life, Hagerstown: January, 2002. Vol. 18-1 p. 42-43.
3. Li and I. Ramzan. “Role of Ethanol in Kava Hepatotoxicity”. University of Sydney – Faculty of Pharmacy, Sydney: November 26, 2009. Phytotherapy Research 24: p. 475-480.
4. Makaira. “Do Kava and Alcohol Combine?” Makaira’s Kava Kava Blog: January 1, 2010. http://www.konakavafarm.com/blog/?p=231
5. Mcdonald, Jim. “Kava kava – Piper Methysticum”. http://www.herbcraft.org/kava.html
6. Whitton, Lau, Salisbury, Whitehouse and Christine S. Evans. “Kava Lactones and the Kava-Kava Controversy”. Pergamon: June 5, 2003. Phytochemistry 64: p. 673-679.
7. Wikipedia. “Kava-Toxicity and Safety”. Last modified: February 21, 2014. http://en.wikipedia.org/wiki/Kava#Toxicity_and_safety