Is driving under the influence of kava associated with motor vehicle crashes? A systematic review of the epidemiological literature.
OBJECTIVE
Kava is marketed as a herbal anxiolytic in several countries and is consumed recreationally in high doses in many indigenous Pacific and Australian Aboriginal communities. We reviewed the published literature examining the association (if any) between kava use and motor vehicle crashes (MVCs), MVC-related injuries or driving performance.


METHODS
Search of MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus, AMED, Australian Medical Index, Australian Transport Index and trials registries and injury journals up to August 2014.


RESULTS
No studies quantifying the effects of kava on MVCs or related injury were located. Four experimental studies using computer-based driving simulation examined the effects of pharmacological doses of kavalactones on cognitive and visuomotor performance. While no statistically significant adverse changes attributable to kava were found, there was weak evidence of slowed reaction time. One study found the visuo-motor performance on driving simulation to be significantly impaired when kava was consumed with alcohol.


CONCLUSIONS
With equivocal evidence limited to experimental studies using simulated driving settings, the contribution of kava to MVCs is unknown.


CONCLUSIONS
The gap in knowledge regarding the potential risk of injuries associated with therapeutic and recreational use of kava requires priority attention.
School of Population Health, University of Auckland, New Zealand.
Iris
I
Wainiqolo
School of Population Health, University of Auckland, New Zealand.
Bridget
B
Kool
School of Population Health, University of Auckland, New Zealand.
Vili
V
Nosa
School of Population Health, University of Auckland, New Zealand.
Shanthi
S
Ameratunga
D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D001334:Automobile Driving / Q000523:psychology*; D000066448:Driving Under the Influence; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D020901:Kava / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D018986:Motor Vehicles; D010139:Pacific Islands; D010936:Plant Extracts / Q000009:adverse effects*; D012307:Risk Factors
D006993:Hypnotics and Sedatives; D010936:Plant Extracts
Pacific Islands; accidents; injuries; kava; risk factors; traffic