More kava bashing ergo indigenous bashing

[Agamemnon]

From ABC online news http://www.abc.net.au/news/stories/2007/08/29/2018191.htm

Interesting to read the feedback after the article. God help the women and kids when alcohol takes it's grip in the indigenous communities to replace peaceful kava!

Kava's grip on NT communities must be loosened

By Alan Clough

Posted 9 hours 38 minutes ago

Kava has long been a challenge for policy.

Kava has long been a challenge for policy. (AFP: Torsten Blackwood)

Kava, the mood-altering drink prepared from crushed roots of the pepper plant (Piper methysticum Forst. f.), widely used in south Pacific countries on ceremonial occasions and in secular drinking, was brought to Arnhem Land Aboriginal communities in the Northern Territory early in 1982, with the support of missionaries who themselves came from Pacific island countries.

Kava drinking was rapidly adopted in most coastal and island communities across the NT's Top End (Figure 1).

I have observed and studied the health and social effects of kava use in these communities for almost 20 years (since 1988), including nine years when I lived and worked in these communities followed by more than 10 years of systematic research into health effects of substance misuse generally in the region.

Kava has long been a challenge for policy. Service providers and regulatory authorities quickly became unsettled after its introduction by emerging community dysfunction, concerns for health effects of 'excessive' use without traditional social controls, and economic hardships brought about by a vigorous informal, and later illegal, trade in kava.

There have been two legislative attempts by the NT Government to control its supply and consumption; the first attempt in 1990, and the second in 1998 which culminated in the NT's regulatory regime which has now been nullified (from June 26 2007) by Commonwealth action to tightly restrict the importation of kava into Australia as a whole.

Along with colleagues, including Aboriginal health workers, senior clinicians and fellow researchers, I recently published my concern in the Medical Journal of Australia that the NT's second attempt to control kava had also not succeeded to limit its availability. Under the NT's Kava Management Act, one wholesaler was licensed to supply kava to six licensed retailers in Arnhem Land communities.

'Kava Management Plans' in 'Kava Licence Areas' under the Act, permitted these retailers to supply from 600-800g per week of kava powder to each purchaser, more than double known harmful consumption levels (240-440g per week), a level identified from several years of systematic research and observation in kava-using communities.

Health effects

Kava's well-documented health effects in Arnhem Land include seizures and extreme weight loss in heavy users (up to 20 per cent body mass) similar to that seen in anorexia nervosa. Extreme weight loss, evident during the 1980s, has re-emerged in the region's kava users.

Elevated total- and LDL-cholesterol levels add to unresolved concerns that heavy kava use may be a risk factor for cardiovascular disease and sudden cardiac deaths. Potential immunosuppressive effects are suggested by relative lymphocytopaenia in heavy users and by increased risks for serious infections such as melioidosis and pneumonia.

Elevated liver enzymes in kava users must be monitored closely because of fatal hepatotoxicity documented in a number of countries around the world, including Australia, in users of manufactured kava products available as natural therapies. Evidence of similar liver injury in some Pacific island kava users has also emerged.

Given the scarcity of substance misuse treatment services in Arnhem Land, with no treatments for kava misuse, tight supply control provides the only practical measure to reduce kava-related harms to individuals and communities.

Financial burden

As well as health harms for individual users, kava is the psychoactive substance with greatest financial impact on communities and individuals in Arnhem Land (Figure 2).

Quantities of illegal kava and its impact are difficult to estimate. Total licensed plus illegal kava supplied in 2005, around 34 tonnes, was worth approximately $5.6 million (Figure 3).

Since kava has been made available again in all Arnhem Land communities where it has ever been used by the NT's licensing system combined with the illegal trade, its overall annual financial burden may be at least $740 per capita, equivalent to 12 per cent of these impoverished communities' total cash resources.

High prices

Prices paid by users of licensed kava in Arnhem Land are five times its retail price in Fiji markets.

Licensed kava supplied by the wholesaler increased from three tonnes supplied in 2002 (worth $0.4 million retail), to eight tonnes in 2003 (worth $1.1 million), to 20 tonnes in 2004 (worth $2.8 million). Approximately 26 tonnes were supplied in 2005 worth $3.6 million (Figure 3), around one-third of all kava imported into Australia in that year.

This rapid increase in licensed kava mirrors the increase seen during 1985-1989, reaching 24 tonnes in 1989, just before the first attempt to regulate it.

The recent trend in licensed kava up to 2005 suggests that unprecedented quantities were supplied in 2006, higher than known problematic levels (28-36 tonnes per year) seen in the mid-1990s when kava was uncontrolled.

Two retail licences issued since 2005 probably further increased kava's availability, however up-to-date information about this has not been disseminated.

The six Arnhem Land communities with licensed kava retailers comprise around 3,300 people; approximately 43 per cent of 7,600 people in communities where kava has ever been used. The remaining larger communities with a history of kava use have consistently refused a kava licence.

Illegal re-selling

A new kind of illegal kava trade was created by the licensing system itself.

Observation and surveillance indicate that kava sold in all licensed communities was being transported to the nearby unlicensed communities.

In these communities community leaders have steadfastly refused to have a kava licence but the kava brought from other licensed areas was being re-sold illegally in these communities and at grossly inflated prices.

Kava was also still available from other illegal sources; possibly as much as eight tonnes per year, an additional financial burden of around $2 million, given known 'black market' prices (Figure 2).

This kava was being transported into the NT illegally from southern and eastern states where, until the Commonwealth action on June 26, it was possible to import large quantities of kava with few requirements to account for its end use.

Controlling kava coming into Australia should also eliminate this long-standing, troublesome component of illegal kava dealing in Arnhem Land.

Kava will be under much tighter control at the national level.

Along with the recent much tighter controls on supply of other illicit substances in these remote Indigenous communities in Arnhem Land, the opportunity should be vigorously pursued to address the core underlying issues of substance abuse in these communities, especially to ensure constructive engagement of Indigenous youth in community life, employment, training and economic activity.

Alan Clough is Associate Professor at the School of Public Health, Tropical Medicine and Rehabilitation Science and School of Indigenous Australian Studies at James Cook University.

Notes

Figure 1

Figure 2

Figure 3

Further reading:

* Northern Territory of Australia. Kava. Darwin: Northern Territory Department of Justice, Racing, Gaming and Licensing Division;2007. Available at: http://www.nt.gov.au/justice/licensing/sta...tatistics.shtml (accessed August, 2007).

* Clough AR. Enough! or too much. What is 'excessive' kava use in Arnhem Land? Drug Alcohol Rev 2003; 22: 45-53.

* Clough AR, Jacups SP, Wang Z, et al. Health effects of kava use in an eastern Arnhem Land community. Intern Med J 2003; 33: 336-340.

* Currie BJ, Fisher DA, Howard DM, et al. Endemic melioidosis in tropical northern Australia: a 10-year prospective study and review of the literature. Clin Infect Dis 2000; 31: 981-986.

* Currie BJ, Clough AR. Kava hepatoxicity with Western herbal products: does it occur with traditional kava use? Med J Aust 2003;178:421-422.

Comments (5)

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Jon:

29 Aug 2007 5:04:18pm

It concerns me that so called 'experts' who may have researched kava consumption amongst Aborigines fail to realise that they lose weight because they do not eat (simple). It may be because they do not feel like it after drinking kava, but nothing in kava makes you just lose weight (Jenny Craig) It is a 'financial burden' because they 'choose' to buy kava, alcohol, grass, tobacco and gamble it away. The kava is highly priced because it is NOT regulated well enough. Always be aware that the indigenous people determined to get kava as an alternative to 'alcohol' which has and continues to have a devastating effect in indigenous communities. They 'experts'do not tell us anything new except saying that 'constructive engagement' of indigenous youth in community life is needed. We all know that..now that kava is banned, tell us how it is done!!

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Susan:

29 Aug 2007 4:14:01pm

We have a strong Pacific Island contingent in our family who to my knowledge have used Karva responsibly for years maintaining their health, their families and their culture on a regular basis particularly with the male side of their community. Someone else has misused it and now their cultural practices are being undermined. I can understand supervision amongst some communities but amongst those who are responsible it should not just be a blanket ban. It costs too much to travel to Figi and bring back one kilo. Give them a break.

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Linda Visman:

29 Aug 2007 3:01:26pm

Anyone who reads this rational and objective report must agree that the problem of kava use in Top End communities is a real problem. That the federal government has moved to ban imports of kava is a necessary first step. Banning substances is fine - but there must be a real effort, by the Commonwealth, to follow up black market sources, which always appear when something is banned.

However, as with problems of alcohol and other substance abuse in the wider indigenous - and general Australian - population, the root causes must be addressed before there can be any hope of overcoming this problem. Lack of interest, lack of motivation, health and social ills result from social, economic and spiritual dysfunction, from a sense of the futility of life.

How is all that going to be dealt with?

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Gordon:

29 Aug 2007 2:37:26pm

Kava ban is having a major impact on the way of life of people from Pacific Island living in Australia. Kava is a very important cultural/religion/social drink for the people of the Pacific Islands and a ban is not fair for these people who have nothing to do with the misuse in other communities.

On the basis that you did not ban Alcohol for all Australian, why then you have ban Kava?

Thats allow the importation of Kava, may be with limitation that it is not taken into Aboriginal communities where it has been misused.

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Jethro:

29 Aug 2007 1:32:13pm

It reminds me of a time when bible basher's wanted to get rid the evil of drinking. So what did they propose? Use heroin instead. This is what happens when well meaning people with little formal education and alot of "morals" happen to get a little power within a dysfunctional community. Maybe the government should regulate the missionaries.