A clinical trial is set to explore the ancient Pacific tradition of kava drinking as a potential treatment for post-traumatic stress disorder.

PTSD affects nearly 4% of the global population at some point in their lives.

Pacific island researchers believe that ceremonial drinking of kava—a plant-based beverage with calming properties— combined with talanoa, a form of open, respectful dialogue, can offer relief to people with PTSD, especially those who haven’t responded well to conventional treatments.

They have published their work in Frontiers of Psychology.

Current standard care for PTSD often involves medications such as benzodiazepines, tricyclic antidepressants, and antipsychotics. While these drugs may offer short-term relief, they carry risks – as the people behind the trial note, they have “addictive potential, are only effective in the short term, are contraindicated for key populations such as the elderly and have significantly problematic track records in indigenous populations”.

What is Kava?

Kava root for sale at Nadi Municipal Market in Fiji. (Photo by Fiona Goodall/Getty Images)

Kava, made from the root of the Piper methysticum plant, has been used in Pacific cultures for more than 2,000 years. It has natural sedative and anti-anxiety properties. But lead author of the paper, Dr Apo Aporosa from the University of Waikato says kava is more than a drink—it’s a practice steeped in ritual, social structure, and community.

“Kava is both a noun and a verb”, says Aporosa. “It’s holistic and includes the associated cultural knowledge and practices that nurture vā (relational connection). Those practices include the woven mats we sit on, the tanoa (kava bowl) we serve from, the order in which we serve those present, the bilo or ipu (coconut shell cup) we drink from, and most importantly, the relational connection we create in that space.”

For Aporosa, this research is deeply personal. While working as a police officer in New Zealand, he developed PTSD.

“One major traumatic incident during my time in the police was the breaking point… I avoided talking about any of it,” he says. “After leaving the police, things worsened. My anxiety increased, and sleep became severely disrupted by vivid, recurring trauma dreams – sometimes up to six a night – leaving me in a state of constant fear and hyper-alertness.

“When medication didn’t help, I went home to my village in Fiji, genuinely believing I might die. But the opposite happened. Sitting for hours drinking kava and engaging in talanoa, often with friends who had served in the British Army, I slowly relaxed. My panic eased, sleep improved, and within a couple of months, I felt like myself again.”

“Several years later, at Aldershot Barracks in the UK, drinking kava and talking with Fijian mates just back from Afghanistan, I realised my healing wasn’t unique. Others were experiencing the same. That kava-talanoa session became the catalyst for the research I describe in this paper.”

Clinical trials coming 

The trial, scheduled to begin in mid-2025, will evaluate how effective kava-talanoa sessions are as a clinical treatment for PTSD.

“In our study, we will have several cohorts doing different things, but one will take tablets only and another will drink kava in a traditional setting, with the aim of identifying dose-response relationships and informing the design of standardised intervention guidelines,” says Aporosa. “This comparison will also allow us to explore the relational space that kava facilitates, a cultural dimension that’s essential to fully understanding what kava is”.

Meghan, Duchess of Sussex watches as Prince Harry, Duke of Sussex drinks Kava in Nadi, Fiji. (Photo by Samir Hussein/Samir Hussein / WireImage)

More than just medicine

Aparosa says the hope is not only that kava-talanoa proves effective, but that it is respected and protected from cultural misappropriation. 

“Pacific peoples are proud of kava and want others to enjoy it.

“What we don’t want is our cultural keystone species, based in 2000 plus years of traditional knowledge and safe use, adulterated, misrepresented, exploited and appropriated by the ‘culture industry’, by those who seek to profit from our culture.”

The secrets of kava