Piper methysticum (kava kava) is a perennial plant native to the Pacific Island region, and has been used ceremonially for thousands of years. Traditionally, a beverage is prepared, then drunk before the evening meal. Indigenous methods of mastication of the kava root have given way to grinding or pounding the plant substance, which is then mixed with water or coconut milk. The active constituents consist of a group of lactones, organized around an arylethylene-alpha-pyrone skeleton.1 They are similar in structure to myristicin, which is found in nutmeg.2 These kava lactones (AKA kava pyrones) make up 3-20 percent of the root by dry weight. Fifteen lactones have been isolated from kava, nine of which have been fully identified.