In early 1982, kava, a mood-altering drink prepared from crushed roots of the pepper plant and used in South Pacific countries, was introduced to Arnhem Land Aboringinal communities in the Northern Territory (NT), thereby creating a challenge for policymakers. The objective of this study was to describe parameters for use in monitoring health, social and economic effects of kava use in Arnhem Land. Information in this study came from three studies conducted in Arnhem Land communities at different times between the late 1980's through to the present time: (1) recent data on kava use collected in eastern Arnhem Land 2001-2002; (2) cross-sectional study of health effects of kava use in one community in eastern Arnhem Land in 2000; and (3) observations of social and economic effects of kava use in one community in western Arnhem Land, 1989-1991. Result highlights from the studies include: (1) in males who did not use alcohol, kava users showed dermopathy characteristic of heavy kava use more frequently, and a lower body mass index (BMI); (2) between 1989-1990 to 1990-1991, there was a fivefold increase in the amount of kava used in this community; and (3) the average consumption among kava users grew to around 370 g/week of kava powder in 1990-91 from a level of 145 g/week in 1989-90 before the management regime. In combining these results, it is suggested that average kava consumption in a community from 240 g/week and up to 440 g/week is a level at which health and/or social effects may begin to appear. Controlled use of kava may allow people to have enough kava to meet their desire to use it but avoid adverse effects by moderating their consumption below the range of 240-440 g/week The amount of kava that is enough to maintain a stable legal trade must be balanced not only against prevalence and use levels and probable health, social, and economic effects, but also against the persisting threat of a rival and aggressive illegal trade. 2 Tables, 4 figures, 33 references