Khat - a cause for concern
Khat is a stimulant drug derived from a shrub that is native to East Africa and southern Arabia. The plant is widely used in many Arab and Some African countries as well as in some immigrant communities in USA and Europe. Because of its wide useage, its health risks and how it relates to social marginalisation and inequalities, khat is a growing cause for concern.
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The effects
The main psychoactive ingredients in khat are cathine and cathinone, chemicals that are structurally similar to, but less potent than, amphetamine, yet result in similar psychomotor stimulant effects. Chewing khat leaves induces a state of euphoria and elation as well as feelings of increased alertness and arousal. The user also experiences an increase in blood pressure and heart rate. The effects begin to subside after about 90 minutes to 3 hours, but can last 24 hours. At the end of a khat session, the user may experience a depressive mood, irritability, loss of appetite, and difficulty sleeping.
There are a number of adverse physical effects that have been associated with heavy or long-term use of khat, including tooth
decay and periodontal disease; gastrointestinal disorders such as constipation, ulcers, inflammation of the stomach, and increased
risk of upper gastrointestinal tumors; and cardiovascular disorders such as irregular heartbeat, decreased blood flow, and
myocardial infarction. There is also consistent epidemiologic evidence for a weak association between chronic khat use and
mental disorders. Although there is no evidence that khat use causes mental illness, chewing khat leaves may worsen symptoms
in patients who have preexisting psychiatric conditions.
It is unclear whether khat causes tolerance, physical dependency, addiction, or withdrawal, but nightmares and slight trembling
have been reported several days after ceasing to chew.
In addition to the reported health problems, the regular consumption of khat is associated with a variety of social and economic problems affecting the consumers and their families. Several authors have argued that regular consumption of khat seriously affects the social and economic life of the user.
Regulation
Khat is not under international control at present, but two substances that are usually present in khat, cathine and cathinone are. The regulation of khat differs considerably between countries. Khat is illegal in France, Switzerland, Sweden, Eritrea, Finland and Jordan. Khat is illegal in the USA if it contains cathinone or cathine. There are ongoing debates in other countries about its prohibition or regulation.
Cultivation and trade
Khat is mainly found in Ethiopia, Yemen, Somali, Sudan, Madagascar and South Africa, but it is also seen in Turkestan and Afghanistan.
The bush grows at altitudes of 1500-2500 meters and it usually reaches a height of 3-8 meters. Under optimal conditions the trees may reach 15-20 meters. The leaves and shoots are harvested after 3-4 years. A tree gives two crops a year.
Khat is normally consumed fresh. The effects of khat are obtained by chewing the tender leaves and shoots. Fresh leaves are preferred as the psychoactive properties decrease after harvesting, in particular during drying of the plant material.
A WHO report quotes estimates that in the UK where khat is not illegal, about 7000 kg of khat pass through Heathrow Airport each week from where it is distributed into the UK and into other European countries. (Sources and quotes from WHO and NIDA, below).
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WHO expert committee Assessment of khat (2006)
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National Institute on Drug Abuse, US National Institute of Health (2007)
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Khat - a Drug of Growing Abuse (2008)A report by Asha Omar and Renee Besseling 2008. The reports objective is to enable discussions and thinking about khat.
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