Many people believe that when a drug comes directly from the natural world, it is somehow safer than other drugs. However, across the centuries, it has been shown that natural substances like opium, cocaine, and tobacco can pose serious health risks, both physically and mentally.
Khat is a natural drug from an evergreen shrub that many people use ritually or socially through cultural tradition. For many, use of this drug is as natural as drinking coffee. However, the stimulant properties of khat are far more extreme than those of coffee, and they can result in health risks to the user, including the potential for violent or aggressive behaviors. For these and other reasons, it is important to understand how khat works in the body and what risks arise from its use.
Description and History of Khat
Most simply, khat is a plant – a shrub that grows in East Africa and along the Arabian peninsula. As described by Live Science, this plant contains two compounds that have psychoactive properties: cathinone and cathine. When consumed, these compounds create a stimulant response in the body.
People from the plant’s native regions have used it for centuries as a social and societal tradition, chewing the leaves in a variety of circumstances, similar to the ways in which people around the world use coffee, including:
- Before exams
- As a morning ritual
- Before or during social gatherings
- In special khat cafes known as mafrishes
As individuals and families from Yemen, Somalia, Ethiopia, and other parts of that region have settled in other parts of the world, the use of khat has traveled with them. However, not all countries are happy about the use of khat, finding it to be more similar to amphetamines in its effects on people than to coffee. In fact, the US classifies cathine as a Schedule IV substance, while cathinone is listed as a Schedule I restricted substance; nevertheless, the plant itself is not controlled in the US. Britain has banned khat use.
How Khat Is Used and What It Does in the Body
Similar to tobacco, khat leaves are most often chewed and held in the mouth to release the stimulant chemicals. It can also be dried and smoked or sprinkled on food; however, the potency is greatly reduced by using it this way. Fresh leaves are used to get the most cathinone from the plant.
Khat’s behavior in the body is similar to amphetamine, according to a study from the Qatar Medical Journal. The active substances in the plant stimulate the body’s stress response – also known as the “fight-or-flight response” – which affects a number of mental and physical processes. Effects include:
- Increased rate of messages traveling through the brain
- Increased heart rate and breathing
- High level of focus and stimulation
- Increased physical responses
- Suppressed digestion
Khat can also cause a mild feeling of euphoria; however, there is some disagreement on whether or not khat is addictive. While studies at this point show it does not cause physical addiction, it can result in psychological dependence on the ritual of using it. Still, long-term abuse of khat can lead to some serious physical and mental issues.
Who Abuses Khat?
An article in the Journal of Ethnopharmacology explains that the majority of people who abuse this drug are from the cultures that have traditionally used khat for thousands of years – Somalis, Ethiopians, and others from the region where the plant grows naturally. As these individuals have moved and settled around the world, they have shared this tradition with the communities they live in.
This growth in khat use is becoming a public health risk to larger communities, expanding beyond just those immigrants whose cultures use khat. One example is shown in an article from The Guardian that discusses the identification of a major drug distribution ring that was selling khat on the street in parts of the US. Through organizations like this, khat use is spreading to a wider segment of the population in this country and others.
Prevalence of Khat Abuse
A study from the Annals of Medical & Health Sciences Research estimates that 5-10 million people worldwide use khat. Not much information is available about use of the drug by demographics outside of those whose cultures have historically used the drug.
However, use of the drug in these communities abroad has been growing. Anecdotal information from articles like one from the LA Times indicates that more and more people from East African or Middle Eastern communities found within Western countries are importing khat in order to maintain their cultural traditions in their new homes. This is creating a public health and drug control issue in the countries that have banned the drug or its components.
Signs and Symptoms of Khat Abuse
According to the National Institute on Drug Abuse, there are a number of physical and mental effects that can be evidence of khat abuse.
Physical effects:
- Insomnia
- High heart rate and fast breathing
- Loss of appetite
- Brown staining on teeth, leading to tooth decay or gum disease
- Constipation, ulcers, and other digestive issues
- Heart arrhythmia and other heart disease
Mental effects:
- Depression
- Inability to focus or concentrate
- Irritability, anxiety, or panic attacks
- Psychosis
- Aggression and anger
- Grandiose delusions
Many of these symptoms, especially if they occur together, can result in violent behavior. Other behaviors that can generally indicate a drug use disorder involving khat include:
- Inability to stop using the drug, even after multiple attempts
- Inability to control use of the drug
- Inability to keep up with responsibilities
- Loss of friendships or troubled relationships
- Lack of interest in formerly enjoyed pastimes
- Cravings for more substance use
- Using the drug during risky behavior or in dangerous situations
If these signs and symptoms are recognized, it is possible that the individual is struggling with khat abuse.
Khat Abuse Treatment Options
Because substance abuse is chiefly a chronic mental health disorder, appropriate treatments for psychological addiction include those that are typically part of traditional drug rehab programs, including:
- Cognitive Behavioral Therapy to learn to manage and control cravings on a long-term basis
- Social therapy to provide alternatives to drug abuse
- Peer support or 12-Step programs, offering resources and support through others who have abused the drug and recovered
- Motivational programs to encourage alternatives to abusing khat
While it can be challenging to stop drug abuse, especially in the face of breaching cultural tradition, it is possible to recover from khat abuse using the same techniques that can help with addiction and other forms of substance use disorders. Making a conscious decision to change behaviors and improve current and future health takes motivation. In the long run, it is this motivation that can help individuals struggling with khat abuse to move forward with more positive behaviors and traditions, establishing a brighter, healthier future.