Twenty million people worldwide use khat. While it has traditionally been a custom associated with older Muslim men, khat’s use has expanded to include women and younger people. In Eastern Ethiopia, nearly 30% of adolescent girls and over 70% of adolescent boys chew khat. Cathinone is a Schedule I Controlled Substance. Khat is illegal in the United States and Canada, but is legal in many other parts of the world, including Ethiopia, Somalia, Yemen, and Kenya, where is it commonly seen as a food rather than a drug (much the way that coffee is viewed in the United States). Also Known As: Qat, Kat, Chat, Miraa, and Quaadka Drug Class: Stimulant (khat has a stimulant effect when chewed that is similar to the leaves of the coca plant, which is used for making cocaine) Common Side Effects: Increased respiration, elevated blood pressure, heart arrhythmias, and dilated pupils; regular use can cause tooth decay, gum disease, ulcers, and constipation
What Does Khat Do?
Khat’s effects are similar to those of other stimulants, such as caffeine. People who use khat may become talkative, alert, elated, and experience euphoria. Some people report feeling increased self-esteem. Others describe increased imagination and ideas. People who use khat typically chew fresh leaves, because the active components of the plant break down quickly as they dry out. Dried leaves are sometimes used as a tea, although the effects are less potent. Khat is usually chewed, with people typically holding the chewed leaves in their cheek for several hours, chewing periodically. Chewing sessions typically last 3 to 4 hours. When people from these countries migrate to other parts of the world, they often use the social act of chewing khat to maintain a sense of connection to their community. The practice has lead to the development of an international drug trade for khat.
What the Experts Say
According to the World Health Organization (WHO), the effects of khat consumption are similar to those of strong coffee. Research published in 2011 suggested the effects of khat are seen in the central nervous, cardiovascular, respiratory, endocrine, gastrointestinal, and genitourinary systems.
Other Uses
Khat has no approved or evidence-based medical uses in the United States. In countries where its sale and use are legal, khat is sometimes used to treat fatigue, headaches, colds, and depression. People also use khat to experience the effects of euphoria, increased energy, and appetite suppression.
Common Side Effects
Since it is only a mild stimulant, people sometimes mistakenly believe that khat does not have any serious side effects. But though khat is a relatively low-risk drug, it’s associated with an increased risk for a variety of medical complications, including:
Blurred visionConstipationDental diseaseDizzinessHeadachesHemorrhoidsImpotenceWeight loss
It’s unclear whether the health risks associated with khat use are directly related to the drug cathinone, the consumption of caffeinated drinks that intensify the high, or if they’re partially related to inhalation of second-hand smoke in poorly ventilated chewing houses. Additionally, many people who use khat do not wash the leaves before chewing (they believe washing the leaves will reduce the drug’s potency), so some of these health problems may also be the result of toxic pesticides. Mental health conditions associated with khat use, including psychosis, have been documented but are not well understood. Khat use is also associated with symptoms of depression, mood swings, and violent behavior. Research has indicated that khat use can cause relationship and social difficulties, particularly when its use takes men away from their families for extended periods and when a large amount of money is spent on the drug.
Signs of Use
If you are concerned that a loved one is using khat, there are some behavior and physical signs and symptoms you can look for. Signs that someone is using khat can include:
IrritabilityChanges in sleep habitsHigh blood pressureExcitability or hyperactivityDepressed moodLack of appetiteWeight loss
Tolerance, Dependence, and Withdrawal
Chewing khat releases the drug slowly. It does not produce the immediate and intense high of addictive drugs such as cocaine and meth. Khat chewing is traditionally an all-male social activity. Women who chew khat tend to do so alone and in secrecy, putting them at increased risk for dependence.
How Long Does Khat Stay in Your System?
Once consumed, the effects of khat peak after approximately 15 to 30 minutes. The drug has a half-life of approximately three hours.
Addiction
Khat might be an addictive drug. The substance is believed to create a physical addiction similar to that of caffeine. However, it is hard to differentiate dependence from addiction to the psychoactive compounds in khat, as there is a lack of criteria to make such a determination. Research has found that khat use is often associated with the use of other addictive substances. For example, a 2011 study of Yemeni subjects living in the UK found an association between nicotine use and khat chewing. More research is needed to determine the addictive potential of khat.
Withdrawal
The severity of withdrawal symptoms ranges from mild to severe, depending on the frequency, amount, and duration of the person’s khat use. The symptoms people experience when withdrawing from khat tend to be relatively mild. The possible symptoms of khat withdrawal include:
Mood changes Cravings Irritability Depression
How to Get Help
The type of help you will need (and how much help you need) if you want to stop using khat will depend on how long you have been using, how much of the drug you use, and the severity of the symptoms you have related to using and stopping khat. People who use khat recreationally might be able to stop taking the drug with a combination of guidance from their doctor, a social support network, and self-help strategies. However, people who have been using khat for a long time (chronic use), or who use large amounts of the drug might need more resources and help to quit. If you or a loved one wants to stop using khat, start by talking to a trusted doctor or mental health care professional. They can help you find the right type of treatment and support. Behavioral treatments, including cognitive behavioral therapy, can be effective for people who want to stop using substances. For more mental health resources, see our National Helpline Database.
