Understanding Khat: Effects, Risks, and Treatment Options for Chronic Use

Khat (also known as qat/kat) is a leafy green plant that originates from East Africa, the Arabian Peninsula or the Middle East. Khat is at its most potent when it’s freshly cut, and as such, is often chewed like tobacco.

Its use in America is primarily by people who have immigrated from places like Yemen, Somalia, and Ethiopia. According to a 2013 Drug Seizure System (FDSS) study, American law enforcement seized almost 90,000 kg of Khat in the United States in 2010.

Understanding Khat

This plant contains two stimulants: cathinone (a classified Schedule I substance) and cathine (a classified Schedule IV substance).

Although the drug also contains cathine, a less addictive substance, the Drug Enforcement Agency (DEA) considers Khat (or any other drug containing cathinone) to be a Schedule I substance with highly addictive qualities.

Both stimulants are similar to amphetamine, and like amphetamines, Khat works by stimulating the central nervous system (CNS) to produce feelings of euphoria, energy, and well-being.

Cathinone is considered to be the active/potent stimulant in Khat, and Cathinone levels are at their highest when the plant is first cut. Once cut, the levels immediately start declining – which is why many people choose to chew the leaves when they are freshly cut.

However, cooling the plant will reduce the rate of Cathinone decline. Dried or dehydrated Khat leaves have shown that Cathinone can still be detected for months or even years after cutting the leaves from the plant. This is how the drug is commonly transported.

Dried Khat can be used in tea or made into a chewable paste. Other ways of ingesting Khat can include smoking or sprinkling onto food, but these are not so common.

The History of Khat

Khat is a naturally grown plant that originates from East Africa and originates from places like Yemen, Kenya, and Ethiopia but has been available in the United States since 1995.

Khat is also known by the street names Abyssinian Tea, African Salad and Bushman’s Tea.

Many substances that are commonly known in America first started out with popular use in their countries of origin and spread from there – and Khat is definitely an example of that. Over 64% of the Ethiopian population uses Khat recreationally.

Although Khat is classified as an illegal substance in most of Europe and North America, it’s been transported around the world from East Africa and the Middle East.

Khat Side Effects and Symptoms of Use

With Khat use, you experience the typical short-term effects of the drug, one of which is euphoria and feelings of well-being and high energy.

It’s this feeling that causes people to crave Khat and use it again. Because of this cycle, many people who use Khat describe not feeling quite “like themselves” without regular use of Khat – many people even equate it to how people need a morning coffee to perk themselves up for the day.

Khat users describe the effects of Khat to include:

• Euphoria or feelings of well-being
• Increased alertness and arousal followed by loss of energy and/or insomnia
• Loss of appetite
• Mood swings – aggressiveness or anxiety
• Manic behaviour, in some cases paranoia or psychosis
• Lack of concentration
• Increased blood pressure and breathing rate
• Increased heart rate

Prolonged use of Khat can lead to physical problems such as chronic migraines, dry mouth, heart problems, bronchitis, tooth or gum disease, anorexia, and liver problems. The use of Khat can also result in more psychological problems such as aggression, mood swings and depression.

Some of the dangerous (physical) side effects that can stem from chronic use of Khat are:

• Tooth decay/periodontal disease
• Gastrointestinal disorders, ulcers and/or stomach inflammation
• Cardiovascular disorders, irregular heartbeat, myocardial infarction
• May worsen pre-existing psychiatric disorders
• Liver damage
• Inability to sleep well, disturbances in sleep patterns
• Anorexia, weight loss
• Anxiety

Khat Timeline, Withdrawal and Overdose Potential

The effects of Khat have been described as very similar to other amphetamines, and because Khat is significantly less potent and addictive, many Khat users believe it’s okay to continue their chronic use of Khat. However, even with the addictive properties of this drug being significantly less than other amphetamines, Khat is still addictive and is very likely to do damage to your physical body if you continue to use it on a regular basis.

The effects of Khat typically last between 90 minutes – 3 hours, but some can linger for up to 24 hours. The peak effects of Khat are usually felt within 15-30 minutes of ingesting the leaves.

Khat is generally only consumed when it is freshly cut because, within 48 hours of cutting the leaves, the cathinone in the plants turns into cathine, which is considerably less potent. Recreational use of Khat is usually always followed by a crash, with difficulty sleeping, numbness, lack of concentration and mood swings.

People who have chronically used Khat also describe unpleasant psychological symptoms such as vivid nightmares, suicidal thoughts and loss of interest in activities that once brought them joy.

The withdrawal symptoms of Khat can include:

• Depressive state
• Irritability
• Loss of appetite
• Difficulty sleeping/insomnia
• Intense mood swings
• Psychosis

Khat and Mental Health

Chronic use of Khat can and will lead to changes in personality and can also cause various mental health issues such as increasing the risk of psychosis.

A report filed by the World Health Organization (WHO) concluded that chewing khat on a regular basis can cause persistent psychological dependence on the drug, and several studies have found negative social land economic consequences from continued use of the drug.

As possible with any substance abuse, your Khat addiction can have negative consequences in your personal life, potentially damaging friendships, relationships with loved ones and negatively affecting your work and home life. In many cases, it’s these negative impacts from prolonged drug use that deepen feelings of depression, anxiety and paranoia in people who struggle with addiction.

Effective Khat Addiction Treatment Options

Although Khat is considered a mild drug and many people who continuously use this drug don’t consider themselves to have an addiction, a 2016 study showed that more than half of the 400 Khat users enlisted in the study met the American Psychiatric Association’s criteria for a substance use disorder.

Signs that you or a loved one is abusing Khat and may need help to quit can include:

• Justifying their use because they don’t view it as a dangerous substance
• Cravings for Khat, “needing it to feel normal”
• Using Khat more frequently in order to avoid any “downtime” or crashes
• Paranoia and mood swings become more prevalent
• The use of Khat becoming more important than social activities or responsibilities such as work or family

If you or someone you know recreationally use Khat on a regular basis, you may start to realize the continued use of Khat has negative consequences in your home, work and social life.

Unlike many other substances, quitting Khat doesn’t always have to involve any kind of detoxification center or formal treatment program. Although, these services are available to you if you feel you could benefit from a detox center or inpatient addiction treatment plan.

Rehabilitation centers are often less and less about the substance you’re addicted to and more often about managing your addictive thoughts and lifestyle.

Even if you feel that your use of Khat doesn’t require treatment, treatment programs can still be extremely beneficial for you. Khat treatment programs can offer things like 12-step programs, cognitive behavioural therapies, group therapies, family counselling and individual counselling.

Participating in these types of addiction treatment options will not only help you end your Khat use but can also help you understand more about your personality and how to avoid addictive behaviours that can lead to relapse.

However, a sense of community is essential when trying to maintain sobriety. With the help of support groups, therapy, and helpful family and friends – you too can put an end to your chronic Khat use and get back to leading a healthy, happy, substance-free lifestyle.