Khat Abuse and Addiction Treatment Options

What Is Khat?

Khat is an evergreen plant with the scientific name Catha edulis. It is native to the Horn of Africa and the Arabian Peninsula. Khat goes by many names including qat, jaad, jimaa, kafta, miraa, Arabian tea, Somali tea and bushman’s tea. The plant has dark green leaves and woody stems that contain the alkaloid cathinone and a chemical called cathine, both of which are stimulants.

Growing khat is relatively easy because it only requires water and sunlight. It grows best in hot, arid climates. However, it is a slow-growing plant that takes about seven to eight years to grow to its full size. This can be anywhere from three feet up to 33 feet in areas along the equator. In some countries such as Yemen, khat growing is a major industry.

Many cultures in the region where khat grows have a long history of consuming the plant. This includes Yemen, Kenya, Somalia, Djibouti, Uganda and Ethiopia. In many of those countries, khat chewing dates back centuries and even predates coffee consumption. Today khat chewing is still a popular pastime in this part of the world. Research shows that the global estimated number of people who use khat daily is between five and 10 million people¹https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4804659/.

How Do People Use Khat?

The most common way that people use khat is by chewing the leaves and the soft parts of the stems. This releases the cathinone alkaloid. Some people chew khat on its own, while others chew it with food or chewing gum to help mask the flavor and break down the leaves and stems. The khat leaves and stems can also be steeped in hot water and consumed as a tea.

Is Khat Legal?

Khat is an illegal or controlled substance in some countries, but it is legal in other countries. Most of the countries that have histories of traditional khat use do not have laws against khat production, sales or use. Many of these countries depend on khat as a large part of their economies. These include Yemen, Ethiopia, Somalia, Djibouti and Kenya. Khat is also legal in South America and Israel if it is consumed in its natural form.

Khat is illegal in most Western countries, including the US, Canada, Australia, New Zealand and most European countries. Some countries such as Canada and Australia ban it for personal use but allow it for medical use. Others do not allow it for any type of use including for medical reasons.

There is no legal justification to buy, sell or import khat in the United States. In 1993, the DEA classified cathinone as a Schedule I drug²https://www.dea.gov/sites/default/files/2020-06/Khat-2020_0.pdf under the Controlled Substance Act in the United States. Cathine is the other active stimulant ingredient in khat, and it is classified as a Schedule IV drug. In addition, the FDA has not approved khat as an accepted drug for medical use.

How Does Khat Affect the Body and Mind?

It only takes about 50 to 70 grams of khat to produce effects. Khat users typically feel effects within an hour of chewing khat leaves and stems. These include euphoria, increased alertness, a boost in energy and talkativeness. Many people use khat to enhance social interactions and to fight fatigue.

Cathine and cathinone are stimulants, so they produce the same types of effects as amphetamine. Chewing the khat leaves and stems releases the chemicals, which are then absorbed into membranes in the mouth and stomach lining. The cathine and cathinone activate receptors in your brain that release hormones including serotonin, epinephrine and norepinephrine. These produce the feel-good and stimulating effects of the drug.

The chemicals cathinone and cathine typically stay in your body for up to three hours. Your liver metabolizes up to 98 percent of the substance in your body. However, you may only feel the effects for up to an hour. This is why many people consume more than one dose of khat over a few hours.

Short-Term Side Effects of Khat

Khat reacts differently with each person, so some people may experience side effects, while others do not. These are a few of the reported side effects of khat:

• Alertness
• Euphoria
• Increased energy
• Arousal
• Talkativeness
• Lack of concentration
• Blurred vision
• Dry mouth
• Dizziness
• Rise in blood pressure
• Increased heart rate
• Tremors
• Difficulties sleeping
• Constipation
• Difficulty urinating
• Lack of appetite

Is Khat Addictive?

Numerous studies suggest that khat can be highly addictive³https://applications.emro.who.int/emhj/v23/03/EMHJ_2017_23_03_236_244.pdf?ua=1&ua=1, especially when users take it frequently and for long periods. Khat can cause physical and psychological dependence because users may constantly chase the euphoric and energizing feelings it can provide. This can cause a wide range of problems. Some users spend money they can’t afford on khat. Others exhibit a decrease in productivity, which affects their earning potential.

Khat users may find that their tolerance to khat increases over time. This means they need stronger doses to produce the same effects as before. Users may find that they rely on the drug for social interaction or to increase energy levels. In addition, users who abruptly stop taking khat regularly may find that they experience withdrawal symptoms that can be very uncomfortable.

Khat Withdrawal Symptoms

• Depression
• Irritability
• Insomnia
• Loss of appetite
• Lethargy
• Migraines
• Low motivation
• Slow reaction times

Long-Term Side Effects of Khat

Frequent khat use over an extended period can have negative effects on the body and mind. Just the act of chewing on the leaves and stems can take its toll on the teeth, mouth and gastrointestinal system. In addition, chemical stimulants can cause reactions in the body and brain that may not be reversible. Long-term side effects can include:

• Insomnia
• Anxiety
• Malnutrition
• Cardiovascular damage
• Gastrointestinal disorders
• Periodontal disease
• Liver damage
• Impotence
• Hemorrhoids
• Teeth discoloration
• Oral cancers
• Psychotic episodes including hallucinations, paranoia and delusions

The Psychological Impact of Khat

While khat can be physically damaging, it is the psychological effects that many people are more worried about. One study in Ethiopia found that khat chewers were 25 percent more likely to be depressed than non-chewers⁴https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5317140/. It also reported higher instances of anxiety among khat chewers. Another paper suggests a link between heavy and prolonged khat use and psychotic episodes and symptoms.

One reason that khat may contribute to psychological issues is that the chemicals in the plant react with receptors in the brain. Cathinone encourages the brain to release dopamine and serotonin, both of which are feel-good hormones. When these hormones are constantly overproduced, they can cause imbalances that affect cognitive ability and emotional balance.

How to Treat Khat Abuse

Battling khat addiction may seem overwhelming, but it is possible with the right support. If you or someone you know has become dependent on khat, the best thing to do is seek professional help. Get in touch with an addiction recovery center like Windward Way Recovery to discuss what options are best for you. The experts at Windward Way Recovery can create a customized plan that will help you or someone you care about kick the habit for good.

What to Expect From a Khat Recovery Program

Every person is different, so your khat recovery program may not be the same as another person’s. When developing a recovery program, it is important to incorporate elements that fit with your lifestyle, level of addiction and unique needs.

Detoxification

The first step on the road to recovery is quitting khat use and getting it out of your system. Detoxification involves abstaining from a substance so that the chemicals in the drug are no longer present in the bloodstream and body. It only takes about 24 hours for the liver to absorb the main active ingredients in khat (cathine and cathinone). However, you may need to detox longer to help combat cravings and prevent using again.

Rehabilitation

A rehabilitation program is like a blueprint for quitting a substance and staying sober. Rehab goes beyond just detoxification. It involves various strategies to help you uncover the underlying issues behind your addiction and create coping mechanisms for dealing with your addiction in the future. A rehab program can also help prepare you for the challenges you will face in the world and set you up for a new way of life.

Depending on your needs, you may want to opt for an inpatient program where you live in a residential center and receive 24-hour clinical care. If you are confident in your ability to live outside the center without using, you can choose an outpatient program. A partial hospitalization program is another option that includes elements of inpatient and outpatient programs including detox, therapy sessions and independent activities such as a 12-step program.

Recovery Aftercare

Aftercare is often overlooked, but this is one of the most crucial parts of any recovery plan. Studies show that up to 60 percent of addicts relapse in the first month after rehab. Over 80 percent will relapse in the first year. An aftercare program provides ongoing support to help adjust to life after addiction. Having this support can make a huge impact in staying successfully sober.

Recovery aftercare can include a variety of activities and strategies that encourage sobriety. An aftercare program can include various therapies such as cognitive-behavioral therapy, medically assisted therapy or alternative therapies, such as nature therapy. It can also include membership in an addiction support group, healthy activities like yoga and sports and reliance on a sponsor.

Khat use can quickly turn from a casual social activity into a full-blown addiction. Even infrequent use can be considered abuse if it is sustained over a long time. This can lead to a wide range of physical and mental issues including insomnia, gastrointestinal issues and even psychotic episodes. Seeking professional help is the first step in making a positive change for a healthier, substance-free lifestyle. Contact Windward Way Recovery to find out how we can help you change your life for the better.