Khat is a flowering plant that is found natively from the Arabian Peninsula to the Horn of Africa. Chewing the leaves has been a practice among people living in that area for years because the leaves contain a stimulant. Cathinones like MDMA are derived, originally, from khat. Khat and the chemical compounds derived from it – cathinone and cathine – are controlled under Schedule I and IV, respectively, per the Controlled Substances Act and the Drug Enforcement Administration (DEA). It is also controlled or restricted in other nations around the world and through the World Health Organization.

Although ingesting khat leaves directly – through chewing, brewing into tea, or smoking, most commonly – provides 10 times less CNS stimulation than cathinones, the drug can still be very addictive and cause many short-term and long-term side effects. The main populations around the world who abuse khat are Yemeni, Somali, and Ethiopian populations, but the drug received short-term popularity among native-born Americans in the US because it was briefly legal. It is also easy to acquire online, despite being now illegal in the US.

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Desired Effects of Khat

  • Increased Energy
  • Mental Alertness
  • Physical Stimulation
  • Mild Euphoria
  • Sensory Perception Changes
  • Boosted Confidence
  • Lowered Inhibitions
  • Increased Talkativeness

Negative Effects of Khat

  • Aggression
  • Suicidal Ideatio
  • Anxiety
  • Paranoia
  • Manic Behaviors
  • Insomnia
  • Depression
  • Increased Heart Rate
  • Nausea or Vomiting
  • Anoxeria Weight Loss
  • Dental Problems
  • Pulmonary Issues

Khat can produce several effects. These can be broken down by the organ systems affected.

Desired Mental Effects

People who abuse khat typically do so for increased energy, mental alertness, or physical stimulation. These effects do occur, and they can also include a mild euphoria, sensory perception changes, boosted confidence, lowered inhibitions, and increased talkativeness.

Mental Effects

Khat’s negative effects on the brain include aggression or violence toward oneself or others, suicidal ideation, anxiety and restlessness, paranoia, manic behaviors, lowered inhibitions leading to dangerous choices, insomnia, and emotional changes during withdrawal like depression or anhedonia.

Cardiovascular Effects

Because khat is a stimulant, it can affect the heart and blood vessels. Small amounts of khat might feel like drinking a lot of coffee, which opens the blood vessels in the brain to allow more oxygen to pass through and causes the heart to pump faster. Larger doses of khat, however, can lead to radically increased heart rate, tachycardia, increased blood pressure, heart arrhythmia, heart attack, or stroke.

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Gastrointestinal Effects

Khat can affect the stomach and intestines. The drug can cause stomach pain, nausea and vomiting, and anorexia or prolonged loss of appetite leading to weight loss. A person struggling with khat addiction can also experience reduced urine output.

Dental Effects

One of the most common ways of ingesting khat is to chew the leaves. This can lead to oral and dental problems, like brown staining or discoloration of the teeth and gums, cracks in the teeth due to structural damage, cavities, gum disease, and oral cancer.

Pulmonary Effects

Smoking khat has been linked to an increased chance of developing lung issues like pneumonia, pulmonary embolism, emphysema, and lung cancer.

Long-Term Effects

Consistent abuse of khat, especially in very large doses over a long period of time, can lead to khat-induced psychosis. This mental illness is rare, although one study published on BMC Medicine found that a random assessment of 4,854 households in North-West Somalia found mental health disorders and khat use co-occurred in 8.4 percent of males ages 12 and older. Although it was difficult to tell whether post-traumatic stress or pre-existing mental illness came before khat abuse, or vice versa, the issues seem closely correlated.

Khat abuse over many years has also been linked to liver damage and failure. This condition is referred to as khat-induced hepatitis. According to LiverTox, some reports show that khat-induced liver damage can lead to fibrosis or cirrhosis.

Overcoming Khat Abuse

For people who have become addicted to khat, it is important to overcome this addiction before long-term physical and mental damage occurs. A comprehensive rehabilitation program can provide the therapeutic support and care needed to address issues of substance abuse and addiction.

Frequently Asked Questions

Khat, sometimes spelled qat and pronounced “cot,” is a very addictive stimulant drug manufactured from the Catha edulis plant, which originates in East Africa and along the Arabian Peninsula. While it is known to lead to addiction, and there are no acceptable medical uses for this substance, the Drug Enforcement Administration (DEA) lists it as a Schedule IV cathinone drug, so it is not tightly regulated compared to other stimulants, like cocaine or synthetic cathinones (bath salts).

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What drugs interact with Khat?

Khat is relatively new to the United States, and its interactions with medications and recreational drugs are not well understood. People who take medications for preexisting heart problems, blood clotting issues, lung problems, or liver problems should use extreme caution; khat will make these underlying health conditions worse and is likely to interact with the medications involved in treating these conditions, making them less effective.

Additionally, people who ingest other stimulants, including Adderall, cocaine, or amphetamines can worsen side effects from those drugs if they also take khat.

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Can you overdose on khat?

It is possible to overdose on khat, although this is not well understood among medical professionals right now. Typically, overdose symptoms are found in people who have struggled for a long time with khat addiction because they develop a tolerance to the drug and use it more and more frequently in much larger doses. Symptoms of khat toxicity, or overdose, include:

  • Delusions
  • Appetite loss
  • Trouble breathing
  • High blood pressure
  • Increased heart rate

Long-term abuse can cause liver damage and heart problems, particularly cirrhosis and myocardial infarctions. People who are predisposed to psychiatric problems, especially psychosis or schizophrenia, are more likely to induce these mental health problems if they abuse khat. Chewing khat in East Africa has led to oral cancer; using the drug in other ways may increase the chances of liver cancer, lung cancer, stomach cancer, and other cancers. The connection between using khat and cancer risk is not well understood.

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What are the comedown effects from khat?

As the body metabolizes khat out of the system, the person’s stimulation will decrease and khat’s effects will begin to wear away. This is the comedown period, and with other stimulant drugs, this period could lead to a cycle of bingeing to avoid the hangover. Whether khat produces this effect in people who take it is not well understood right now.

Symptoms of khat comedown include:

  • Depression
  • Lethargy
  • Nightmares
  • Tremor

These symptoms are similar to those associated with a comedown from other stimulants, although people who use khat self-report that they do not experience intense comedown effects. Khat might be less likely to induce a cycle of bingeing than cocaine or amphetamines.

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What forms does khat come in?

The most common form of khat is dried leaves, which can be chewed, brewed into a tea, sprinkled on or in food, or smoked. Although the stimulant chemicals in khat are most potent while the leaves are fresh, the leaves are dried or ground into a powder when imported to the US. This may dampen the intense high that fresh khat leaves can induce, so dried versions are not as potent and, thus, may not be as addictive.

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