Khat

Khat (Catha edulis) is a shrub-like plant whose leaves contain psychoactive substances. The most important of these are cathinone and cathine, found especially in the young leaves of the plant. [1] [2] The intoxicating effect of khat occurs when its fresh leaves are chewed. Chewing is the most common method of use. [1] [2] [3] Tea or paste can also be made from dried leaves. [4] Khat is sometimes also used by smoking. [1] [2]

Legal status: In Finland, khat is classified as a narcotic substance. Its use, purchase, sale, and possession are prohibited. [5] [6] The Supreme Court has ruled that khat does not meet the criteria for a highly dangerous narcotic. [10]

How does it work?

Khat acts as a stimulant, similar to amphetamine and other stimulants. It particularly enhances the activity of the neurotransmitters dopamine and noradrenaline in the brain. [1] [3] The effects of khat begin about an hour after one starts chewing the leaves. [1] The leaves are typically chewed for several hours until the stimulating effects wear off. [2]

Psychological effects: Desired effects of khat include increased alertness, excitement, cheerfulness, sociability, talkativeness, and self-confidence. [1] [2] [7] [8] Negative effects usually begin after about two hours of chewing: these typically include irritability, mood swings, and depression. [2] [8]

Physical effects: Khat increases heart rate and blood pressure. It also raises body temperature, causing sweating. [1] [2] [4] [7] Physiological effects of khat also include dry mouth, constipation, difficulty urinating, and reduced sexual performance. [1] [2]

Key risks

Risks of heavy use: Heavy and long-term use of khat is particularly harmful to the cardiovascular and digestive systems. [1] Khat use can lead to palpitations, arrhythmias, and high blood pressure. In the digestive system, khat can cause constipation and chronic gastritis. [2] There is also some evidence that khat may cause oral cancer. [1] [8] However, the cause-effect relationships are not fully certain, as systematic research on the health harms of khat is very limited. [7]

Acute risks: Because the mechanism of action is similar to that of amphetamine, khat use carries an increased risk of psychosis. [1] [3] Paranoid thoughts have been reported even among khat users with no family history of mental illness. [8] The intoxicating effects of khat are relatively mild. There is very little information on severe poisoning or overdose cases. [8]

Dependence: Khat is not considered to be a highly addictive drug. [3]

Use during pregnancy: Babies born to mothers who used khat during pregnancy are, on average, smaller in size. [2] [9] Khat may also cause stillbirth and reduce milk production. [9]

How can risks be reduced?

The health harms associated with long-term khat use can be avoided by using the substance as rarely as possible.

Use should be avoided if there are mental health issues in the immediate family: like other stimulants, khat use is also associated with a risk of psychotic symptoms.

People react very differently to the same substances and doses. This should also be kept in mind when it comes to khat.