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Khat, a potentially psychoactive drug, is not very well-known in the United States, yet the number of people addicted to it is rising. This plant-based product originally belongs to the Middle East and Africa, where the local people use it as a part of their culture to seek multiple benefits. The plant carries stimulant effects comparable to those of cocaine and amphetamine and, therefore, carries an equally high potential for abuse and addiction. Because of this, it is imperative to know what khat truly is, how it affects the body, and what can be done to manage khat addiction.

Khat refers to an evergreen plant popular among the scientific communities by the name of Catha edulis. It is native to the Arabian Peninsula and Africa, known by different names, such as kafta, Arabian tea, qat, jimaa, jaad, Somali tea, Bushman’s tea, and miraa. With a woody stem and dark green leaves, khat is a rich source of a chemical called cathine and an alkaloid called cathinone, both of which carry stimulating properties.

Many countries in the Middle East and Africa grow khat and consume it as a part of their native cultures. These countries include Uganda, Ethiopia, Djibouti, Somalia, Kenya, and Yemen, and most of them have khat-chewing cultures dating back centuries. Even today, khat remains a popular pastime on this side of the world, with an average of five to ten million people using it daily.

With time, the use of khat spread to other parts of the world, primarily through immigrants who left their home countries to settle in different parts of Europe and America. Today, it is slowly popularizing in the western world, indicated by a sharp increase in the cases of addictions related to its use.  Due to this alarming rise in khat addiction cases, most countries have declared khat an illegal or controlled substance; however, many still consider it legal. These countries where khat remains a legal substance are primarily the ones that depend on khat as a large part of their economies, such as Yemen, Somalia, and Kenya. Interestingly, this drug is even legal in South America and Israel as long as a person is consuming it in its natural form.

So far, khat remains illegal in most parts of the western world, including countries like Australia, New Zealand, Canada, the United States, and most parts of Europe. Some of these countries, like Australia and Canada, have banned khat for personal use but allow people to use it for medical reasons. The United States has no legal justification for buying, selling or importing khat into the country. In 1993, the DEA categorized cathinone, a primary component of khat, as a Schedule I drug. Cathine, another main ingredient of khat is classified as a Schedule IV drug. Additionally, the FDA also does not recognize this drug as a medication for any underlying disease.

An individual requires as little as 50 grams of khat to experience its effects. Typically, this psychoactive drug starts producing these effects within an hour of chewing the stems and leaves. These effects commonly include talkativeness, an energy boost, increased alertness, and euphoria. Many people rely on this drug to fight fatigue and enhance their social interactions.

Khat primarily comprises cathinone and cathine, two chemicals with stimulant-like properties that produce multiple effects comparable to those of amphetamine. As a person chews the stems and leaves of khat, these chemicals are promptly released and absorbed into the bloodstream through the linings of the stomach and mouth. They then enter the brain, activating their respective receptors to release hormones, like norepinephrine, epinephrine, and serotonin. These hormones collectively work to induce stimulating and pleasurable effects in the user.

Both cathine and cathinone typically persist inside the body for up to three hours, during which the liver metabolizes up to 98 percent of them. However, an individual usually feels their effects for up to an hour in most cases. Due to these short-lived effects, many people attempt to consume more than one dose of khat to experience its effects for longer. However, doing so also exposes them to long- and short-term side effects.

Short-Term Side Effects of Khat

Khat usually reacts differently for different users; hence, some may experience its side effects while others may not. Regardless, the following are some of the most commonly reported short-term side effects of khat:

  • Euphoria
  • Dry mouth
  • Hyperarousal
  • A rise in blood pressure
  • Tremors
  • Lack of concentration
  • Blurred vision
  • Constipation
  • Dizziness
  • Difficulty in sleeping
  • Increased heart rate
  • Difficulty in urinating

Long-Term Side Effects of Khat

Using khat for a long time can negatively affect the mind and body. The act of chewing its stem and leaves can take a toll on the mouth, teeth, and overall digestive health. Additionally, due to its high chemical concentration, the khat chewing effects may also alter the body and the brain in irreversible ways.

Some common long-term side effects of khat include:

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

Because every individual is different, their khat addiction recovery program may not be the same as anyone else’s. While developing a recovery plan, a mental health expert may incorporate certain elements that fit with their lifestyle, unique needs, and level and severity of the addiction.

Detoxification

The first and most crucial step of khat addiction is detoxification which involves attempting to quit khat use and getting it out of the system. Detoxification requires an individual to abstain from khat so that its chemicals are no longer present anywhere in the body. It may only take as little as 24 hours to get rid of the main active ingredients of khat from the body; however, most people need to detox much longer to combat the expected khat withdrawal.

Khat withdrawal constitutes a group of symptoms that the body develops as a response to a lack of this drug in its system. Some of the most common khat withdrawal symptoms include:

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

A detox expert typically provides medications and therapy to help addicts get through the uncomfortable khat withdrawal effects with comfort, ease, and 24/7 supervision and monitoring.

Rehabilitation

Following detox is rehabilitation, a program that provides the blueprint to addicts for quitting khat and maintaining sobriety. This program involves various evidence-based strategies to help addicts uncover the underlying issues fueling their addiction and create healthy coping mechanisms to deal with future positively in the future. Rehabilitation usually takes place in accredited treatment centers where highly-trained addiction specialists prepare each individual for the challenges they are bound to face in the world regarding their addiction and set them up for a new way of life.

Depending on individual needs, a person may opt for an inpatient program where they stay at dedicated accommodation within the treatment center and receive round-the-clock care, or go for an outpatient program where they visit the rehab every day to receive therapy and return home later on. For people who wish to choose a blend of inpatient and outpatient services may join a partial hospitalization program that includes detox, therapy, and other independent settings, like 12-step meetings.

Recovery Aftercare

Aftercare is one of the most critical parts of a khat addiction recovery plan. Considering how up to 60 percent of people who seek treatment relapse in the first month of sobriety, an aftercare program becomes mandatory to maintain a sober lifestyle. This program ensures ongoing support to ensure that every recovering addict smoothly transitions back to their life. It also includes several strategies and activities that promote sobriety in the long run, such as medically assisted therapy, cognitive behavioral therapy, and other alternative therapies, like art and nature therapy. Most people who seek aftercare for khat addiction are also provided access to addiction support groups where they meet other people with similar issues and develop robust support systems. Some rehabs keep calling their old clients for regular follow-ups for up to a year after their formal rehabilitation ends to help them get back on track with a sober life with ease.

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