Drug Guide

Catha Edulis (Khat)

By Anthony McDaniel, M.D.

Khat is a flowering plant native to tropical East Africa and the Arabian Peninsula. Khat contains the alkaloid called cathinone, an amphetamine-like stimulant which is said to cause excitement, loss of appetite, and euphoria. In 1980, the World Health Organization classified khat as a drug of abuse that can produce mild to moderate psychological dependence (less than tobacco or alcohol). The plant has been targeted by anti-drug organizations like the DEA. It is a controlled or illegal substance in many countries, but is legal for sale and production in many others. Khat consumption induces mild euphoria and excitement. A meta-analysis in The Lancet has stated that khat creates a pleasuring effect to the same degree as ecstasy. Individuals become very talkative under the influence of the drug and may appear to be unrealistic and emotionally unstable. The effects of oral administration of cathinone occur more rapidly than the effects of amphetamine, roughly 15 minutes as compared to 30 minutes in amphetamine. Khat can induce manic behaviors and hyperactivity. The use of khat results in constipation. Dilated pupils (mydriasis) are prominent during khat consumption, reflecting the sympathomimetic effects of the drug, which are also reflected in increased heart rate and blood pressure. A state of drowsy hallucinations (hypnagogic hallucinations) may result when coming down from khat use, as well.

Withdrawal symptoms that may follow occasional use include mild depression and irritability. Withdrawal symptoms that may follow prolonged khat use include lethargy, mild depression, nightmares, and slight tremor. Khat is an effective anorectic (causes loss of appetite). Long-term use can precipitate the following effects: negative impact on liver function, permanent tooth darkening (of a greenish tinge), susceptibility to ulcers, and diminished sex drive.

Regularly khat use compromises the ability to inhibit undesirable behavior. Frequent use was shown to decrease self-control, with all the potentially dangerous consequences this implies. Researchers, led by Dr. Lorenza Colzato, employed the "stop-signal task" This task requires participants to react quickly and accurately by pressing a left or right key in response to the direction of a left- or right-pointing green arrow. However, in the case that the green arrow turned red, participants had to abort the go response. Compared to non-users, Khat users performed similarly in terms of response initiation but need significantly more time to inhibit responses to stop signals than non-users. This impairment has several implications in stopping particular activity or response. Many real-life situations require the well-performance of this cognitive process, as the case of traffics lights turning red or of criminal actions. This cognitive impairment has serious implications for personal and societal functioning.

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