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AKA: Chat, Qat, Miraa, and numerous other names. Khat is one of the many names for the plant Catha Edulis. The plant Khat contains the psychoactive compounds cathinone and cathine, amongst others.
Drug Category: Cathinone and Cathine are stimulants with a significant euphoric action. These active components are phenylalkylamines and are structurally similar to amphetamines.
SOURCE: The plant is grown extensively in Sub-Saharan Africa, especially Kenya, Eritrea, Ethiopia, Somalia, and The Yemen. In addition to use in-country it has been exported to other countries, either for use there by immigrant communities re-exportation.
Prior to legal changes in June 2014, Khat was exported to the UK where it was used in-country and exported to countries where it was illegal.
Before the prohibition of Khat it had been openly sold in the UK, from street markets, taxi offices, local shops, and also from Mafrishes. The mafrish is a place where Khat is communally chewed. They can be found in London and other UK cities.
APPEARANCE: Bundles of twigs, with leaves attached. The twigs are often wrapped in palm leaves to maintain freshness. Leaves are also sold by the bag, stripped from the plant.
Dried leaves are also used, though held to be less potent.
COST: Prior to prohibition, £3-5 per bunch
DOSE RANGE: a moderate user may get through a bunch of khat over the course of a day, or in a chewing session. Heavier users may get through several bunches a day.
QUALITY: Variable: Khat varies in strength, and its strength also deteriorates after the plant is picked. Some users will argue that the quality of khat varies with country of origin, and the grade of the product harvested.
METHODS OF USE: Khat is usually chewed. The leaves and soft pulp are placed in the mouth and masticated for a long period of time. Khat chewing is frequently treated as a social activity, taking place in small groups and lasting for several hours at a time.
Dried leaves are also used. They are rehydrated and made in to tea or chewed. Some users also chop leaves finely for use in (for example) salads.
MECHANISM of ACTION: The active compounds are believed to elevate levels of dopamine and nor-adrenaline. The dopaminergic activity causes significant feelings of euphoria, reward and arousal. The nor-adrenal activity causes restlessness, excitement, anxiety and increased energy.
EFFECTS: Cathinone and cathine are stimulants. The effects are similar to amphetamine, but milder. They increase energy, reduce appetite, and cause users to become talkative and animated. As with amphetamine, some people will experience anxiety and possible irritability during use. Post-use, there is likely to be a come-down which could include fatigue, low mood and craving.
Some users claim that they can enhance sexual arousal and performannce.
HEALTH IMPLICATIONS: Excessive use can cause a range of symptoms including irritability, paranoia, insomnia and weight loss. Unless discontinued, it can, in extreme case, lead to psychosis.
As a stimulant, khat increases heart rate and blood pressure.
Frequent chewing can cause tooth and gum damage, and jaw problems. Chewing in unhygienic settings can lead to health problems.
Heavy use can lead to a significant come-down, craving and dependency.
INDICATORS of USE: Khat is probably one of the easiest drugs to identify during use. The presence of herbal material, specifically leaves, stalks or bunches of khat is distinctive. Some users may chew and spit, leaving green residue with leaf material. There may be green staining to teeth.
If no plant material is present, nor staining of teeth, then khat use is hard to differentiate from another stimulant. The presenting symptoms could include elevated blood pressure, elevated heart rate, perspiration, faster breathing, agitation and restlessness. However this could be caused by other stimulants, not just khat.
LEGAL STATUS: Cathinone and Cathine are controlled drugs (added in 1986). Khat is a Class C, schedule 1 compound. It was added to the Misuse of Drugs Act in June 2014. Prior to 2014 possession of Khat plant was legal.
The Government and ACPO agreed that khat possession would be policed in a similar way to cannabis, with simple possession being handled with three tiers of response: a first offence resulting in confiscation and a "khat warning." A second offence can result in a PND and third offence arrest and criminal proceedings.
The supply of khat, importation and allowing premises to be used for khat supply are treated as more serious offences and not the subject of this warning system.
TRENDS: The ACMD says "Most of the prevalence data comes from the Somali community. Figures range from 34% to 67% of the Somali community who identify themselves as current users of khat. The figure of 34% is from the highest power study and likely to be the most accurate figure." This figure is similar to reported levels in Somalia (in anything the Somali figures were slightly lower).
There is no evidence about if trends had been rising or falling prior to prohibition.
OTHER INFORMATION: Khat use is common in certain cultural settings, and has been practised for many centuries in certain areas of East Africa and the Arab Peninsula. Use in-country is the source of much controversy and debate.
For some, khat has been considered a mild stimulant and export crop. It has been likened to strong coffee, and tolerated as a traditional and cultural activity.
Others viewed it as resulting in physical and mental health problems, an expensive vice, and something to be discouraged.
Khat use has been a significant issue during armed conflict, increasing anxiety and energy amongst soldiers and used to embolden and desensitise child soldiers.
Khat use in the UK has been the subject of ACMD scrutiny who explored whether or not it should be made a controlled drug. This was in light of escalating and problematic UK use, especially amongst young Somali men. Whereas use of Khat had traditionally taken place in social settings and was often generally not sustained for long periods, young Somali khat users were reported to be chewing daily, for extended periods of time. Such heavy use brought with it higher levels of physical and psychological risk.
However the ACMD had, to date, declined to advocate adding Khat to the list of controlled drugs, fearing that to do so would drive the drug, and problems related to use, deeper underground.
Khat use has not been taken up beyond its cultural users, and is not popular with other stimulant users.
However, despite ACMD recommendations, the Government decided to add khat to the list of controlled drugs, citing health fears, community integration, fears of the UK becoming an export hub for khat, and claiming links between khat trade and religious fundamentalist groups.
Khat and cathinone should not be confused with 4-methylmethcathinon (4-mmc). 4-mmc is a 'substituted cathinone,' sharing the same core structure as cathinone. Although in the same chemical family as cathinone it was not made directly from cathinone or extracts from the khat plant, but instead in a synthesis from other compounds, including ephedrine.

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