Khat: A widely used drug of abuse in the Horn of Africa and the Arabian Peninsula: Review of literature

Khat or Catha edulis, is a flowering plant most commonly found in countries of the African Horn and the Arabian Peninsula. Khat chewing goes far back in history and has always been a kind of tradition in some of these countries. Khat contains an alkaloid, cathinone, an amphetamine-like stimulant believed to cause excitement, loss of appetite, and euphoria. Khat is therefore classified by the World Health Organization as a possible drug of abuse but with less addictive potential than alcohol or tobacco. Khat has been targeted by many anti-drug organizations around the globe and is outlawed in Qatar. However it is legal and widely used in the nearby country of Yemen. Despite all the obstacles and severe legal consequences on any attempt to smuggle in the plant to Qatar, patients may still present with one of the complications of Khat abuse (Figure 1). The earliest description of Khat in western literature was in 1697 by the French Barthélémyd'Herbelot de Molainville when he travelled to Yemen, he specifically said (translated) "[It] is made with a seed which is unknown to us, which has been forbidden by the doctors of the law in the province of Yemen where it originated . . . .because it is too strong, and affects the brain". However it was not until 1975 that the Laboratories of the United Nations first discovered that cathinone was the biochemically-active ingredient of Khat. In this article we present a short review of this plant as an example of a drug of abuse that is particularly common and is relatively over-used in the Middle East and North Africa mainly Somalia, Djibouti, and Kenya. As Yemen has the largest population in the world consuming Khat, most of the information presented and discussed in this paper concerns that country (Figure 2). OPEN ACCESS