Khat Addiction: Effects and Treatment

People may use khat, the leaves of a plant commonly grown in Africa, for its stimulant and euphoric effects.¹ Khat may have a high potential for misuse and doesn’t have any known medical use.² It may have the potential to cause psychological dependence and other adverse effects; however, little is known about whether khat addiction can occur because of long-term misuse.³

This page will explain what khat is, if it is addictive, the effects it can produce, and more.

What is Khat?

Khat is a flowering evergreen shrub or small tree with leaves that are chewed for their stimulant effects.^1,2 It is commonly used in the Southwestern Arabian Peninsula and East Africa, but in recent years, its use has risen in other parts of the world.^2,4 People primarily use khat by chewing the leaves like tobacco, but it can also be made into tea, a chewable paste, or sprinkled on food.²

The chemicals in khat, cathine and cathinone, are controlled under the Controlled Substances Act.² Cathinone is a Schedule I substance, meaning that it has a high potential for misuse, no currently accepted medical use in the U.S., and a lack of accepted safety for use under medical supervision. Cathine is a Schedule IV substance, meaning it has a potential for misuse, but lower than substances listed in other categories.^2,5

Is Khat the Same as Bath Salts?

Khat is not the same as bath salts. Bath salts are synthetic stimulants that contain chemicals that are like cathinone, which is a key active ingredient in khat.⁶ Bath salts are part of a new group of substances known as new psychoactive substances (NPS), which are unregulated.⁶

Bath salts can be more potent and potentially more dangerous than khat.⁶ Unlike khat, which is a natural substance, bath salts are manmade and usually look like a white or brown crystal-like powder.⁶ They are sold in plastic or foil packages labeled “not for human consumption.” This is thought to be done to divert attention from the fact that these products are made to be misused for their psychoactive and stimulant properties.^6,7

Bath salts addiction is possible, and people have reported experiencing withdrawal symptoms, such as depression, anxiety, tremors, and paranoia when they stop using it.⁶

Effects of Khat

Khat can have different effects depending on factors like whether the leaves are used fresh or dried, as the chemical content of cathinone is usually higher in fresh leaves. However, the level of psychoactive chemicals can also vary widely depending on the source.¹

Khat mainly produces effects on the gastrointestinal system and central nervous system, or CNS.¹ Khat stimulant effects are like those produced by other stimulant drugs, such as cocaine, amphetamine, and methamphetamine.²

Potential physical and psychological effects of khat can include:

• Constipation.¹
• Brown stains on teeth.²
• Urinary retention.¹
• Increased alertness.¹
• Migraines.¹
• Increased blood pressure. ¹
• Tachycardia (rapid heart rate).¹
• Arrythmias.⁸
• Pulmonary edema.⁸
• Gastric disorders and problems such as constipation, gastritis, and ulcers.^2,8
• Impaired sexual potency in men.¹
• Insomnia.¹
• Anorexia.¹
• General malaise.¹
• Irritability.¹
• Manic behavior, such as grandiose delusions, paranoia, nightmares, hallucinations, and hyperactivity.²

Chronic use of khat can cause long-term effects such as exhaustion, violence, and suicidal depression.² People who chronically use large doses of khat may experience liver damage, including hepatitis, fibrosis, and cirrhosis, and cardiac complications, such as heart attacks.^2,8

Is Khat Addictive?

Khat misuse does show signs of the potential for addiction; however, there is not much conclusive research regarding its addictive potential by Western researchers.⁹

Cathinone and cathine are the main chemicals in khat that have psychoactive effects.⁸ Using khat affects dopaminergic and serotonergic actions in the central pathways of the CNS, resulting in a variety of effects.⁴

Some research has shown that cathinone can increase levels of dopamine, a brain chemical that is strongly associated with reinforcing and rewarding behaviors, like addiction, which may explain why people continue to use khat despite the negative consequences.⁸

Signs of Khat Addiction

There are no specific diagnostic criteria for khat addiction in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the handbook mental health practitioners use to diagnose psychiatric disorders.^4,9

Some research has shown that people who use khat experience symptoms that are consistent with some of the general criteria for addiction (or substance use disorder) in the DSM-5, including compulsive substance use and withdrawal symptoms.⁹

Some criteria for SUDs include:¹⁰

• Using more of the substance than originally intended.
• Expressing a persistent desire to cut down or control substance use but being unable to do so.
• Spending a great deal of time obtaining, using, and recovering from the effects of the substance.
• Cravings, or strong urges to use the substance.
• Recurrent social or interpersonal problems due to substance use.
• Tolerance, meaning you need to use more of the substance to experience previous effects.
• Withdrawal symptoms when you stop using the substance.

Can You Overdose on Khat?

It is possible to overdose on khat.² The exact amount that is needed to cause an overdose is unknown.² One study found that using MAO inhibitors along with khat may increase the risk of overdose.⁸

Symptoms associated with khat overdose may include:²

• Delusions.
• Appetite loss.
• Breathing difficulty.
• Increased blood pressure and heart rate.

Treatment for Khat Addiction

More research on treatment for khat addiction is needed. However, if you or a loved one are struggling with khat or any other type of substance misuse, or display symptoms of addiction, treatment may be helpful.

Treatment can take place in different settings, including inpatient rehab or an outpatient drug treatment center for stimulants.

Stimulant addiction is commonly treated with behavioral therapies.¹¹ During rehab, you may participate in therapies such as:

• , which helps people learn different coping skills and ways to avoid substance use.⁶
• , also known as motivational incentives, which involves providing rewards for positive behavioral changes, such as negative drug screens.⁶
• , which helps people explore and resolve their ambivalence to change.¹¹

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