As of today, khat is now banned as a class C drug in the United Kingdom . . . and I’ll spare you the “I prefer dogs” jokes, they’re all pretty lame. But in a sentence, khat is a plant chewed by individuals of Horn of African decent for it’s stimulant properties. So while many countries are rethinking their stance on drug prohibition, with even states from the US legalizing recreational marijuana, the UK saw fit to criminalize yet another plant/drug. Being an American, I naturally assumed that khat was already banned in the UK, as it has been in the US for over 20 years. Silly me. From both a philosophical and toxicological viewpoint, khat is an interesting plant with a long history and intriguing chemical properties. Exploring both will help gain insight as to how we got where we are today, so we’ll start there.

Chewing khat by Ferdinand Reus (CC BY-SA 2.0)

Khat (kat, or quat), Catha edulis, is a plant native to the Horn of Africa and the Arabian Peninsula. For the geographically challenged – OK, me – that’s primarily the countries of Ethiopia, Somalia, Yemen, and Saudi Arabia. The chewing of khat dates back nearly 800 years in the area known today as Ethiopia, and over the years spread into Somalia (1). Even in those regions however, khat use was controversial, and at various times banned by local governments. As a historical example of how prohibition failed in Somalia, the British, in 1921, passed a law forbidding the growing and sale of khat. Khat was then smuggled into the country, and areas that had not traditionally used khat before, started chewing. And in the 1950’s “khat chewing spread to southern Somalia as more and more Somalis took up the habit as an act of defiance against colonial authority” (1). And today, it is a routine and integral part of society. When people and families from khat-chewing nations immigrated to the UK, they brought their habits with them.

So what’s the deal with khat? Most people don’t chew on bitter leaves solely as an act of defiance, so there must be something to it. And there is. In fact, some pretty cool history, chemistry, and mystery.

The lore surrounding the “discovery” of khat explains some of its physiological properties, though it sounds surprisingly like that of caffeine and horny goat weed. A goat herder in Yemen noticed the effects on his goats when they ate from the plant. He ate some himself and noticed the effects (2):

“he experienced wakefulness and added strength, and took some home and consumed a small amount before retiring for the night. He had no sleep that night and was able to stay up to pray and meditate for long hours.”

Though it sounds suspiciously like a gamer’s Mountain Dew high, it’s not caffeine that gives khat its kick. In 1930 the chemical cathine (d-norpseudoephedrine) was isolated from dried khat leaves (3), but something still didn’t seem right. The potency and stimulant effects of khat didn’t match up with those of cathine, a fairly mild stimulant. Khat was much more potent than an equivilant dose of cathine. It wasn’t until around 1970 (4) that another chemical was discovered: cathinone. Cathinone is structurally similar to amphetamine, and is the backbone of the designer drugs known collectively as “bath salts”. It is around five-times more potent than cathine, and its effects are stimulation of the central nervous system, and include euphoria, excitation, hyperthermia (increased body temperature), anorexia, logorrhea (increased talkativeness) and sensory stimulation (5). It works by blocking both dopamine and serotonin reuptake systems, meaning that it increases the extracellular concentrations of these neurotransmitters. Increased dopamine is associated with the stimulation and anorexia effects, and serotonin with a general sense of well being. Cathinone is often described as a mix between amphetamine and cocaine, at least from a pharmacology point of view, not from a societal one.

The mystery is why it took 40 years after the discovery of cathine to identify the primary stimulant cathinone. Both cathinone and cathine are present in khat in roughly equal amounts – about 1 milligram per gram of khat (6). But because these chemicals are from a biological source, their concentrations and ratios to each other can vary wildly depending upon location, time of year, and growing conditions. So how was it missed?

Bundles of khat by US DEA (publc domain)

Cathinone is not stable, and appears to be a biosynthetic intermediate in the khat plant. Younger leaves and shoots have higher concentrations of cathinone, while more mature parts have less, and higher concentrations of cathine (7). Whether this is by the plant’s design, I’m not sure, because this can be replicated in the laboratory. Once picked, cathinone is quickly reduced to cathine, and once dried contains little cathinone – something that forensic chemists have to deal with even today (8). Researchers from the early days all worked with dried khat material, explaining the lag in identifying cathinone, and also the reason why, once harvested, khat is wrapped in banana leaves, kept moist, and quickly transported and sold. This phenomenon makes the “shelf life” of khat around four days.

Once harvested and sold, the typical user – which is almost always a male – will place a wad of leaves in his mouth and chew away, effectively extracting out cathinone. Effects kick in quickly, but subside after 1-2 hours, requiring re-dosing if desired. Users are typically in a social setting, akin to a bar, chatting away loquaciously.

As a point of reference, in the US cathinone was placed into schedule I of the DEA controlled substances list in 1993 – meaning that it has a high potential for abuse and no accepted medical value, such as heroin.

So what is the UK’s problem with khat? From what I can gather, and believe me, it’s more complex than this, it’s three fold: 1) immediate health effects, 2) psychosis, and 3) integration with family and society. I’ll cover each one quickly, with a bit of commentary.

Immediate health effects: This primarily concerns the stimulant effects, which could trigger anxiety, aggression, or other bizarre behavior. This is dumb. Stimulants like caffeine or nicotine do the same thing. Then there is the damage to the teeth and gums – which I admit can be extreme . . . and gross – but these are grown men, if they wanted to chew on rocks and fracture their teeth, they should be able to do so without any governmental restrictions.

Psychosis: This is a big one, in which some researchers have postulated that chewing khat could trigger psychosis. There was some bad science going on here. It’s akin to “Seattle has high rates of suicide, Seattleites consume more caffeine than the rest of the country, therefor we must ban Starbucks.” Not so cut and dry is it? In short, meta-analysis – looking at the combined results of many different studies – has shown there to be no link to psychosis (6):

“the current data is not sufficient enough to imply a causal relationship between khat chewing and long-term psychopathology. Studies claiming such associations have been criticized for not being based on rigorous clinical evaluations.”

 Integration with family and society: Of concern is the East African immigrants staying up all night chewing on the stimulating khat and having stimulating conversations, then going home exhausted and tired and ignoring their family and familial duties. Replace khat with alcohol, and you’ve described the pub scene and half the UK. I’m just kidding, but you get the idea. I admit, this is a concern, but you don’t legislate because of it.

What we have here in the UK is a moral panic. What’s a “moral panic”, you ask? It’s a condition, a mania so to speak, in which the perceived fears of the public, and government interventions, greatly exceed the real “threat.” Some examples in the US center around video games and music associated with school shootings or role playing games for advocating satanism. After time goes by, it is apparent how silly and misguided it all was. Just ask those that lived through the McCarthy era. And the targets of moral panics are usually those in the minority, as they don’t have the voice or support to stand up for themselves, much like the UK’s Somali and Ethiopian population.

But don’t misunderstand what I  am saying here, khat use isn’t necessarily harmless. There are absolutely physical, mental, and societal implications associated with khat use. I just find them to be grossly exaggerated. Taking all forms of harm into consideration, I’d place khat above coffee, but below tobacco and alcohol. Do I think anyone should use khat? No. Use tobacco? No. Use alcohol? No, but I do at times.

So what’s the downside to the ban on khat? Well, it will make those that break the law criminals, for one, placing another burden on an already stressed population. Loss of jobs in the UK and abroad is another. But one thing that most people haven’t discussed revolves around that cathinone instability I mentioned earlier. As the transport of khat moves from simple shipment to smuggling, the amount of time to enter the UK will invariable increase, while cathinone concentration decreases. The recipient may not like the less potent khat, and in response an unscrupulous seller may spray the leaves with cathinone or its synthetics (a.k.a. “bath salts”) to increase the stimulant properties. Now we’ve got a bigger problem with dosing and unknown effects and toxicity.

If you’ve made it this far, thank you, I owe you one. I’m just hopeful that over time the UK will see the error in their ways and reverse their decision. I’ve had my fill of moral panics for the year.

*** Homepage featured image of khat leaves by Neil Palmer (CC BY-SA 2.0) ***

References:
1. Gebissa, Ezekiel. “Khat in the Horn of Africa: Historical Perspectives and Current Trends.” Journal of Ethnopharmacology 132.3 (2010): 607-14.
2. Getahun, Amare, and A. D. Krikorian. “Chat: Coffee’s Rival from Harar, Ethiopia. I. Botany, Cultivation and Use.” Economic Botany 27.4 (1973): 353-77.
3. Wolfes, O. “Über Das Vorkommen Vond-nor-iso-Ephedrin in Catha Edulis.”Archiv Der Pharmazie 268.2 (1930): 81-83.
4. Sorry folks, I’m having a rough time finding the primary source in which they specifically identify cathinone.
5. Kalix, Peter. “Pharmacological Properties of the Stimulant Khat.” Pharmacology & Therapeutics 48.3 (1990): 397-416.
6. Feyissa, Anteneh M., and John P. Kelly. “A Review of the Neuropharmacological Properties of Khat.” Progress in Neuro-Psychopharmacology and Biological Psychiatry 32.5 (2008): 1147-166.
7. Kalix, Peter. “The Pharmacology of Khat.” General Pharmacology: The Vascular System 15.3 (1984): 179-87.
8. Chappell, John S., and Marsha M. Lee. “Cathinone Preservation in Khat Evidence via Drying.” Forensic Science International 195.1-3 (2010): 108-20.