What Khat Withdrawal Is Like
Khat is a widely abused drug around the world, including certain areas of the United States. The abuse of khat in the United States is highest in regions where people from khat-producing countries like Yemen, Somalia, and Ethiopia have relocated, such as Boston, Columbus, and Washington, D.C.1
Khat is linked to numerous physical and psychological dangers, as well as a withdrawal syndrome that, while not exhaustively documented in the scientific literature, is reported to be similar to that of other stimulants.
What Is Khat?
Khat (Catha edulis) is a plant that produces stimulant effects when consumed. Throughout history, people have harvested and chewed the leaves for their stimulant effects, a trend that continues today. In fact, in countries like Ethiopia, khat is still legal and serves as a huge source of revenue for the country.2
Reports indicate that as many as 20 million people around the world use khat regularly for its stimulant high, despite the fact that this can lead to significant health issues.3 Khat produces amphetamine-like effects, and the drug contains two central nervous system (CNS) stimulants: cathinone* and cathine.3
Studies note that the effects of khat last anywhere between 90 minutes and 3 hours.1 People who use khat may experience euphoria, increased energy and alertness, reduced need for sleep, feelings of relaxation, and increased sociability.1 However, while khat can produce these pleasurable effects, it can also result in some less-than-desirable side effects, such as:1
- Elevated blood pressure.
- Hyperthermia (elevated body temperature).
- Arrhythmias (irregular heartbeats).
- Dilated pupils.
- Physical exhaustion.
- Gum disease.
- Stomach problems.
Some people chew the green khat leaves and keep it in their cheeks in a manner similar to those who chew tobacco. The leaves can also be smoked, made into a tea, or sprinkled on food.4
According to the Drug Enforcement Administration (DEA), there are no accepted medical uses for khat in the United States. 1
*Synthetic versions of cathinone, or “bath salts,” are potent drugs of abuse.
What Are the Dangers?
There are over 10 varieties of khat leaves, and the drug’s effects vary depending on the variety of leaf and the amount consumed.2 When chewing khat, some people will become hot and agitated, while others feel an increased level of concentration that leads them to a state of “merkana” (the intensely euphoric state reached after chewing).5
However, chronic abuse can lead to negative health effects, including:1,7
- Manic behavior.
- Suicidal thoughts.
Various researchers have also found that people who abused khat over a long period of time experienced khat-induced psychosis with paranoid delusions.6 Due in part to these risks, the DEA outlawed the use of khat in the United States.1
The harm isn’t limited to psychological problems. The negative physical health ramifications of consuming khat range from mild aftereffects to debilitating conditions like gastric and liver disorders, cardiovascular disease, periodontal (teeth and gum) problems, insomnia, and impotence.6
Chronic use of khat can also lead to dependence, wherein you go through withdrawal when you quit, as well as addiction.
What Are the Withdrawal Symptoms?
In a study of 651 undergraduate students in Ethiopia, researchers found that 26.3% of students reported chewing khat in their lifetime, and 23.9% reported currently chewing khat. Among students who reported chewing khat, 68.2% reported experiencing withdrawal symptoms when they stopped using the drug.7
The withdrawal symptoms reported included:7
- Low mood/feeling depressed.
- Increased appetite.
- Sleeping too much.
- Feeling hot in the arms or over the whole body.
- A slight tremor of the tongue, hand, or whole body.
Among people who reported experiencing withdrawal symptoms, 66.3% said that the withdrawal symptoms caused problems in important areas of their lives such as their jobs or relationships.7 The biggest concern with khat withdrawal is depression and low mood, which can increase your chance of relapsing or turning to other substances to fill the void. When you want to quit using khat and/or any other addictive substances, it can help to seek out professional help via a detox program and/or rehabilitation program to minimize your chances of relapse or other harm.
Why Is Getting Help Necessary?
Although khat abuse is a problem in numerous places throughout the world, few studies have examined treatments for khat withdrawal. What we do know is that compared to alcohol and benzodiazepines, khat withdrawal symptoms are less complicated and generally not as severe.
However, khat withdrawal could unmask underlying disorders. Depression, PTSD, and psychotic symptoms are common among khat users. In a study of 33 Somali refugees living in Kenya, researchers found that khat was heavily abused as a way to relieve stress. Most users chewed khat either to help them deal with painful memories such as war experiences or other traumas or to self-medicate for psychiatric disorders.
The results of the study showed that khat chewers were significantly more likely to have experienced traumatic events than non-chewers, and those who had experienced traumatic events were more likely to binge on khat. Within the study sample, khat users often reported chewing khat for more than 24 hours straight, without interruption.6
Withdrawal is usually managed without medications, although depending on your situation, your doctor may prescribe medications if it is deemed necessary. This may be more likely if you’re abusing other drugs or alcohol, which could complicate the detox process and heighten certain withdrawal risks.
During detox, you will begin to learn strategies to avoid giving into cravings and to maintain your sobriety.
Entering a supervised detox program will provide you with the appropriate level of medical, social, and psychological support to decrease your chances of relapse and help you move forward into a sustained period of recovery.
During detox, you will begin to learn strategies to avoid giving into cravings and to maintain your sobriety. As your withdrawal symptoms subside, you may be referred to a substance abuse treatment program where you will continue to build on the skills you’ll need to stay in recovery.
Treatment options include:
- Inpatient residential treatment: These programs are very intensive and allow you to live at the treatment center. Programs typically last for 30, 60, or 90 days. During an inpatient residential rehab program, you will participate in individual counseling, group counseling, family counseling, and other types of care that help you look inward at behaviors fueling your addiction. Inpatient programs vary in terms of price, and the most expensive programs offer the luxuries of a world-class resort.
- Outpatient treatment: Outpatient programs are less intensive than inpatient programs, but they can provide a structured schedule and environment for you while you rehab. You will visit the facility multiple times per week and return home at night, giving you the flexibility to keep your commitments to school, work, or childcare. At the core of outpatient programs is group therapy, and you may spend the majority of your time meeting with other people going through recovery to offer support, guidance, and acceptance.8 Group therapy has numerous benefits; for example, it can be very helpful to get out of your own head and offer support to someone else who is hurting or in a cycle of addiction.
No matter which path you take, be proud of yourself for taking the necessary steps to get yourself into a safe situation, free from drugs. If you know you need help but are unsure of where to start, reach out today to begin the process of discussing your personal treatment journey.
- Drug Enforcement Administration. (2013). Khat.
- New York Times. (2017). For Ethiopia’s Underemployed Youth, Life Can Center on a Leaf.
- El-Menyar, A., Mekkodathil, A., Al-Thani, H., & Al-Motarreb, A. (2015). Khat Use: History and Heart Failure. Oman Medical Journal, 30(2), 77–82.
- LiveScience. (2013). Why the Herbal Stimulant ‘Khat’ Was Banned.
- Anderson, D., Beckerleg, S., Hailu, D., & Klein, A. (2007). The khat controversy: Stimulating the debate on drugs. Berg.
- Widmann, M., Warsame, A. H., Mikulica, J., von Beust, J., Isse, M. M., Ndetei, D., … & Odenwald, M. G. (2014). Khat use, PTSD and psychotic symptoms among Somali refugees in Nairobi–a pilot study. Frontiers in public health, 2, 71.
- Abdeta, T., Tolessa, D., Adorjan, K., & Abera, M. (2017). Prevalence, withdrawal symptoms and associated factors of khat chewing among students at Jimma University in Ethiopia. BMC Psychiatry, 17, 142.