Does Khat Drug Use Induce Madness?

Khat use is older than coffee. This plant has been employed as a stimulant for centuries in the Horn of Africa and the Arabian Peninsula (Yemen).

Its fresh leaves and tops are chewed or, less frequently, dried and consumed as tea, to achieve a state of euphoria and stimulation, the way coca leaves are used in South America.

Now a team led by Dr Nasir Warfa - lecturer in Transcultural Psychiatry at Queen Mary, University of London, has made the first ever review of clinical case reports on khat use and mental illness, published in the last 50 years. It appears that khat does increase pre-existing psychological problems, but there is no clear proof that khat triggers the development of mental illness.

There are about 10 million khat consumers in east Africa and Arabian peninsula, but the plant is also consumed by immigrants in western countries coming from Somalia, Yemen and Ethiopia.

Khat may have cultural functions, but it is also aggravating social and medical issues like anti-social behavior, unemployment, psychoses, depression, self-neglect and poverty.

60 % of the East African population lives below the poverty line, yet many khat users borrow money to get the drug, boosting poverty levels and ruining their life quality and that of their communities.

There is a widespread popular belief that excessive use of khat boosts mental illness, particularly where there is a pre-existing mental illness or vulnerability to psychological distress, but the team found "there are many other alternative hypotheses to a causal relationship between khat use and mental illness including the use of khat for self-medication".

The team signals that more qualitative research, integrating social, medical and pharmacological factors, are needed to see the real psychological and social impact of khat on individuals and communities.

"Potential legislators should consider the repercussions of criminalizing large sections of the community - such as the evolution of new organized crime groups based on khat trafficking, and the perverse consequence of increased risk behavior among khat users." warned Dr Axel Klein, lecturer in the Study of Addictive Behavior, University of Kent.