Tox Tuesday: Khat

A stimulant traditionally used in some communities may soon face new restrictions in the United Kingdom (U.K.).

Khat, an evergreen shrub native to East Africa and the Arabian Peninsula, most commonly is chewed like tobacco, although dried khat can also be smoked or eaten. It releases cathine and cathinone, which act as stimulants albeit more mildly than other stimulants such as amphetamines.

Although it is illegal or restricted in many countries, khat still is legal in the U.K, although that is slated to change soon. In July 2013, Home Secretary Theresa May proposed the making khat a class C drug, which has caused pushback from those who say khat is a mild stimulant and poses few or no health risks, or that making it illegal will actually cause more problems.  Those charged with selling a Class C drug face an unlimited fine and up to 14 years in prison.

A January 2013 report from the U.K.’s Advisory Council on the Misuse of Drugs (ACMD) recommended that khat not be controlled under the U.K.’s Misuse of Drugs Act as the ACMD believed khat’s effects weren’t harmful enough to warrant classification. In a statement, the Home Office noted that although ACMD didn’t recommend the classification, concerns about the amount of information available and community issues related to the drug helped lead to the decision.

In other countries, khat (and its active ingredients cathinone and cathine) are controlled, including the 1971 United Nations Convention of Psychotropic Substances with cathinone being listed as Schedule I and cathine falling under Schedule III (khat itself isn’t internally controlled).  Khat is controlled across Europe, including France, Italy, Ireland, Poland and Switzerland. In the U.S., khat’s active ingredients – cathinone and cathine – are listed as Schedule I and Schedule IV substances respectively. Schedule I is defined as having a high risk for abuse and no currently accepted medical use in the U.S., according to the U.S. Drug Enforcement Administration (DEA).

These stimulants affect the central nervous system and can lead to physical effects such as a feeling of euphoria, heightened alertness and increased blood pressure. When used frequently and in high doses, psychotic effects have been reported, according to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). Khat usage in the U.K. was about 0.2 percent in 2011-2012.

Cathinone in particular has made headlines recently as synthetic cathinones, or related substances, are found in the designer drug commonly called bath salts. Synthetic cathinones can cause euphoria, paranoia, hallucinations and even psychotic and violent episodes.

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