Not yet medically reviewed, information on this site is in preparation and has not been verified by a medical reviewer.
Drug index / Stimulant / Khat
Stimulant

Khat

(2S)-2-amino-1-phenylpropan-1-one

Khat is a flowering plant (Catha edulis) whose fresh leaves are chewed for a mild stimulant effect; its main active compound is cathinone (see the cathinone page for the pharmacology). Chewed traditionally across East Africa and the Arabian Peninsula, khat is legal in some of those regions but is a Schedule I controlled substance in the United States. Its risks are stimulant-type plus route-specific harms from prolonged chewing.

Pending medical review. This page has not yet been checked by a clinician, so read it as general information, not medical advice.

Overview

Khat (Catha edulis) is a flowering shrub native to East Africa and the Arabian Peninsula whose fresh leaves and shoots are chewed for their stimulant effect, a practice with deep social and cultural roots in countries such as Yemen, Somalia, Ethiopia, and Kenya. The plant is the natural source of cathinone, the compound responsible for most of its effects (see the cathinone page for the full pharmacology). A key feature of khat is freshness: cathinone breaks down within days of harvest as the leaves wilt, converting to the weaker cathine, which is why khat is traditionally consumed fresh and quickly. This page focuses on what is specific to the plant; see cathinone for the compound-level detail.

Source: DEA; WHO; peer-reviewed literature (NIH/PMC)

Chemistry & mechanism of action

Khat's effects come primarily from cathinone, a naturally occurring stimulant structurally related to amphetamine that increases release of dopamine and norepinephrine (see the cathinone page for detail). Because cathinone degrades to the milder cathine as the leaves age, fresh khat is more potent than wilted khat. Chewing releases the compound gradually, producing a slower, milder onset than concentrated synthetic cathinones.

Source: WHO; peer-reviewed literature (NIH/PMC)

Effects

Chewing khat produces mild stimulation: increased alertness, talkativeness, euphoria, and suppressed appetite, typically building over a chewing session lasting hours. Users report sociability and a sense of energy, followed by a comedown that can include low mood, irritability, and difficulty sleeping. The effects are generally milder and slower than amphetamine or synthetic cathinones. See the cathinone page for the compound's broader effect profile.

Source: WHO; peer-reviewed literature (NIH/PMC)

Risks & harms

Khat carries the stimulant risks of cathinone (raised heart rate and blood pressure, cardiovascular strain, anxiety, and dependence — see the cathinone page) plus harms specific to how it is used. Prolonged chewing is associated with oral and dental problems, including gum disease and an elevated risk of oral cancers (mouth and esophagus), as well as constipation and other gastrointestinal effects. Regular heavy use is linked to raised blood pressure and cardiovascular strain, sleep disruption, and — in some users — anxiety, irritability, and psychological dependence, with occasional reports of khat-induced psychosis at heavy use. Because the active cathinone content varies with the plant's freshness, potency is inconsistent. Khat use also carries social and economic harms in some communities tied to heavy daily consumption. As with any plant product, imported khat could be contaminated with pesticides. Anyone with chest pain, a dangerously high blood pressure, severe agitation, or psychiatric crisis should seek medical care; Poison Control at 1-800-222-1222 can advise. This page has not yet been medically reviewed.

Source: WHO; DEA; peer-reviewed literature (NIH/PMC)

Subjective effects

euphoria, alertness, energy, hyperactivity, talkativeness, relaxation; anorexia

Long-term effects

psychological dependence; manic behavior, grandiose delusions, violence, suicidal depression, schizophreniform psychosis; periodontal + GI disease

Duration

90 min–3 hr

After-effects

lack of concentration, numbness, insomnia

Harmful effects

psychological dependence; manic behavior, grandiose delusions, violence, suicidal depression, schizophreniform psychosis; periodontal + GI disease

Medicinal use

none

History

used in East Africa/Arabian Peninsula since the 13th century

Prevalence

NFLIS >7,800 reports since 1998

Images

Visual references coming soon.

If it’s too intense

If an experience becomes overwhelming, the goal is to stay safe and let it pass, most difficult experiences ease as the drug wears off.

  • Get to a calm, safe space with someone you trust who is sober and can stay with you.
  • Cool down if you’re overheating, move somewhere cool, remove extra layers, rest. Overheating is especially a risk with stimulants and MDMA.
  • Sip water to thirst, but don’t over-hydrate. Drinking large amounts of plain water (especially after MDMA) can dangerously dilute your blood sodium (hyponatremia). Electrolytes help more than volume.
  • Slow your breathing, long, slow exhales help settle a racing heart and anxiety.
  • A sugary drink, fruit juice, or a snack can ease shakiness and the anxiety that comes with low blood sugar.
  • Do not take more, and do not add another substance to manage it. Redosing or adding something else (including a sedative like a benzodiazepine) can make things worse, not better.

With stimulants, overheating and a racing heart are the main concerns, get somewhere cool, stop any physical activity, and don't take more.

Call 911 (or Poison Control, 1-800-222-1222) right away for chest pain, a very high body temperature, a seizure, unconsciousness, or severe confusion. These are medical emergencies, not something to wait out.

Source: general harm-reduction guidance from SAMHSA, NIH/NIDA, and MedlinePlus, in our own words. Draft, not yet medically reviewed.

Dosage

Pending medical reviewer

Sources

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