Chewing Over Khat Prohibition the Globalisation of Control and Regulation of an Ancient Stimulant
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Series on Legislative Reform of Drug Policies Nr. 17 January 2012 Chewing over Khat prohibition The globalisation of control and regulation of an ancient stimulant By Axel Klein, Pien Metaal and Martin Jelsma 1 In the context of a fast changing and well documented market in legal highs, the case of khat (Catha edulis) provides an interest- ing anomaly. It is first of all a plant-based substance that undergoes minimal transfor- mation or processing in the journey from farm to market. Secondly, khat has been consumed for hundreds if not thousands of years in the highlands of Eastern Africa and Southern Arabia.2 In European countries, khat use was first observed during the CONCLUSIONS & RECOMMENDATIONS 1980s,3 but has only attracted wider atten- Where khat has been studied exten- tion in recent years. sively, namely Australia, the UK and until Discussions about appropriate regulatory recent-ly the Netherlands, governments systems and the implications of rising khat have steered clear of prohibition because 4 use for European drug policies should take the negative medical and social harms do cognizance of social, demographic and not merit such controls. cultural trends, and compare the existing Strict bans on khat introduced ostensi- models of control that exist in Europe. Khat bly for the protection of immigrant com- provides a unique example of a herbal munities have had severe unintended stimulant that is defined as an ordinary negative consequences. vegetable in some countries and a con- trolled drug in others. It provides a rare Khat prohibition has failed to further the opportunity to study the effectiveness, costs integration, social incusion and economic and benefits of diverse control regimes. As prosperity of the Somali community. long as khat is legally produced and traded, Assumptions about causal relations it also allows for the views of stakeholders between khat use and the problems of a such as farmers and traders to be included vulnerable minority with untreated mental in policy discussions. health conditions need to be dealt with carefully and should not be used as a pre- KHAT - WHAT IS IT; WHAT DOES IT DO? text for criminalising khat. Khat is a naturally occurring stimulant that Migrant communities and problematic has been compared to coca leaves, coffee users need a constructive engagement and and amphetamine. It is consumed by pluck- targeted interventions. The criminalisation ing off the leaves of the khat tree and roll- of a cultural practice will only intensify the ing them into little balls that are pushed problem that community leaders are into the side of the cheek, where they form seeking to address. Legislative Reform of Drug Policies | 1 a large bolus (soft mass of leaves). The prac- duuf' or bundles. These bundles are the tice is usually referred to as khat chewing, unit of account, made up of the leafy stems but in fact the leaves are simply kept in the of the khat tree, about 150 to 300 grams in side of the cheek to masticate over time. weight, rolled tightly into banana leafs to When the juice (and the psychoactive preserve moisture. In the United Kingdom alkaloids it contains) has been extracted, (UK), where khat is consumed in commer- the detritus is either swallowed or spat out. cial establishments, these venues also act as Because of its astringent taste, khat users communal centres where food and drinks often use sweet drinks or chewing gum. are served, the television is often tuned into Arabic news channels or Somali music is According to pharmacologists, cathinone, played. They are subject to local licensing, one of khat's psychoactive chemicals, af- health and safety regulations, and have to fects the central nervous system “like a mild ensure that there is no nuisance for local 5 amphetamine”. The classical khat ‘high’ residents.8 goes through a number of stages, that all have different names in Arabic. Some ten to THE GLOBALISATION OF KHAT fifteen minutes into the process of mastica- tion, the first wave of euphoria known in In contrast to other psychoactive sub- Yemen and Somalia as ‘mirquaan’ washes stances, khat undergoes minimal process- over the user. This is a point of excited con- ing or refinement. It has to be brought to versation and much planning, where users market before the active alkaloids disinte- are prone to build ‘their castles of spit’.6 It is grate, within 48 to 72 hours after harvest- followed by a quieter and introspective ing. Speed is therefore of the essence, and phase, where users would traditionally play explains why khat could become a global music, recite poetry or read the Koran. commodity only after production areas Towards the end, the ‘haddaar’ or come- were linked up by road, rail and airports. down sets in, leaving the user restless, irri- The khat producing regions of Ethiopia, the table and melancholic. Depending on the Kenyan highlands and Yemen are now amount of khat consumed, the entire supplying consumers in Europe, North experience typically lasts between four to America, India and even Australia. Over six hours, but can drag on for longer. the past twenty years, a global khat market has come into being, providing significant Traditionally, khat has been chewed com- regular foreign exchange earnings for the munally, after work, on social occasions, in exporting economies. public spaces or dedicated rooms in private houses. It is used as a marker to distinguish Global markets are driven by demand from leisure time from work, and was built into diaspora populations, particularly from the rhythms of the day. The traditional Somalia. There has been little cross-over after-lunch chewing session is called ‘barje from migrants to mainstream, and there or ‘quayil’ and lasts until evening prayer are indicators that khat use falls dramati- around 6pm. Sessions outside this time cally among second-generation immi- frame scheme are indicated by their names, grants. Estimates of khat use, published in such as the pre-lunch ‘xareedin’ or luxury the UK, report 0.2% of respondents admit- chew, or the all night ‘qarxis’ or explosion.7 ting to khat use in the last year.9 At present, then, khat use is strongly associated with Both men and women chew in Ethiopia first-generation immigrants from Eastern and Yemen, though they are usually segre- Africa, many of whom acquired the habit gated on social occasions. In the khat cafes prior to their migration. or 'mafrishes', customers buy khat and drinks on the premises, then sit down on Within Africa, however, khat use is spread- cushions or divans to lay out their ‘mar- ing fast. Markets have developed in Eritrea, 2 | Legislative Reform of Drug Policies all found that the potential for misuse was low.11 By distinguishing khat as a plant product from the synthesised extract of cathine and cathinone, governments legally distinguish between different risk ratios. A bundle of 100 grams of khat leaves may have a cathi- none content of between 30 to 200 mg, 90% of which is extracted by mastication. This corresponds to a low to medium dose of amphetamine, but the slow and laborious mode of ingestion restricts the cumulative dose and peak plasma levels. In other words, because khat leaves are chewed over time, the psychoactive ingredients are extracted slowly so that the build up of toxic and intoxicating chemicals in the body is mod- erate.12 There is only limited evidence that intensive use over a period of several years can exacerbate coronary conditions and produce tachycardia (increased heart rate), reduce appetite, and affect the respiratory, Young man with two bundles of khat hepatic, reproductive and central nervous systems.13 While it may also complicate Sudan, Uganda, Rwanda and South Africa. pre-existing chronic psychotic disorders, While traders from Yemen or the Swahili and has been associated with hyperactivity, coast have played an important pioneering insomnia, anxiety and irritability,14 the evi- role, the habit is quickly catching on in dence is clear that the physical and mental many of Africa’s fast growing cities. In health risks of khat remain very low.15 rural areas farmers are benefiting from a Excessive users and vulnerable individuals new cash crop.10 Without the know-how or suffering from post traumatic stress disor- resources to assess the associated risks, der are more exposed to harmful conse- African governments rely on partners in quences, but this is only partially related to Europe or international organisations for khat use. advice on regulation. Legislative controls have been advocated as KHAT HARMS a precautionary measure16 in order to pre- Two of the psychoactive ingredients, vent khat being taken up by mainstream cathine and cathinone are scheduled populations,17 and from fear of khat pro- substances under the 1971 United Nations duction becoming established.18 The most (UN) Convention on Psychotropic Sub- trenchant critics refer to reports of shifting stances, but not the vegetable matter of consumption patterns, with a growing khat itself, though some countries have incidence of regular and possibly depend- interpreted the convention that way. ent use reported from the very different Recent assessments by the World Health settings of Somaliland and the UK.19 They Organisation (WHO) Expert committee on argue that this results in a number of social Drug Dependence (see text box: Khat and harms, including the diversion of scarce UN drug control), the UK Advisory Coun- resources, domestic violence and family cil on the Misuse of Drugs, and expert break-up. Combined with pressure from councils in the Netherlands and Australia conservative Islamic clergy following the Legislative Reform of Drug Policies | 3 Khat and UN drug control Khat is not subject to international control at pre- reviewed the data on khat and determined that the sent.