Transcript Document

Khat Training
Khat Workshop
Hassan Isse
Aim
 To give participants an understanding of
khat, its effects, risks and harm
associated.
Learning outcomes
By the end of the course participants will have:
1. Have considered the difference between
other substance use and Khat
2. Have gained an updated knowledge of khat,
its effects and risks
3. Have considered why people use khat
4. Understand treatment options.
Khat
Khat
Khat & its Types
What is it?
Khat is a green leafy plant
cultivated throughout Eastern
Africa and Yemen. Khat is a
natural stimulant from Catha
edulis and it has effect like
speed and amphetamines.
Street names Commonly
known as qat, Jaad, chad,
Khat and Miraa. There are
more than 70 varities of khat
in the world such as
 Miraa from Kenya
 Hawadaaye from Somalia
 Kaad methani sabir from
Yemen
 Harari from Ethiopia
How taken
It can be chewed or drunk. A khat
chewing session fulfils an important
social function similar to the use of
caffeine and alcohol in Europe. A
khat chewing session may last 3-5
hours.
Extent of use
Used by specific Arabic and north,
central and eastern Africans.
Commonly associated with Somali
men. Has a similar function to coffee
with a meal, but some say its use in
the UK is escalating - causing harm
to certain communities.
How to chew khat
Khat Project resources 2004
Chewing sessions
Khat Project resources 2004
Khat session
Khat Project resources 2004
How It Grows
 Khat grows in Ethiopia, Kenya and Yemen. It grows
in highlands between 3000-8000 feet as natural.
 Size is a 10 to 20-foot flowering evergreen.
 There are two type of khat “white and red” size is 510cm long and 1-4cm wide.
Khat Project resources 2004
Ethiopian Hills Where Khat is cultivate
Khat Project resources 2004
Khat and Law
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Khat is not illegal to use or trade in the UK
It is controlled by law in countries such as an
America, Canada, Norway and Sweden.
In 1980 the WHO classified Khat as drug of abuse
that can produce mild to moderate psychic
dependence due to Cathinone.
In the USA listed as schedule 1 drug, which is
controlled substance.
In UK although Cathenione and cathine controlled
by the Misuse of Drug Act 1971 (class C) khat itself
is not. An offence is committed only if the active
constituents are isolated from the plant. However
there will be some legislations soon .
Khat Project resources 2004
Chemical Constituents
 Khat leaves contain psychoactive known as
Cathinone which is structurally and
chemically similar to Amphetamine and
Cathine a milder form of Cathinone.
 Other components include: Cathidine,
Celastrin, Tannin and many amino acids,
minerals and vitamins mainly Vitamin C.
What gives khat its stimulant effect on the
Central Nervous System?
 Presence in fresh, young leaves of cathinone; older
leaves contain cathine (norpseudoephedrine)
 Similar in chemistry to amphetamines
CH3
CH3
CH3
CH3
O
HO
NH2
NH2
NHCH3
NH2
O
OCH3
O
Cathine
(-)-Cathinone
(+)-Amphetamine
'Ecstasy'
Khat Project resources 2004
Effects
 After chewing khat people
 Excessive khat use can
mild euphoria and
'talkativeness', users often
report calming effects.
 Inflammation of the mouth
and other parts of the oral
cavity is common with
users.
 Long time khat use can 
causes Psychological
dependence.
bring on depression,
anxiety and irritation,
sometimes leading to
psychosis (severe mental
disorder in which the
individual's contact with
reality becomes highly
distorted (delusions).
It might lead to heart
disease and loss of sex
drive in men.
 Oral cancer can develop.
Pharmacological effect
 Mydriasis (dilation of pupil of the eye)
 Tachycardia (increased heart bating)
 Elevated blood pressure
 Headaches
 Hyperthermia (warm)
 Increased respiration
 Urinary retention
 Increased urine output (due to fluid intake)
Khat Project resources 2004
Medical Aspects of chewing
 Periodontal Disease
 Stomatitis and oral cancer
 Gastritis and gastric ulcer
 Cirrhosis of liver
(Hepatotoxic effect)
 Chemical hepatitis A. B
and C. (chemical
treatments)
 Constipation
 Anorexia (loss of Appetite
and weight), leading to
malnutrition
Khat Project resources 2004
Heart and cardio-vascular effects
Hypertension/increased blood
pressure
Migraine
Brain haemorrhage
Increased heart rate/palpitation
Other heart problems
Khat Project resources 2004
Mental Health problems causes by khat use
 Insomnia (loss of sleep)
 Anxiety and nightmares
 Aggressive behaviour and
irritation
 Paranoia
 Depression and Psychosis
 Sex problems such as
impotence
Khat Project resources 2004
Risk factors associated with khat use
 Decreases life span due to chronic illnesses
 Susceptibility to infectious diseases such as
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TB, Increasing HIV/AIDS and STD (sex trade)
Smoking increases risk of lung cancer
Poor hygiene increases risk of infections
Chemical poisoning due to use of pesticides
Social and economic uncertainty
Khat Project resources 2004
Khat Overdose
 Agitation, paranoia, and repetitive
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behaviours
Rapid heart beat and breathing
High body temperature
Convulsions
Emergency treatment includes basic
support, keep person cool, and calling
the emergency
Khat Project resources 2004
Positive side of khat use
 Almost a hobby type of interest
 Subdued feeling, leading to lowered risks of violence
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and less aggression
Allows longer working hours, e.g. long distance lorry
drivers, students whilst ‘cramming’ for exams
Sociable drug for those using
Many people belief that it helps people with diabetics
Many others belief that khat use helps with weight
loss
Used as cash crop to generate income to support
themselves and their families.
Khat Project resources 2004
Treatments options one
 Assessments Referral to appropriate
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treatment
Support for young people their
families.
One to one and group work
Harm minimisation and reduction (use
dairy)
After care support such as education,
employment, training and football
activities
Complementary therapeutics' such
as Acupuncture, Yoga and general
health check
Monitoring progress and life style
Khat Project resources 2004
support
Treatments option 2
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Sessionss Cognitive-behaviour therapy (CBT)
Coping skills training
Relapse prevention therapy programme
Motivational interventions one to one support 6
weeks
 Contingency management on going keyworking
with regular sessions as well as appointments and
progress monitoring
 Community reinforcement approaches such as
volunteering and family approaches, cultural and
customs acceptable approach
Khat Project resources 2004
More information and support
 Hassan Isse
Khat and Community Consultant
Tel: 02085694822 Fax 02085694759
E-mail: [email protected]
Sceptre House 75-81 Staines Road Hounslow
TW3 3HW
Khat Project resources 2004
Information Sources
 World Health Organisation research
studies
 UN Office on Drugs and crimes studies
 UK & National Governments
studies/report
 Research papers (Hassan Isse)
 Khat users case studies