Khat Chewing Habits in the Population of the Jazan Region,Saudi Arabia: Prevalence and Associated Factors

The use of khat (Catha edulis) is a major public health and social problem that is believed to be growing globally. The khat chewing habit is prevalent in all areas of the Jazan region, Kingdom of Saudi Arabia (KSA). However, few studies have been conducted at the community level to investigate the khat chewing habits in this area. This study was conducted with the aim of assessing the prevalence and predictors of khat chewing among the Jazan community population. A cross-sectional study was conducted with a sample (n = 4,500) of the Jizani population who attended primary heath care centers in Jazan region. The participants were selected using a two-stage cluster random sampling. A structured questionnaire was used for data collection. The overall lifetime prevalence of khat chewing was 33.2% (95% CI 31.8–34.7) and was significantly higher for males 42.2% (95% CI 40.4–43.9) than for females 11.3% (95% CI 9.6–13.1) (P < 0.001). Current khat chewers accounted for 28.7% (95% CI 27.4–30.1) of the population sampled; 36.9% (95% CI 35.2–38.6) of whom were males, which is a significantly higher percentage than the 8.7% (95% CI 7.3–10.4) of current khat chewers who were females (P < 0.001). The multivariate logistic regression analysis suggests that the most important independent predictors of khat chewing were having a friend who chewed khat (OR = 20.1, P < 0.001), participant''s smoking status (OR) = 3.9, P < 0.001), friend''s smoking status (OR = 2.2, P < 0.001), gender (OR = 2.2, P < 0.001) and educational level (OR = 1.5, P < 0.05). A large proportion of the Jizani populations chew khat. Government and non-governmental organizations NGOs should design and strengthen community prevention programs to curb the high prevalence of khat use.     

Chemical composition of <Emphasis Type="Italic">Catha edulis</Emphasis> (khat): a review

Khat (Catha edulis) belongs to Celastraceae family which contains 60–70 genera and 850–900 species. It is an indigenous plant to Ethiopia and Yemen as the countries of origin. It is also found in many other east and southern African countries. Khat leaves are chewed by the local people for their stimulant action. The main active ingredient compounds those are responsible for this action is cathinone and a mild stimulant cathine. In addition to these khat contains several phytochemicals such as alkaloids (phenylalkylamines and cathedulins), flavonoids, steroid and triterpenoids, monoterpenes and volatile aromatic compounds, and other miscellaneous compounds like vitamins and amino acids. Hence, this paper presents a comprehensive and unified review of literatures which concerned on the phytochemical composition of khat plant. And it also provides the isolated compounds with their chemical structures.     

Transcriptome Profiling of Khat (Catha edulis) and Ephedra sinica Reveals Gene Candidates Potentially Involved in Amphetamine-Type Alkaloid Biosynthesis

Amphetamine analogues are produced by plants in the genus Ephedra and by khat (Catha edulis), and include the widely used decongestants and appetite suppressants (1S,2S)-pseudoephedrine and (1R,2S)-ephedrine. The production of these metabolites, which derive from L-phenylalanine, involves a multi-step pathway partially mapped out at the biochemical level using knowledge of benzoic acid metabolism established in other plants, and direct evidence using khat and Ephedra species as model systems. Despite the commercial importance of amphetamine-type alkaloids, only a single step in their biosynthesis has been elucidated at the molecular level. We have employed Illumina next-generation sequencing technology, paired with Trinity and Velvet-Oases assembly platforms, to establish data-mining frameworks for Ephedra sinica and khat plants. Sequence libraries representing a combined 200,000 unigenes were subjected to an annotation pipeline involving direct searches against public databases. Annotations included the assignment of Gene Ontology (GO) terms used to allocate unigenes to functional categories. As part of our functional genomics program aimed at novel gene discovery, the databases were mined for enzyme candidates putatively involved in alkaloid biosynthesis. Queries used for mining included enzymes with established roles in benzoic acid metabolism, as well as enzymes catalyzing reactions similar to those predicted for amphetamine alkaloid metabolism. Gene candidates were evaluated based on phylogenetic relationships, FPKM-based expression data, and mechanistic considerations. Establishment of expansive sequence resources is a critical step toward pathway characterization, a goal with both academic and industrial implications.     

Correlation between Resistin,Tuberculosis and Khat Addiction: A Study from South Western Province of Saudi Arabia

Tuberculosis(TB) is a disease of global significance, which accounts for a death in every 15 seconds. Recent studies shows TB is rising in certain parts of the world, and Saudi Arabia is one of them. Several factor contribute in predisposing the subjects for infection including but not limited to addiction to various compounds which have immune modulation properties, such as amphetamines and Heroin etc. Khat a plant whose leaves are chewed for its euphoric effect in east Africa and Arabian Peninsula including Saudi Arabia, is considered as mildly addictive, and its principle compound, Cathinone shares structural and functional similarity with amphetamine a known immunomodulator. Tuberculosis being a disease of immune modulation has a varied spectrum of complex interplay of proinflammatory molecules, resistin is one of them. In the present study, we try to explore the trinity of khat addiction, serum resistin level and tuberculosis by correlating the serum resistin level in non khat addicted healthy subjects, khat addicted healthy subjects, and in patients, both khat addicted and non khat addicted, with active tuberculosis. We observed significantly higher resistin level among the apparently healthy khat addicted subjects as compared to non addicted healthy controls. Thereafter, when we compare the resistin levels between khat addicted and non khat addicted TB patients we did not found significant difference between the two groups. However bacillary load was observe to be significantly higher among the khat addicted TB patient as compare to non addicted one. Validation of above results in animal model revealed dose dependant increase in bacillary growth in the Wistar rats treated with khat. Taken together these results suggest the role of khat in immune modulation albeit in the limited frame of resistin level.     

Effects of form of leftover khat (Catha edulis) on feed intake,digestion, and growth performance of Hararghe Highland goats

Khat (Catha edulis) is a lucrative cash crop in many African countries and other areas of the world. Leftover khat can be used as a feedstuff for ruminants, although seasonal production limits the extent of utilization. Practical methods of feed conservation to preserve nutritional value would be beneficial. Thus, a study was conducted to investigate effects of feeding different forms of leftover khat on intake, digestion, and growth performance of a tropically adapted indigenous goat genotype of eastern Ethiopia. Twenty-four (six per treatment) individually housed Hararghe Highland yearling male goats with an initial body weight of 18 ± 0.4 kg were used in an on-station experiment, and 32 similar yearlings with an initial body weight of 19 ± 0.4 kg were employed under on-farm conditions. The on-farm experiment occurred at two villages, with four farmer groups (two farmers per group co-managing animals) per village. Four animals in each farmer group were subjected to each of the four different treatments. Experiments were 90 days in length, with inclusion of a subsequent 10-day period on-station to determine digestibility. Khat in fresh, dry, and silage forms was fed at 1.5% body weight (dry matter; DM), whereas control animals did not receive khat. Animals on-station consumed grass hay ad libitum and those on-farm grazed/browsed surrounding areas. Grass hay DM intake on-station was greater (P < 0.05) without than with khat (528, 358, 387, and 368 g/day; SE = 20.3), although total DM intake was increased by feeding khat regardless of form (528, 649, 622, and 639 g/day for control, fresh, dry, and silage, respectively; SE = 22.9). Digestibility of organic matter was increased (P < 0.05) by feeding each form of khat (62.3%, 75.7%, 75.2%, and 72.4% for control, fresh, dry, and silage, respectively; SE = 1.63). Nitrogen balance was increased by fresh and ensiled khat (P < 0.05) (?0.54, 2.07, 0.80, and 0.86 g/day for control, fresh, dry, and silage, respectively). Average daily gain (ADG) was increased by khat regardless of form on-station (13, 49, 33, and 39 g; SE = 4.6), and on-farm ADG was less for control than for fresh and dry forms (P < 0.05) (32, 56, 47, and 42 g for control, fresh, dry, and silage, respectively SE = 2.0). The ratio of ADG:DM intake on-station was lower for control than for fresh (P < 0.05) and silage (P < 0.05) (26, 76, 54, and 61 g/kg for control, fresh, dry, and silage, respectively; SE = 7.6). In conclusion, feeding leftover khat to Highland goats consuming low to moderate quality forage-based diets can increase growth performance. Khat can be preserved for use as a feedstuff throughout the year by drying or ensiling without marked effect on performance.     

Chewing over the Future: Khat Consumption, Anxiety, Depression, and Time Among Young Men in Jimma, Ethiopia

This article draws on qualitative and quantitative research to examine the relationship between the consumption of khat, symptoms of depression and anxiety and the experience of time among young men in urban Ethiopia. Young men claim that khat, a mild stimulant, both causes and alleviates symptoms of depression and anxiety. However, our quantitative data indicate that there is not a direct relationship between khat and symptoms of depression and anxiety. We analyze this apparent contradiction in terms of young men’s experiences of time. Long-term ethnographic research indicates that khat consumption and mental distress have a close relationship with young men’s temporal problems. In a context of high urban unemployment, young men struggle to negotiate overabundant amounts of unstructured time in the present and place themselves within a narrative in which they are progressing toward future aspirations. These temporal struggles generate symptoms of depression and anxiety. For young men, khat consumption functions to reposition them in relation to time, both in the present and the future. Ultimately, we argue that the relationship between khat and time has implications for the economic issues that underlie young people’s symptoms of depression and anxiety.     

Khat habit and its health effect. A natural amphetamine

Chewing the leaves of the khat shrub is common in certain countries of East Africa and Arabian Peninsula mainly Yemen. It has been established that a khat plant leaves contain an active psycho-stimulant substance known as cathinone that is similar in structure and pharmacological activity to amphetamine in affecting the CNS. Intoxication with khat is self-limiting but chronic consumption can cause certain health disturbances in the user and also lead to social and economic damage to the individual and the community. In recent years, several cases of intoxication have been observed outside the area of its use. In this view, the khat habit, its health effects and socioeconomic aspects are described with the political issue they imply.     

Acute exposure to Catha edulis depresses contractility and induces myocardial infarction in spontaneously contracting,isolated rabbit’s heart

Khat chewing is a recreational habit known to pose major socio-economic and medical problems in countries of Southern Arabia and the Horn of Africa. Among other adverse health effects, khat chewing has been associated with an increased risk of myocardial infarction (MI) in heavy consumers. This study was carried out to examine the direct effects of Catha edulis extract on contractility of spontaneously contracting, isolated rabbit heart and to investigate its mechanism of action. Isolated six rabbit’s hearts attached to a Langendorff apparatus were perfused with extract at a constant flow rate and continuously bubbled with a 95% O₂/5% CO₂ gas mixture. Each heart served as its own control, as responses were recorded before and after administration of C. edulis extract. Varying concentrations of extract (50, 100 and 250 mg/ml) were loaded in the perfusate, their effects recorded and effluent fluid collected for assay of cardiac enzymes. Histological examination of the cardiac tissue was performed at the end of perfusion with 250 mg/ml extract. This study revealed that acute exposure to C. edulis extract exerted negative inotropic and chronotropic effects on isolated hearts. The extract also had a vasoconstrictor effect on coronary vessels, independent of α₁ adrenergic receptor stimulation. Histological examination of hearts perfused with 250 mg/ml C. edulis extract revealed the presence of histological changes unique to myocardial infarction, a finding consistent with observed increased levels of cardiac enzymes in perfusates. Thus, we have demonstrated experimentally a direct cardiac depressant- and MI inducing effects of C. edulis extract. These results are consistent with the earlier reported deleterious effects of khat on cardiovascular function among khat chewers.     

Khat Chewing Practice and Associated Factors among Adults in Ethiopia: Further Analysis Using the 2011 Demographic and Health Survey

Background

Khat chewing has become a highly prevalent practice and a growing public health concern in Ethiopia. Although there have been many small scale studies, very limited national information has been available in the general population. This study aimed to identify factors associated with khat chewing practice among Ethiopian adults.

Methods

The study used the 2011 Ethiopian demographic and health survey data. The survey was cross-sectional by design and used a multistage cluster sampling procedure. Bivariate and multivariable logistic regression models with adjusted odds ratio (AOR) and their 95% confidence intervals (CI) were used to quantify the predictors.

Results

The overall khat chewing prevalence was 15.3% (95% CI: 14.90–15.71). Regional variation was observed with the highest in Harari [(53.2% (95% CI: 43.04–63.28)] and lowest in Tigray regional state [(1.1% (95% CI: 0.72–1.66)]. Multivariable analysis showed that Islam followers were 23.8 times more likely to chew khat as compared to Orthodox followers. Being a resident in Oromiya, South Nation, Nationalities and People (SNNP), Gambella, Harari and Dire Dawa regions had 1.9, 1.6, 3.1, 5.2 and 3.5 times higher odds of chewing khat as compared to Addis Ababa residents, respectively. Adults in the age group 45–49 years were 3.6 times more likely to chew khat as compared to 15–19 years. The middle and richest wealth quintiles were 1.3 and 1.5 times more likely to chew khat, respectively, as compared to the poorest category. Rural residents had 1.3 odds of chewing khat than urban residents. Those individuals who had occupation in sales, agriculture, service sector, skilled and unskilled manual workers were 1.6, 1.3, 2.4, 1.7 and 2.3 times more likely to chew khat, respectively, as compared to those who have no occupation. Females were 77% less likely to chew khat as compared to males. Formerly married and those experienced in child death had 1.4 and 1.2 times higher odds to chew khat as compared with those never married and never had child death, respectively. Those who attended mass media were 1.4 times more likely to chew khat compared with not attended.

Conclusion

Khat chewing is a public health concern in Ethiopia. The highest wealth quintiles, older age group, rural residence, child death, formerly married, males, regions of Oromiya, SNNP, Gambella, Harari and Dire Dawa and Islamic followers had statistically significant association with khat chewing. Due attention needs to be given for these factors in any intervention procedures.     

Effect of the alkaloid (−) cathinone on the release of radioactivity from rabbit atria prelabelled with 3H-norepinephrine

In certain countries of East Africa and the Arab Peninsula, fresh leaves of the khat shrub are used as a stimulant. The effect of the plant material can be explained by the presence of the phenylalkylamine alkaloid (?) cathinone in the leaves, since this substance has been shown to have an amphetamine-like releasing effect on CNS tissue prelabelled with ³H-dopamine. Characteristically, the chewing of khat is accompanied by sympathomimetic effects, especially at the cardiovascular level. To test whether these might be due to release of neurotransmitter from adrenergic nerve endings, the effect of (?) cathinone on the efflux of radioactivity from isolated rabbit atrium tissue prelabelled with ³H-norepinephrine was investigated. It was found that, at concentrations below 1 μM, (?) cathinone caused an immediate increase of efflux. The effect was dose-dependent and was potentiated by pretreatment of the rabbits with reserpine. Preincubation of the tissue with desipramine and cocaine prevented the induction of release by (?) cathinone. The results indicate that the alkaloid (?) cathinone has an amphetamine-like releasing effect on noradrenergic nerve endings and they suggest that the cardiovascular symptoms observed during khat consumption are due to release of neurotransmitter from physiological storage sites.     

Concentration Levels of Essential and Non-essential Metals in Ethiopian Khat (Catha edulis Forsk)

The levels of essential (Ca, Mg, Mn, Fe, Zn, Cr, Cu, and Co) and non-essential (Cd and Pb) metal in six different varieties of Ethiopian khat (Catha edulis Forsk, an evergreen stimulant plant) commonly consumed in the country and exported to the neighboring countries were determined by flame atomic absorption spectrometry. Known weight of oven-dried khat samples were wet-digested using 2 mL of (69–72%) HNO₃ and 2 mL of (70%) HClO₄ for 2 h and 30 min at variable temperature (120–270°C). The mineral contents in the digests were analyzed using flame atomic absorption spectrometer. The following concentrations ranges in fresh-weight basis were recorded in decreasing order: Ca (1,038–2,173 µg/g)?>?Mg (478.2–812.3 µg/g)?>?Fe (53.95–82.83 µg/g)?>?Zn (5.18–9.40 µg/g)?>?Mn (6.98–8.66 µg/g)?>?Cu (1.85–5.53 µg/g)?>?Cr (0.66–3.47 µg/g)?>?Co (0.41–0.80 µg/g). A wide variation in the mineral contents of khat from different region of Ethiopia was noticed. The toxic metals (Pb and Cd) were not detected in all the samples analyzed.     

Khat use is associated with impaired working memory and cognitive flexibility

Rationale

Khat consumption has increased during the last decades in Eastern Africa and has become a global phenomenon spreading to ethnic communities in the rest of the world, such as The Netherlands, United Kingdom, Canada, and the United States. Very little is known, however, about the relation between khat use and cognitive control functions in khat users.

Objective

We studied whether khat use is associated with changes in working memory (WM) and cognitive flexibility, two central cognitive control functions.

Methods

Khat users and khat-free controls were matched in terms of sex, ethnicity, age, alcohol and cannabis consumption, and IQ (Raven''s progressive matrices). Groups were tested on cognitive flexibility, as measured by a Global-Local task, and on WM using an N-back task.

Result

Khat users performed significantly worse than controls on tasks tapping into cognitive flexibility as well as monitoring of information in WM.

Conclusions

The present findings suggest that khat use impairs both cognitive flexibility and the updating of information in WM. The inability to monitor information in WM and to adjust behavior rapidly and flexibly may have repercussions for daily life activities.     

The consumption of khat and other drugs in Somali combatants: a cross-sectional study

Background

For more than a decade, most parts of Somalia have not been under the control of any type of government. This “failure of state” is complete in the central and southern regions and most apparent in Mogadishu, which had been for a long period in the hands of warlords deploying their private militias in a battle for resources. In contrast, the northern part of Somalia has had relatively stable control under regional administrations, which are, however, not internationally recognized. The present study provides information about drug abuse among active security personnel and militia with an emphasis on regional differences in relation to the lack of central governmental control—to our knowledge the first account on this topic.

Methods and Findings

Trained local interviewers conducted a total of 8,723 interviews of armed personnel in seven convenience samples in different regions of Somalia; 587 (6.3%) respondents discontinued the interview and 12 (0.001%) were excluded for other reasons. We assessed basic sociodemographic information, self-reported khat use, and how respondents perceived the use of khat, cannabis (which includes both hashish and marijuana), psychoactive tablets (e.g., benzodiazepines), alcohol, solvents, and hemp seeds in their units. The cautious interpretation of our data suggest that sociodemographic characteristics and drug use among military personnel differ substantially between northern and southern/central Somalia. In total, 36.4% (99% confidence interval [CI] 19.3%–57.7%) of respondents reported khat use in the week before the interview, whereas in some regions of southern/central Somalia khat use, especially excessive use, was reported more frequently. Self-reported khat use differed substantially from the perceived use in units. According to the perception of respondents, the most frequent form of drug use is khat chewing (on average, 70.1% in previous week, 99% CI 63.6%–76.5%), followed by smoking cannabis (10.7%, 99% CI 0%–30.4%), ingesting psychoactive tablets (8.5%, 99% CI 0%–24.4%), drinking alcohol (5.3%, 99% CI 0%–13.8%), inhaling solvents (1.8%, 99% CI 0%–5.1%), and eating hemp seeds (0.6%, 99% CI 0%–2.0%). Perceived use of khat differs little between northern and southern Somalia, but perceived use of other drugs reaches alarmingly high levels in some regions of the south, especially related to smoking cannabis and using psychoactive tablets.

Conclusions

Our data suggest that drug use has quantitatively and qualitatively changed over the course of conflicts in southern Somalia, as current patterns are in contrast to traditional use. Although future studies using random sampling methods need to confirm our results, we hypothesize that drug-related problems of armed staff and other vulnerable groups in southern Somalia has reached proportions formerly unknown to the country, especially as we believe that any biases in our data would lead to an underestimation of actual drug use. We recommend that future disarmament, demobilization, and reintegration (DDR) programs need to be prepared to deal with significant drug-related problems in Somalia.     

Constipating and spasmolytic effects of Khat (Catha edulis Forsk) in experimental animals.

The constipating and spasmolytic effects of Catha edulis Forsk (Khat) were investigated in whole mice and on isolated guinea pig ileum. D-amphetamine was employed in both experiments for comparison. The total distance travelled (expressed in percentage) by charcoal suspension in the gastrointestinal tract of mice was determined before and after khat administration. The procedure was repeated with amphetamine and normal saline. The results were compared. Amplitudes of contraction were recorded with standard spasmogens, histamine and carbachol, in the presence and absence of khat extract of different concentrations. The same was done with amphetamine. Khat extract was observed to reduce the total distance travelled by charcoal suspension, comparable to D-amphetamine. The spasmogenic effects of both histamine and carbachol were observed to be antagonized by the khat extract in a concentration-dependent manner. The antispasmodic effect of khat extract was observed to be similar to that of D-amphetamine.     

Relative potencies of two phenylalkylamines found in the abused plant Catha edulis, khat

Cathinone and d-norpseudoephedrine are closely related phenylalkylamines isolated from $\text{Catha edulis}$ (khat), a plant much abused for its stimulant properties. We have compared the potency of these two compounds on an operant behavioral procedure in rats. Both suppress fixed ratio 20 responding for food in a dose related manner. Cathinone was 7–10 times more potent and had a more rapid onset of action than d-norpseudoephedrine, although the duration of action of cathinone was shorter. The ability of these two compounds to produce amphetamine-like stereotyped movements was in concordance with this same relative potency and difference in duration of action. Comparison of the behavioral effects in rats with the pattern of stimulation reported for khat use by man suggests that cathinone may be the major CNS active component of $\text{Catha edulis}$.     

Allometric equations for yield predictions of enset (Ensete ventricosum) and khat (Catha edulis) grown in home gardens of southern Ethiopia

Enset is a large, single‐stemmed perennial herbaceous plant domesticated as a staple food crop only in Ethiopia. Khat is a perennial plant cultivated for its economically important leaves and twigs that are the sources of stimulant when chewed. We address the issue of yield estimation of both crops, as they are important for the livelihoods of smallholders in the home garden systems in Southern Ethiopia and have received little attention so far. The objective of this study was to develop linear allometric models for estimating the edible (food and feed) and commercial yields of enset and khat plants, respectively. Data were collected from 20 enset and 100 khat plants. Diameter at 50‐cm height (d₅₀), pseudostem height (h_p) and their combination were good predictor variables for the food products of enset with adjusted R² values above 0.85, while d₅₀, h_p, edible pseudostem height (h_ep), total height (h_t) and their combination were good predictor variables for the feed products of enset with adjusted R² values above 0.70. For dwarf khat plants crown area (ca) combined with total height (h_t) resulted in the best prediction with an adjusted R² of 0.77, while the leaf and twig dry weight for tall khat plants was best predicted by ca with adjusted R² of 0.43. In all cases linear models were used.     

Clastogenic evaluation of cathinone and amphetamine in somatic cells of mice

Clastogenic effects of cathinone, the active principle from khat (Catha edulis) and amphetamine, a compound having similar chemical structure and pharmacological activity, have been studied on the somatic cells of mice. Both of them produced marked clastogenic activity and affected the cell proliferation in the bone marrow of mice. They induced a significant increase in the frequency of micronucleated polychromatic erythrocytes at higher doses. These results substantiate our earlier observations on the clastogenic and mitodepressive activity of cathinone on the meristematic region of Allium cepa, and indicate that cathinone may be responsible for the mutagenic effect of khat reported by other workers. The clastogenic effects of amphetamine are being reported for the first time. Further studies are required to substantiate these findings and to study whether cathinone and amphetamine produce a direct clastogenic effect or whether they act as spindle poisons.     

Cathinone: An alkaloid of Catha edulis (Khat) exacerbated hyperglycemia in diabetes-induced rats

Cathinone, the main bioactive alkaloid of Catha edulis (khat), slightly increased the blood sugar levels of healthy animals, while its effect on blood sugar levels of diabetic animals has not yet been reported. This study investigated the in vitro inhibition of cathinone on α-amylase and α-glucosidase as well as its in vivo glycemic effects in diabetes-induced rats. Rats were fed on a high fat diet for five weeks, which then intraperitoneally injected with streptozotocin (30 mg/kg). Diabetic rats were distributed randomly into diabetic control (DC, n = 5), 10 mg/kg glibenclamide-treated group (DG, n = 5), and 1.6 mg/kg cathinone-treated group (CAD, n = 5). Additional healthy untreated rats (n = 5) served as a nondiabetic negative control group. Throughout the experiment, fasting blood sugar (FBS), caloric intake and body weight were recorded weekly. By the 28th day of treatment, rats were euthanized to obtain blood samples and pancreases. The results demonstrated that cathinone exerted a significantly less potent in vitro inhibition than α-acarbose against α-amylase and α-glucosidase. As compared to diabetic control group, cathinone significantly increased FBS of diabetic rats, while insulin levels of diabetic rats significantly decreased. In conclusion, cathinone was unable to induce a substantial in vitro inhibition on α-amylase and α-glucosidase, while it exacerbated the hyperglycemia of diabetes-induced rats.     

The use of khat

Chewing of khat leaves has been noted to be widespread in Yemen. Immigrants to Israel brought that practice along and have kept it alive ever since their initial settlement over thirty years ago. The small epidemiological study reported here made an inquiry into the extent of khat use in two agricultural villages. It also explored the association of that practice with social and psychiatric variables. Of interest was the finding that — contrary to most addictions — the prevalence rate of psychopathology was not higher among users than among abstainers.