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Background: During recent decades, the consumption of the stimulant khat (catha edulis) has profoundly changed in countries around the Horn of Africa, and excessive use patterns have emerged-especially evident among displaced Somalis. This is related to the development of severe somatic and psychiatric disorders. There are currently no preventive or interventional studies targeting khat use. This study's aim was to test screening and brief intervention (SBI) to reduce khat use among urban Somali refugees living in Kenya with limited access to public healthcare., Methods: In this controlled study, 330 male Somali khat users from the community were either assigned to SBI (161) or an assessment-only control condition (AC; 169); due to field conditions a rigorous experimental design could not be implemented. The World Health Organization's (WHO) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)-linked brief intervention was adapted to khat and Somali culture. Trained local counselors administered the intervention. The amount and frequency of khat use was assessed using the time-line-follow-back method. We compared the month before the intervention (t1) to the two months after it (t2, t3). Baseline differences in khat use frequency were corrected by partial matching and mixed effect models used to evaluate intervention effects., Results: SBI was well accepted and feasible for khat users. Over the complete observation period and from t1 to t2, khat use amount and frequency decreased (p < .001) and the intervention group showed a greater reduction (group x time effects with p ≤ .030). From t2 to t3, no further reduction and no group differences emerged., Conclusion: The results provide preliminary evidence that khat use amount and frequency can be reduced in community settings by SBI, requiring little resources. Thorough assessment alone might have intervention-like effects. The non-treatment-seeking community sample and the non-professional counselors are distinct from SBI studies with other substances in other countries, but support the feasibility of this approach in khat use countries and especially in Somali populations with limited access to healthcare. Future studies that employ rigorous experimental design are needed., Trial Registration: ClinicalTrials.gov identifier: NCT02253589. Date of first registration 01/10/2014, retrospectively registered https://clinicaltrials.gov/ct2/show/NCT02253589 . First participant 16/09/2014., (© 2022. The Author(s).)

Introduction and Aims: Catha Edulis Forsk (khat) is a plant-reported to have a stimulant effect similar to that of amphetamines-grown and used by eastern African communities worldwide. Khat can be legally consumed in many parts of the world, including Victoria, Australia. Recent concerns have been raised about the social and economic impacts of khat consumption among Victoria's East African community members. This study explores khat use and the social impact it has on East African families and communities in Melbourne, Australia., Design and Methods: Focus groups and individual interviews were conducted in 2009 with 29 members of Melbourne's East African community recruited via community leaders and snowball sampling. Fifty-five per cent of the sample reported khat use and the remainder reported only having experience of other people's use of the drug., Results: Participants who did not report chewing khat were mainly concerned with the negative social impacts of its use, such as the extended time men spent away from their families while consuming the drug. These participants (mainly women) expressed their hope that khat would be prohibited in Victoria. Participants who reported the use of khat (mainly men) reported that any social problems existed independently of khat consumption., Discussion and Conclusions: This study found only limited evidence that khat use has been impacting directly on people's health and well-being. Any moves to prohibit khat use may further marginalise already vulnerable groups of people., (© 2011 Australasian Professional Society on Alcohol and other Drugs.)

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.

This study reports the demographic and social characteristics and level of psychological dysfunction in regular khat users compared with matched non-users. The results indicate that khat users resemble non-users on a number of psychosocial variables and GHQ scores, with no evidence to suggest higher morbidity amongst users. The two groups appear to differ only in the level of their use of nicotine and also in their perception of the harmful effects associated with khat use.

Khat (Catha edulis Forsk.), known in Somalia as "qaad" or "jaad", is a plant whose leaves and stem tips are chewed for their stimulating effect. From the Harar area, khat has been introduced at different times into the present day territories of Somalia, Djibouti, South and North Yemen, Kenya, Madagascar, Tanzania and down to south eastern Africa. The plant, which belongs to the Celestraceae family, grows wild at altitudes of 1500-2000 m above sea level. Among the various compounds present in the plant (more than forty alkaloids, glycosides, tannins, terpenoids, etc.), two phenylalkylamines, namely cathine [+)-norpseudoephedrine) and cathinone [-)S-o-aminopropiophenone) seem to account mostly for the effect. The consumers get a feeling of well-being, mental alertness and excitement. The after effects are usually insomnia, numbness and lack of concentration. The excessive use of khat may create considerable problems of social, health and economic nature. These problems have been summarily reviewed. Khat chewing started at different times in different parts of Somalia. Since World War II, the prevalence of the practice has continuously increased and no social group is excluded. An epidemiological research to compare Northern and Southern regions of Somalia and to obtain a rough estimate of prevalence, definition of social characteristics of the groups of consumers, specification of the motivations, patterns of use and effects during and after consumption has been conducted. Consumers and non-consumers (7485 people) were randomly interviewed in the two regions. Khat consumption in relation to sex, age, occupation and grade of education is presented.

The habit of chewing Khat (Catha edulis) to experience its euphorizing and psychostimulant effects has prevailed for centuries among the inhabitants of the Horn of Africa and the Arabian peninsula. In recent years, air transport has removed the major obstacle to the diffusion of Khat, its perishableness. Khat is now air-freighted to Europe and we were able to buy some in Rome. We report the results of interviews with 20 members of the Somali community in Rome, who had continued their habit of chewing Khat whilst abroad. They asserted that they gathered together whenever possible, but preferably at weekends, to chew moderate quantities of Khat (one bundle, about 400 g). The customary habit of drinking tea or other soft drinks containing methylxantines during Khat sessions was maintained and very few subjects admitted drinking alcohol. In this small study sample, Khat chewing still seems to be a social event, as it is in Somalia.

The chewing of the leaves of the plant called khat (Catha edulis Forsk) is a common habit in some countries of East Africa and the Arabian Peninsula. Khat-chewing has a stimulating effect on the central nervous system, which is the reason for the widespread abuse of this plant. From the mid-1960s to the early 1980s, khat-chewing spread from the limited area of the north-western part of Somalia to the whole country, assuming epidemic proportions. Khat-chewing was recognized as a real national problem with adverse consequences for the health and socio-economic development of the country. A law prohibiting the use, importation, cultivation and trade of khat was enacted in 1983, and it has been strongly enforced by a comprehensive national programme that has mobilized the whole country to achieve its objectives. Committees to co-ordinate action on khat control were established at the national, regional and local levels. An information and education campaign through the use of the mass media has been carried out to support the national programme. After the successes achieved in the enforcement of the prohibition law, the national authorities, hampered by a shortage of financial resources, have had major difficulties in providing farmers with adequate compensation for damage caused to them by the destruction of khat plantations. Difficulties were also experienced in coping with the unemployment of those who were involved in the khat business and in establishing the recreational facilities needed to provide healthy social alternatives to khat-chewing sessions. These difficulties have only been partly solved.(ABSTRACT TRUNCATED AT 250 WORDS)

Khat chewing has been found to induce, like amphetamines, psychostimulation and increase in sympathetic tone. The possibility that tolerance develops to these effects has been studied by comparing the influence of the chewing of a standard dose of khat on some physiological parameters in chronic consumers and naive subjects. Systolic blood pressure appears to rise in both groups, but the increase in diastolic pressure was more marked in naive subjects and inversely related to the reduction of pulse rate. The increases of respiratory rate and body temperature were also higher in naive subjects. In both groups, all these effects disappeared after 18 h. These results are consistent with an amphetamine-like mechanism of action and suggest that tolerance develops to the sympathetic effects of khat.