Khat: Scientific knowledge and policy issues

Summary The chewing of khat leaves is common in certain countries of East Africa and the Arabian peninsula, and some khat users are subject to psychic dependence on this stimulant. Recently, important progress has been made in understanding the pharmacological basis for the effects of khat. It is now known that the CNS stimulation is mainly due to the presence of the alkaloid cathinone in the leaves, and the results of various in vitro and in vivo experiments indicate that this substance must be considered a ‘natural amphetamine’. The consumption of khat has strongly increased in recent years, and the drug has also made its appearance in Great Britain. In view of these developments, the socio‐economic and health aspects of the khat habit are discussed together with the political issues that they imply.