Khat is a plant-based stimulant that produces effects similar to a mild amphetamine. Chewing the fresh leaves releases a compound called cathinone, which hits your bloodstream within about 15 minutes and triggers a rush of euphoria, alertness, and energy that lasts roughly three hours. But those initial effects are just the beginning of what khat does to your body, both in the short term and over years of regular use.
How Khat Works in the Brain
Cathinone, the primary active compound in khat leaves, is structurally related to amphetamine. It works by flooding your brain with dopamine and norepinephrine, two chemicals that regulate mood, energy, and attention. Rather than mimicking these chemicals directly, cathinone forces your nerve cells to release more of them while simultaneously blocking their reabsorption. The result is a temporary surplus of feel-good signaling that produces stimulant effects.
Cathinone is released from the leaves within 15 to 45 minutes of chewing and reaches peak levels in your blood between 1.5 and 3.5 hours later. Its half-life ranges from about 1.5 to 4.3 hours depending on the dose. Compared to amphetamine, cathinone kicks in roughly twice as fast (15 minutes versus 30), though its effects are generally milder and shorter-lived.
The Initial High and What Follows
People who chew khat describe feeling sharper, more confident, and more talkative. They report clearer thinking, increased energy, reduced hunger, and a general sense of wellbeing. Some describe it as a productivity boost, with ideas flowing more freely and social conversation coming easily.
That pleasant phase doesn’t last. Within about two hours, the experience typically shifts toward tension, anxiety, emotional instability, irritability, and restlessness. As the stimulant wears off further, users commonly feel low mood, numbness, sluggishness, difficulty concentrating, and insomnia. This pattern closely mirrors what happens with amphetamine use: positive effects gradually give way to increasingly uncomfortable ones.
What Happens to Your Heart
Cathinone acts as a sympathomimetic, meaning it activates your body’s fight-or-flight response. During a chewing session, heart rate increases by about 5 to 6 percent on average, and both systolic and diastolic blood pressure rise. In a study of 25 chewers, three developed heart rates fast enough to qualify as tachycardia.
The cardiovascular risks compound with long-term use. A case-control study published in the British Journal of Clinical Pharmacology found that khat chewers had five times the risk of heart attack compared to non-chewers. Heavy chewers, those with sessions lasting six hours or more, faced a dramatically higher risk. The relationship was dose-dependent: the more khat consumed and the longer the sessions, the greater the danger. This held true even after controlling for other risk factors, making khat an independent risk factor for heart attack.
Effects on Thinking and Memory
Regular khat use appears to impair cognitive abilities that are essential for daily functioning. A study published in PLOS One found that khat users performed significantly worse than non-users on tasks measuring working memory and cognitive flexibility, the ability to mentally shift between different tasks or ideas. Khat users made far more errors on task-switching tests (21.3 percent error rate versus 4.0 percent for controls) and showed clear deficits in tracking and updating information in short-term memory. Earlier research from the same group also found impairments in the ability to inhibit automatic responses, a core component of self-control.
Damage to Your Mouth and Digestive System
Because khat is chewed for hours at a time, with the pulpy leaves held against the cheek, the mouth takes a direct hit. Long-term chewing is linked to increased dental cavities, periodontal disease, and a higher incidence of oral cancer. The mechanism appears to involve oxidative stress from compounds in the leaves that damage oral tissues over time.
Further down the digestive tract, khat contributes to gastrointestinal problems including constipation and gastritis. The appetite-suppressing effects can also lead to poor nutrition with chronic use.
Liver Injury
Khat chewing has been linked to rare but serious liver damage. The National Institute of Diabetes and Digestive and Kidney Diseases rates khat as a “highly likely” cause of clinically apparent liver injury. The damage typically develops after years of use and can show up as acute illness with jaundice, fatigue, nausea, and itching, or as a slow-building chronic condition that progresses toward scarring, portal hypertension, and liver failure.
In documented cases, liver enzyme levels were markedly elevated. One reported case involved a 24-year-old man hospitalized with severe jaundice and liver enzymes more than 50 times above normal. Some patients experience repeated episodes of acute injury that build into cirrhosis. Liver damage can resolve if khat use stops, but relapses are common. There is some evidence that the liver toxicity may be partly related to how the leaves are stored and shipped, since most reported cases outside East Africa involve khat that has traveled long distances.
Dependence and Withdrawal
The World Health Organization classifies khat as a possible drug of abuse, though with less addictive potential than alcohol or tobacco. That said, dependence clearly develops in regular users, and quitting is harder than it might seem.
A study tracking 59 young adults attempting to quit khat found that withdrawal symptoms were far from trivial. Depression, cravings, nervousness, tiredness, restlessness, poor motivation, irritability, and negative mood all increased substantially after stopping use, peaking around day seven and remaining elevated well beyond that. The study noted low success rates during unaided quit attempts, suggesting that the withdrawal experience is a real barrier to stopping.
Legal Status
Khat’s legal status varies widely around the world. In the United States, cathinone is a Schedule I controlled substance, making khat effectively illegal. The UK banned it in 2014 after years of large-scale importation, with an estimated seven metric tons passing through Heathrow Airport each week from Yemen, Ethiopia, and Kenya. It remains legal and widely used in Yemen, parts of East Africa, and other regions where it has deep cultural roots. In Qatar and several other countries, cultivation, sale, and casual chewing are all prohibited.