Khat is a flowering shrub native to East Africa and the Arabian Peninsula whose fresh leaves are chewed for their stimulant and euphoric effects. More than 20 million people chew khat daily, primarily across Ethiopia, Yemen, Somalia, and parts of Saudi Arabia. The plant’s key compound, cathinone, is structurally related to amphetamine and produces a mild to moderate high that users describe as energizing and mood-lifting.
The Plant and Its Active Compounds
Khat (Catha edulis) is a leafy shrub that produces the small, glossy leaves and young shoots people chew. The plant contains several stimulant compounds, but cathinone is the most potent. It acts roughly 7 to 10 times more powerfully than cathine, the second most important compound, and enters the brain faster due to its chemical structure.
Freshness matters enormously. Cathinone is unstable and begins breaking down into the weaker compounds cathine and norephedrine within about 48 hours of harvesting. Drying the leaves accelerates this breakdown. This is why khat is typically wrapped in banana leaves to preserve moisture during transport, and why users strongly prefer fresh leaves over dried ones. A dried form called graba, produced mainly in Ethiopia, exists but delivers a weaker effect.
How Khat Affects the Brain
Cathinone works by flooding the spaces between nerve cells with dopamine, norepinephrine, and serotonin. Rather than simply blocking the recycling of these chemicals (the way some antidepressants work), cathinone actively pushes them out of nerve cells in the opposite direction. The result is a surge of the same brain chemicals responsible for alertness, pleasure, and motivation. This mechanism is similar to how amphetamine works, which is why the effects overlap: increased energy, elevated mood, reduced appetite, and a feeling of mental sharpness.
How People Use It
Khat is almost always chewed. A typical session involves 100 to 500 grams of leaves, stripped from their branches and tucked into the cheek. Users chew sporadically over several hours to slowly release the active compounds, then spit out the fibrous plant material. Sessions commonly last six to eight hours, often in groups of eight to twenty people. Less commonly, khat leaves are brewed into a tea. Smoking is rare.
Short-Term Effects on the Body
The immediate experience of chewing khat combines mild euphoria, increased alertness, and suppressed appetite. These mental effects come alongside measurable physical changes. In one study of 25 habitual chewers, average heart rate increased by nearly 6% after a chewing session, and three participants crossed into tachycardia (an abnormally fast heart rate). Heart rate variability, a marker of how well the nervous system regulates heart rhythm, dropped by almost 20%. Blood pressure rises as well, with increases in both the upper and lower readings documented in khat users.
These cardiovascular shifts are driven by the same flood of norepinephrine that produces the feeling of alertness. For most healthy users in a single session, the changes are temporary. For pregnant women, however, khat chewing has been linked to chest pain, rapid heart rate, and dangerously high blood pressure.
Long-Term Health Risks
Chronic khat use takes a toll on multiple organ systems, with the heart bearing the heaviest burden. Years of elevated blood pressure and increased heart rate place sustained stress on the cardiovascular system, leading to thickening of the heart muscle, structural remodeling of the heart chambers, and eventually heart failure. Research on 50 Yemeni patients with dilated cardiomyopathy found that habitual khat chewing contributed to the condition, particularly in younger patients with a genetic predisposition. Chronic users also face higher risks of heart attack, stroke, dangerous heart rhythm disturbances, and cardiogenic shock.
The digestive system suffers too. The coarse, fibrous leaves physically abrade the lining of the mouth, contributing to oral ulcers and dental problems. Farther down the tract, chronic use is associated with gastritis and peptic ulcers. The liver is not spared either: long-term khat consumption has been linked to liver toxicity, including reported cases of autoimmune hepatitis triggered by habitual use. Neurological, reproductive, and broader gastrointestinal problems have also been documented.
Cultural Significance
In the communities where it grows, khat is far more than a stimulant. It functions as a social ritual with deep historical roots. In Yemen, Ethiopia, and Somalia, chewing khat together is a cornerstone of social life, similar to the role coffee or tea plays in other cultures. Groups gather for hours-long sessions that revolve around conversation and community bonding. The practice is so normalized in Yemen that khat leaves are sold openly in marketplaces and shops, and this easy availability extends across the border into southern Saudi Arabia.
This cultural embeddedness makes khat use difficult to separate from daily social interaction in many communities. For millions of people, declining khat at a gathering carries roughly the same social weight as refusing a drink at a party in Western cultures.
Dependence and Withdrawal
The World Health Organization classifies khat as a drug of abuse capable of producing mild to moderate psychological dependence. Physical withdrawal symptoms are generally less severe than those associated with harder stimulants, but they are real. In a study of university students in Ethiopia who chewed khat regularly, 68% reported experiencing withdrawal symptoms when they stopped. The most common complaints were depression, cravings for khat, and fatigue. Nearly 73% of the chewers in that study had been using khat for a year or more, suggesting that regular use tends to become a sustained habit.
Legal Status
Khat occupies an unusual legal space. In the United States, fresh khat leaves are illegal because they contain cathinone, classified as a Schedule I controlled substance alongside heroin and LSD. Once the leaves lose freshness (typically after 48 hours), the cathinone degrades into cathine, which is a less-restricted Schedule IV substance. The United Kingdom banned khat in 2014, classifying it as a Class C drug. In much of East Africa and the Arabian Peninsula, khat remains legal and widely available, though some countries in the region have introduced restrictions. Canada, Germany, and several other European nations also prohibit it.
This patchwork of laws creates complications for diaspora communities from khat-using cultures, where the practice may be a lifelong social norm but carries criminal penalties in their new home countries.