Khat is a flowering plant whose fresh leaves are chewed as a stimulant, and it holds a central place in Somali social life. The plant, known scientifically as Catha edulis, is native to the Horn of Africa and the Arabian Peninsula. Its primary active compound is structurally related to amphetamine, producing feelings of alertness, energy, and euphoria that can last for hours. In Somalia, chewing khat is legal, widely practiced, and deeply woven into daily routines, though it carries real health and economic costs.
How Khat Works as a Stimulant
Khat leaves contain a group of compounds called phenylalkylamines, the most potent being cathinone. These chemicals are structurally related to amphetamine and produce similar effects on the nervous system, with the differences being a matter of degree rather than type. Cathinone triggers the release of the same “feel-good” brain chemicals that amphetamine does, creating a sense of heightened energy, confidence, and mental sharpness.
The strongest effects come from fresh leaves. Once picked, cathinone begins breaking down within about 48 hours into weaker compounds, which is why khat is rushed from farms to markets and why freshness commands a premium price. Most users chew the young leaves and tender stems raw, tucking a wad into the cheek and slowly extracting the juice over hours. Less commonly, dried leaves are brewed into a tea-like drink.
Khat’s Role in Somali Culture
Chewing khat in Somalia is fundamentally a social activity. Sessions typically involve groups of eight to twenty people and can stretch six to eight hours, often filling the afternoon into evening. These gatherings serve as spaces for conversation, business dealings, and community bonding. For many Somali men, the daily chewing session is as routine as a meal.
The practice skews heavily male. Research on substance use in south-central Somalia found that men had more than seven times the odds of lifetime substance use compared to women. The heaviest use falls among young adults aged 20 to 33, who make up the majority of consumers. While khat use was historically the most common substance habit in Somalia, more recent data from conflict-affected youth populations suggests usage patterns may be shifting, with other substances gaining ground.
Khat’s relationship with Islam in Somalia is complicated. Islamic scholars are split: some consider it haram (forbidden) due to its health effects and intoxicating properties, others classify it as merely makruh (discouraged), and some view it as permissible. In practice, many Somali khat users do not regard their habit as religiously prohibited, and the chewing tradition persists alongside daily religious observance without much friction for most users.
The Economics of Khat in Somalia
Somalia consumes far more khat than it grows. Very little is cultivated domestically; the vast majority is imported from Ethiopia and Kenya, where large-scale farming operations supply the Somali market daily. Khat is legal in Somalia and functions as a taxable commodity.
The financial burden on individual households is significant. Research has documented average daily spending of about $7.29 on khat among Somali users, a figure that represents a substantial share of income in a country where many people live on very little. Across the population, this spending adds up to a major drain, pulling money away from food, education, and savings. Studies from Somalia and neighboring countries consistently link heavy khat consumption to lower productivity, missed work or school, strained family relationships, and broader obstacles to economic development.
Short-Term Effects on the Body
During a chewing session, khat produces a progressive rise in blood pressure and heart rate that continues building over several hours. In one controlled study, both systolic and diastolic blood pressure climbed steadily over a three-hour chewing period, and levels had not returned to normal even an hour after chewing stopped. Users typically experience reduced appetite, increased talkativeness, and a sense of well-being during the first few hours, followed by a quieter, more reflective phase as the session winds down.
Because the stimulant effect lingers, insomnia is one of the most common complaints. Many regular users report difficulty sleeping on nights after chewing, which creates a cycle: fatigue the next morning, then another chewing session to compensate.
Long-Term Health Consequences
Chronic khat use takes a measurable toll on multiple body systems. The mouth bears the most direct damage, since the leaves are in constant contact with oral tissues during long chewing sessions. Research has found that khat is both mutagenic and carcinogenic, meaning it can cause the kind of DNA damage that leads to cancer. One study analyzing cancer-related gene mutations found that khat users developed oral squamous cell carcinoma (a type of mouth cancer) affecting the gums and lower lip, with mutations present in both short-term users (under 15 years) and long-term users.
Beyond the mouth, chronic use is associated with esophageal cancer, chronic gastric problems including constipation and inflammation, and liver disease. The cardiovascular system also suffers from years of repeated blood pressure spikes, contributing to a range of cardiac problems. Anorexia and malnutrition are common among heavy users, since khat suppresses appetite for hours each day.
Psychological Risks and Dependency
The psychological effects of khat range from mild mood changes to serious psychiatric episodes, depending largely on how much and how long someone chews. Among regular users who stop, about two-thirds report withdrawal symptoms. The most common are depression, intense cravings, and fatigue. Other withdrawal experiences include a sensation of heat in the legs, nightmares, mild tremor, and lethargy.
At the more severe end, heavy khat use can trigger full psychotic episodes. Case reports describe patients developing paranoid delusions, auditory hallucinations, grandiose thinking, and severe anxiety after prolonged, excessive chewing, typically more than two bundles per day. These episodes closely resemble amphetamine psychosis, which makes sense given the chemical similarities. There have been documented cases of suicidal attempts and homicidal acts linked to heavy use. The risk is highest among people who start young and escalate their consumption over time. For most moderate users, these extreme outcomes are uncommon, but the pattern is well established enough that clinicians in the Horn of Africa recognize khat-induced psychosis as a distinct condition.
More than 10 million people across East Africa and the Arabian Peninsula use khat regularly. In Somalia, where conflict, displacement, and limited mental health services compound the problem, the psychological toll of heavy use is a growing public health concern with few easy solutions.