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Fatalities Involving Khat in Jazan, Saudi Arabia, 2018 to 2021
Ghassan Shaikhain1, Mohammed Gaballah2, Ahmad Alhazmi2
1Forensic Toxicology Services, Forensic Medical Center, Ministry of Health, Jazan 45142, Saudi Arabia.
Toxics
|June 27, 2023
Summary
Fatalities involving khat are increasing in Saudi Arabia. This study established reference concentrations for cathinone and cathine in postmortem samples, aiding forensic investigations of khat-related deaths.
Area of Science:
- Forensic Toxicology
- Postmortem Investigations
- Drug Abuse and Fatality Analysis
Background:
- Interpreting fatalities involving khat (Catha edulis) is hindered by a lack of established reference concentrations for its active constituents, cathinone and cathine, in postmortem tissues.
- Khat consumption is prevalent in certain regions, necessitating a better understanding of its role in mortality.
Purpose of the Study:
- To investigate autopsy findings and toxicological results in fatalities associated with khat use in Saudi Arabia.
- To establish reference concentration ranges for cathinone and cathine in various postmortem samples.
- To determine the contribution of khat to overall fatalities and its association with other substances.
Main Methods:
- Retrospective analysis of 651 fatality cases investigated by the Forensic Medicine Center in Saudi Arabia's Jazan region (2018-2021).
- Toxicological analysis of postmortem samples (blood, urine, brain, liver, kidney, stomach) for cathinone and cathine.
- Review of autopsy findings, cause of death, and manner of death for cases testing positive for khat constituents.
Main Results:
- Thirty (4.6%) of the 651 cases tested positive for cathinone and/or cathine.
- Khat-related fatalities increased from 3% in 2018-2019 to 9% in 2021.
- Established reference ranges: Blood (cathinone 18-218 ng/mL, cathine 222-843 ng/mL), Brain (69-682 ng/mL), Liver (64-635 ng/mL), Kidneys (43-758 ng/mL).
- Homicide was the most common cause of death (77%) in khat-only fatalities.
- 43% of positive cases also involved other drugs, primarily amphetamine.
Conclusions:
- This study provides crucial reference concentrations for cathinone and cathine in postmortem samples, aiding forensic toxicologists in interpreting khat-related fatalities.
- The increasing trend in khat-related deaths highlights the need for continued monitoring and research.
- Further investigation into the toxicological and autopsy findings is essential for accurately assessing khat's role in criminal cases and mortality.
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