The Scientific Debate on Khat Addiction: Evidence Across Humans, Animals, and Policy Domains.

Area of Science:

• Neuroscience
• Psychiatry
• Public Health

Background:

• Khat's addictive potential is debated, influenced by inconsistent evidence, varied epidemiology, and complex regulations.
• While cathinone and cathine are controlled, khat's legal status remains ambiguous, as seen in the UK's 2014 reclassification.
• World Health Organization (WHO) assessments indicate mild to moderate psychological dependence, with harms often tied to usage patterns and social vulnerabilities.

Purpose of the Study:

• To review the contested addictive status of khat.
• To analyze the influence of sociopolitical factors on khat regulation.
• To highlight the need for standardized assessments and evidence-based treatments.

Main Methods:

• Review of existing epidemiological data and human studies on khat use and dependence.
• Analysis of preclinical research on khat extract's effects on behavior.
• Examination of regulatory approaches and WHO assessments.

Main Results:

• Human studies report inconsistent dependence rates due to cultural factors and diagnostic tool variability.
• Preclinical studies show khat extract can induce conditioned place preference and relapse-like behaviors, but weaker than traditional stimulants.
• Harms associated with khat are often linked to patterns of use and individual vulnerabilities rather than alkaloid exposure alone.

Conclusions:

• Khat's addictive status requires further clarification through standardized assessments and neurobehavioral studies.
• Developing evidence-based treatments for khat use disorder is crucial.
• Community-grounded interventions are needed to address the multifaceted nature of khat-related harms.