Editing Khat (section)

==Effects==
{{more medical citations needed|section|date=May 2018}}
[[File:HarmCausedByDrugsTable.svg|thumb|upright=1.35|Table from the 2010 ISCD study ranking various drugs (legal and illegal) based on statements by drug-harm experts. Khat was found to be the 17th overall most dangerous drug.<ref name="Nutt_2010">{{cite journal | vauthors = Nutt DJ, King LA, Phillips LD | title = Drug harms in the UK: a multicriteria decision analysis | journal = Lancet | volume = 376 | issue = 9752 | pages = 1558–1565 | date = November 2010 | pmid = 21036393 | doi = 10.1016/S0140-6736(10)61462-6 | s2cid = 5667719 | citeseerx = 10.1.1.690.1283 }}</ref>]]
[[File:Rational harm assessment of drugs radar plot.svg|thumb|Addiction experts in psychiatry, chemistry, pharmacology, forensic science, epidemiology, and the police and legal services engaged in [[Delphi method|delphic analysis]] regarding 20 popular recreational drugs. Khat was ranked 17th in dependence, 20th in physical harm, and 20th in social harm.<ref>{{cite journal|last1=Nutt|first1=D|last2=King|first2=LA|last3=Saulsbury|first3=W|last4=Blakemore|first4=C|title=Development of a rational scale to assess the harm of drugs of potential misuse.|journal=Lancet|date=24 March 2007|volume=369|issue=9566|pages=1047–53|pmid=17382831|doi=10.1016/s0140-6736(07)60464-4|s2cid=5903121}}</ref>]]

Khat consumption induces mild [[euphoria (emotion)|euphoria]] and excitement, similar to that conferred by strong coffee.<ref name="Kciy" /><ref name= "ZMadar2018" /> Individuals become very talkative under the influence of the plant. Animal testing has shown that khat causes an increase in motoric activity.<ref name= "ZMadar2018">{{Citation |contribution=The Khat Phenomenon in Yemen, and the Dangers it Poses|title=Ascending the Palm Tree: An Anthology of the Yemenite Jewish Heritage|last1=Madar|first1=Zecharia|editor1=Rachel Yedid|editor2=Danny Bar-Maoz|publisher=E'ele BeTamar|place=Rehovot|page=147|year=2018 |oclc=1041776317 }}</ref> The effects of oral administration of cathinone occur more rapidly than the effects of amphetamine pills; roughly 15 minutes as compared to 30 minutes in amphetamine.{{medical citation needed|date=May 2018}} Khat can induce [[mania|manic]] behaviours and [[hyperactivity]], similar in effects to those produced by amphetamine.<ref name="Kalix">{{citation|last=Peter |first=Kalix |chapter=The Pharmacology of Khat and of the Khat Alkaloid Cathinone |editor1-first=M. |editor1-last=Randrianame |editor2-first=K. |editor2-last=Szendrei |editor3-first=A. |editor3-last=Tongue |title=The Health and Socioeconomic Aspects of Khat Use |year=1983 |location=Lausanne, Switzerland |publisher=Intl. Council on Drug and Addictions |pages=140–43}}</ref><!--can't tell what format this is supposed to be (conference or book) so used {{Citation}}-->

The use of khat results in [[constipation]]. [[Pupillary response|Dilated pupil]]s ([[mydriasis]]) are prominent during khat consumption, reflecting the [[sympathomimetic]] effects of the drug, which are also reflected in increased heart rate and blood pressure. Long-term use can precipitate permanent [[tooth]] darkening (of a greenish tinge), susceptibility to [[peptic ulcer|ulcer]]s, and diminished [[Libido|sex drive]]. Khat is an effective [[anorectic]], causing loss of appetite.<ref>{{cite journal| first1 = Andrine M. | last1=Lemieux | first2 = Bingshuo | last2 = Li | first3 = Mustafa | last3 = al'Absi | title = Khat use and appetite: An overview and comparison of amphetamine, khat and cathinone| journal = Journal of Ethnopharmacology | date = 3 February 2015| volume = 160 | pages = 78–85 | doi = 10.1016/j.jep.2014.11.002 | pmid=25435289 | pmc = 4281284 }}</ref>

It is unclear if the consumption of khat directly affects the mental health of the user or not.<ref name="drugs"/> Occasionally, a psychotic episode can result, resembling a [[hypomanic]] state in presentation.<ref>{{Cite journal|last1=Giannini |first1=A.J. |last2=Castellani |first2=S. |title=A manic-like psychosis due to khat (Catha edulis Forsk.) |journal=Journal of Toxicology. Clinical Toxicology |volume=19 |issue=5 |pages=455–59 |date=July 1982 |pmid=7175990 |doi=10.3109/15563658208992500}}</ref> In humans, its prolonged consumption creates an uplifted mood and a sense of release from time and space.<ref name= "ZMadar2018" />

Khat is mainly chewed by men, but there are cases of its use by women, and in particular it has been associated with increased likelihood of adverse outcomes during pregnancy.<ref name=pregnancy>{{cite journal|url=https://pubmed.ncbi.nlm.nih.gov/36689029/|title=The effects of khat use during pregnancy on perinatal and maternal outcomes: a meta-analysis|year=2023 |pmid=36689029 |last1=Yitayih |first1=Y. |last2=Vanderplasschen |first2=W. |last3=Vandewalle |first3=S. |last4=Rita |first4=V. D. |last5=Gilbert |first5=L. |journal=Archives of Women's Mental Health |volume=26 |issue=1 |pages=11–27 |doi=10.1007/s00737-023-01293-5 |s2cid=256104043 |hdl=1854/LU-01GSDH896EZMZ7XE4W43AFYSAM |hdl-access=free }}</ref>

===Effects by timeframe===
'''Immediate'''
*alertness<ref name=AlZarouni />{{rp|6}}
*arousal<ref name=AlZarouni />{{rp|5}}
*concentration<ref name=AlZarouni />{{rp|7}}<ref name="Kalix" />
*confidence<ref name=AlZarouni />{{rp|6}}
*constipation<ref name=AlZarouni />{{rp|9}}
*dilated pupils
*[[euphoria]]<ref name="Kciy" />
*friendliness<ref name=AlZarouni />{{rp|7}}
*increased blood pressure<ref name="Kciy" /><ref name=AlZarouni />{{rp|6}}
*increased heart rate<ref name="Kciy" /><ref name=AlZarouni />{{rp|5}}
*insomnia<ref name=AlZarouni />{{rp|7}}
*[[mania]]
*[[psychosis]]<ref name="AlZarouni" />{{rp|8}}
*suppressed appetite<ref name=AlZarouni />{{rp|8}}
*talkativeness<ref name=AlZarouni />{{rp|8}}
*[[thought disorder]]<ref name=AlZarouni />{{rp|9}}
*verbosity<ref name=AlZarouni />{{rp|8}}

'''Long-term'''
*[[Depression (clinical)|depression]]<ref name=AlZarouni />{{rp|10}}
*infrequent hallucinations<ref name="Kciy" /><ref name=AlZarouni />{{rp|10}}
*impaired inhibition (similar to [[alcohol (drug)|alcohol]])<ref name=AlZarouni />{{rp|10}}<ref>{{Cite journal|title=Long-term effects of chronic khat use: impaired inhibitory control |journal=Frontiers in Psychology |volume=1 |pages=219 |publisher=Frontiers in cognition |date=12 January 2011 |doi=10.3389/fpsyg.2010.00219 |pmid=21833274 |pmc=3153824 |last1=Hommel |first1=Bernhard |last2=Bajo |first2=Maria Teresa |last3=Van Den Wildenberg |first3=Wery P. M. |last4=Ruiz |first4=Manuel J. |last5=Colzato |first5=Lorenza S. |doi-access=free }}</ref>
*increased risk of [[myocardial infarction]] (heart attack)<ref name=AlZarouni />{{rp|10}}<ref>{{cite journal|last1=Al-Motarreb |first1=A. L. |last2=Broadley |first2=K. J. |title=Coronary and aortic vasoconstriction by cathinone, the active constituent of khat |journal=Autonomic & Autacoid Pharmacology |volume=23 |issue=5–6 |pages=319–26 |date=October–December 2003 |doi=10.1111/j.1474-8673.2004.00303.x|pmid=15255816 }}</ref>
*oral cancer<ref>{{cite web|url=https://adf.org.au/drug-facts/khat/|title=Khat – DrugInfo|date=20 September 2006|publisher=Alcohol and Drug Foundation|access-date=28 July 2010}}</ref><ref>{{cite web |last1=Hassan |first1=Nageeb |last2=Gunaid |first2=Abdullah |last3=Murray-Lyon |first3=Iain |url=http://www.al-bab.com/bys/articles/hassan05.htm |title=British-Yemeni Society: The impact of khat-chewing on health: a re-evaluation |publisher=Al-bab.com |access-date=28 July 2010 |url-status=dead |archive-url=https://web.archive.org/web/20100607133117/http://www.al-bab.com/bys/articles/hassan05.htm |archive-date=7 June 2010 |df=dmy-all }}</ref>
*[[psychosis]] in extreme cases in the genetically predisposed<ref name="Kciy" /><ref name=AlZarouni />{{rp|11}}
*[[weight loss]]

'''Indeterminate'''
*[[death]]<ref name=AlZarouni />{{rp|12}}<ref name="Khat Chewing: A smokeless gun">{{cite journal|last1=Mateen |first1=F. J. |last2=Cascino |first2=G. D. |title=Khat Chewing: A smokeless gun? |journal=Mayo Clinic Proceedings |volume=85 |pages=971–73 |pmid=21037041 |doi=10.4065/mcp.2010.0658 |issue=11 |pmc=2966359 |date=November 2010}}</ref>
*stroke following [[acute coronary syndrome]] (clogging of the artery)<ref group="note">either from impaired insight into symptoms by the khat chewer, delay to care, or poorly understood [[pathophysiological]] mechanisms</ref><ref name=AlZarouni />{{rp|12}}<ref name="Khat Chewing: A smokeless gun"/>