Refugee Health Fact Sheet – FAQs on Consequences of Khat Use by Refugees
State Letter #07-03
TO: STATE REFUGEE COORDINATORS
STATE REFUGEE HEALTH COORDINATORS
NATIONAL VOLUNTARY AGENCIES
OTHER INTERESTED PARTIES
FROM: Martha E. Newton
Office of Refugee Resettlement
SUBJECT: Refugee Health Fact Sheet – FAQs on Consequences of Khat Use by Refugees
What is khat? Khat is an evergreen shrub (6-12 feet in height) grown and harvested in southern Arabia and Eastern Africa, and primarily in the countries of Somalia, Yemen, Kenya and Ethiopia. Khat is used for its stimulant effects. The active ingredients of khat produce psychotropic, euphoric, metabolic and cardiovascular stimulant effects similar to amphetamine. Several million people in East Africa and the southern Arabian Peninsula are habitual users.
What are “street names” for khat? Khat has over 40 street names, to include Abyssinian Tea, African Salad, Bushman’s Tea, Chat, Gat, Kat, Miraa, Oat, Qat, Somali Tea, Tohai, and Tschat.
Why is khat of concern in the U.S.? Regular consumption of khat by refugees can damage refugee community health and socio-economic vitality, and impede refugee social integration and economic self-sufficiency. Further, the influx to the U.S. in recent years of immigrants and refugees from Africa and the Arabian Peninsula – in particular the Somali community – has increased demand for, and availability and use of khat here. Because only fresh khat leaves produce greatest stimulation, consumption of khat was traditionally confined to regions of its production. But now, faster transportation and improved techniques for preservation have led to increased availability and use of khat in the West.
What are the law enforcement and immigration consequences of khat consumption by refugees? There are also serious law enforcement and immigration consequences for refugee consumption of khat. The active ingredients of khat are alkaloids; cathinone (schedule I drug) and cathine (schedule IV drug), which are regulated under the U.S. Controlled Substance Act (CSA). The importation, possession, or use of khat in the U.S. is a violation of federal law and can lead to a refugee’s arrest, incarceration, detention, and/or removal from the U.S. The same is of course true for asylees, Cuban/Haitian Entrants, and Victims of a Severe Form of Trafficking. There is no legitimate or legal use for khat in the United States.
What are alkaloids? Alkaloids are any of various physiologically active, nitrogen-containing organic bases obtained from plants such as nicotine, quinine, atropine, cocaine, and morphine. Cathinone is 10 times more potent than Cathine but dissipates within 48 hours of harvest. Within 48 hours of harvest khat’s chemical composition breaks down to contain only Cathine, reducing its potency.
How is khat consumed, and by whom? Khat is ingested by chewing the leaves - as is done with loose tobacco. Dried Khat leaves can be brewed in tea or added to food. Males are by far the most common users of khat.
What effects does Khat have on a user? A typical chewing session is thought to be the equivalent of ingesting 5 milligrams of amphetamine. After ingestion the user experiences immediate increase in blood pressure and heart rate. Its stimulant effects begin to diminish 90 minutes to 3 hours after ingestion, but can last up to 24 hours.
What are the risks to khat use? Individuals who consume khat typically experience a state of mild depression following periods of prolonged use. Taken in excess khat can cause extreme thirst, hyperactivity, insomnia, and loss of appetite. Systematic use of khat can reduce the user’s motivation and lead to manic behavior with grandiose delusions, paranoia, and hallucinations. Continued khat use can cause damage to the nervous, respiratory, circulatory, and digestive systems.
How much khat is available in the United States? The availability of khat in the United States has been increasing since 1995. According to the Federal-wide Drug Seizure System (FDSS), law enforcement seizures of khat increased from 14 metric tons in 1995 to over 37 metric tons in 2001. During the first six months of 2002, nearly 30 metric tons of khat were seized. El Paso Intelligence Center reported that law enforcement seized 32, 39, 37, 54, 47, and 32 metric tons of khat in 2000, 2001, 2002, 2003, 2004, and through September 2005, respectively.
How much does it cost to manufacture khat? Khat is purchased from farmers in the horn of Africa region for about $1 per kilogram. Warlords operating in this area use aircraft to ship khat to Europe, where khat consumption is still legal. The khat is sold to middlemen for $200/kg, a profit of $199 per kilogram. Some khat is shipped to the United States and other regions.
What does khat sell for in the United States? Khat generally sells for $300-$600 per kilogram or $30 to $60 per bundle (which is 40 leafed twigs measuring 12-15 inches in length). Evidence suggests that funds from the sale of khat are moved to Europe and the Middle East. The sale of khat generates illegally obtained funds, which can lead to money laundering or other illicit financial transactions.
How is khat shipped to the United States? Khat is brought into the U.S. by couriers who can place between 20 and 140 kilograms in their suitcases, or shipped to the U.S. by express mail in boxes that contain 9-25 kilograms of khat.
Recommendations to address khat use: 1) Establish community campaigns to inform refugees of the harmful health, social, legal, and immigration consequences of khat importation, possession and use; 2) Establish educational campaigns to inform mainstream refugee service providers of the symptoms, health & legal consequences, and cultural aspects of khat consumption; 3) Learn more about the variables associated with khat use in local communities and apply the information to policy, planning and interventions at state and local levels.
 References: Cox G & Rampes H, (2003). Adverse effects of khat: a review. Advances in Psychiatric Treatment 9, 456-463; Dhaifalah I & Santavy J, (2004). Khat habit and its health effect. A natural amphetamine. Biomed. Papers 148(1), 11-15; National Drug Intelligence Center, (2003). Intelligence Bulletin: Khat (Catha edulis). (Document ID 2003-Lo424-002). Retrieved from http://www.usdoj.gov/ndic/pubs3/3920/index.htm