Khat and the creation of tradition in the Somali diaspora
Jane Fountain, Dirk J Korf in Drugs in Society, 2019
Khat (Catha edulis), also known as qat, chat and miraa, is a shrub that grows wild across much of Africa and Asia, favouring altitudes of between 5,000 and 6,500 feet above sea level. The oldest records show that khat was used in the highlands of Yemen and Ethiopia as early as the fourteenth century. It is also well established in the Meru mountains of Kenya. Somalia, by contrast, is an arid, low-lying country dominated by scrubland and savannah. In the pre-colonial era, the majority of the population were pastoralists, and there were pockets of intensive agricultural production in the river valleys and along the coast. Both as groups and individually, Somalis travelled widely and participated in the regional exchange economy, which was centred on the trade of meat, milk, leather and other animal products in exchange for vegetable produce. The trade between protein-producing lowlands, populated by nomadic groups, and the sedentary farmers of the highlands is a well-established feature in the Horn of Africa. Via this exchange system, Somalis were able to access agricultural produce that they could not grow in their own region. There was therefore a cultural memory and an awareness of exogenous crops such as khat.
Substance Use Disorders
Vincenzo Berghella in Maternal-Fetal Evidence Based Guidelines, 2022
Amphetamines were first synthesized in 1887 [151]. Amphetamine is FDA approved (schedule II) for the treatment of attention-deficit hyperactivity disorder (ADHD) and narcolepsy. The more potent stimulant, methamphetamine (schedule II), is FDA approved for the treatment of ADHD and obesity. Methamphetamine is easily made from over-the-counter cold medications and addiction can occur after as little as one use [152]. Ecstasy, which is chemically similar to methamphetamine, was patented in 1912 [153]. In the 1970s, psychotherapists used ecstasy to enhance “openness” with their patients [153]. Ecstasy was classified as a schedule I drug in 1985 [153]. Khat is a shrub (Catha edulis) native to the Southwestern Arabian Peninsula and Eastern Africa. Chewing khatpyy has been chewed for centuries because of stimulant and euphoric effects. The active ingredient is β-ketoamphetamine, a cathinone with properties that are similar to amphetamine [154]. Bath salts are a group of synthetic cathinones (naturally occurring alkaloids which are chemically similar to amphetamines) with amphetamine-like stimulant properties. Bath salts, sometimes also sold as “jewelry cleaner”, “phone screen cleaner”, or “plant food”, get their name from the resemblance of the white or beige crystalline powder to the real thing [154]. Bath salts are not detected on routine urine drug screens.
Geopolitics, human security and health
Kevin McCracken, David R. Phillips in Global Health, 2017
In addition to the million unnecessary deaths from the conflict and ensuing disruption, there are many other health-related side-effects of war and civil disturbance in this region. These also affect other places, such as parts of South and West Asia (e.g. Afghanistan, Pakistan, Sri Lanka, Gaza, Iraq). Those directly and indirectly impacted include people who have been injured and handicapped, who can be identified and perhaps assisted. However, there are millions more hidden casualties, including people with psychological injuries and children without parents who have lost their family lives, education and upbringing, and others suffering from extensive social disruption. These effects can be damaging; for example, ex-combatants have high psychiatric morbidity and use of drugs such as khat (Murthy and Lakshminarayana, 2006). For many children, prolonged exposure to conflict has brought deep psychological scarring.
Acute toxic kidney injury
Published in Renal Failure, 2019
Nadezda Petejova, Arnost Martinek, Josef Zadrazil, Vladimir Teplan
Amphetamines are synthetic, widely abused psychoactive drugs with significant stimulant, euphoric, anorectic, empathogenic, entactogenic and hallucinogenic properties. Common in clinical psychiatric practice are amphetamine, methamphetamine and 3,4 methylenedioxymethamphetamine (MDMA, Ecstasy). However, in human history some natural amphetamines have been used for centuries through the ingestion or chewing the leaves of the Catha edulis plant (Khat) in East Africa and Arabia or plants of the genus Ephedra e.g. Ephedra sinica. The biochemical structure of amphetamines is similar to the monoamine neurotransmitters with competitive action at membrane transporters of dopamine, norepinephrine and serotonin. The results of competitive membrane action are blocking of reuptake and induction of the reverse transport of endogenous neurotransmitters [102]. The clinical presentation of MDMA poisoning varies from hyperpyrexia, arrhythmias, serotonin syndrome, neurological symptoms with seizures, sudden death or coma. In vitro study using rat and human proximal tubular cells showed no direct nephrotoxicity of MDMA or methylenedioxyamphetamine (MDA) in varied concentrations, but alpha-methyldopamine (alpha-MeDA) itself and conjugation with glutathione (GSH) to 5-(glutathione-S-yl)-alpha-MeDA were extremely potent nephrotoxicants with approximately 70–80% cell death. Thus, the metabolism of ecstasy on the apical membrane of renal proximal tubular cells with the extracellular event of redox cycling appears to be the possible part of pathophysiological pathway of MDMA nephrotoxicity [103].
Rate and risk factors of recurrent tuberculosis in Yemen: a 5-year prospective study
Published in Infectious Diseases, 2020
Mohammed Saif Anaam, Alian A. Alrasheedy, Saud Alsahali, Saeed O. Alfadly, Adel H. Aldhubhani
For the independent variables, diabetics were defined as patients diagnosed with diabetes and using anti-diabetic drugs [29]. Patients who habitually and currently chewed khat (Catha edulis) leaves as a stimulant were considered khat chewers. Patients who habitually and currently smoked tobacco were considered smokers. An unemployed person was defined as one who did not have any source of income and relied on the family to meet all needs. Treatment adherence was defined as taking ≥80% of the prescribed doses, usually 56 in the intensive and 168 in the continuous phase [30]. Non-adherent patients were defined as those who had missed at least one month of the total anti-TB treatment [29]. Cavitation was defined as the formation of cavities in the lungs, as a consequence of TB, which could be either single or multiple and generally had thick walls with irregular margins. There could be fluid within these cavities, visualised by an air-fluid level and generally progressing to linear or fibrotic lesions in cured patients [31]. Patients with body weight less than 90% of ideal body weight at time of diagnosis were considered underweight.
Manganese concentration in patients with encephalopathy following ephedrone use: a narrative review and analysis of case reports
Published in Clinical Toxicology, 2022
Michal Ordak, Natalia Sloniewicz, Tadeusz Nasierowski, Elzbieta Muszynska, Magdalena Bujalska-Zadrozny
The abuse of ephedrone has become a public health problem in several Eastern European countries, although isolated cases have also been noted in Central Europe and Turkey [8,12]. A total of 1.613 notifications of drug-related deaths (including ephedrone) occurring in 2012 in the UK and Islands were submitted to the National Programme on Substance Abuse Deaths [13]. Home synthesis of ephedrone from drugs is related to the reaction of pseudoephedrine with potassium permanganate, acetic acid and water. Crude oxidation ephedrine/pseudoephedrine with potassium permanganate (KMnO4) forms methcathinone (ephedrone) and manganese dioxide. Clinical features of manganism were soon seen in ephedrone users attributed to manganese dioxide (MnO2) contaminating the ephedrone [14,15]. It is structurally very similar to ethcathinone and cathinone – stimulating alkaloids – found in Catha edulis [16].