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.
Djibouti
Ebby Elahi in World Compendium of Healthcare Facilities and Nonprofit Organizations, 2021
Chewing khat, a practice that dates back thousands of years in the Horn of Africa, is widespread in Djibouti, and can lead to adverse health effects, such as depression. In addition to pervasive khat chewing, other factors that contribute to poor health include: malnutrition, unsafe sex, air pollution, high blood pressure, tobacco, dietary risks, high fasting plasma glucose, high body-mass index, kidney dysfunction, non-optimal temperature, and a lack of water, sanitation, and hygiene. The causes of most deaths in the country include HIV/AIDS, neonatal disorders, lower respiratory infections, ischemic heart disease, stroke, tuberculosis, diarrheal diseases, cirrhosis, diabetes, protein-energy malnutrition, and congenital defects. Notably, deaths due to non-communicable diseases such as ischemic heart disease, stroke, cirrhosis, and diabetes have all increased by at least 48 percent or more over the past decade.
Khat and the creation of tradition in the Somali diaspora
Jane Fountain, Dirk J Korf in Drugs in Society, 2019
The difference between UK-based Somali complaints about khat and those of colonial administrators is telling. In the latter case, the objections were made on political and economic grounds. Users were more boisterous and assertive after chewing, whilst the imports from neighbouring Ethiopia were seen as an outflow of wealth from the British Empire. Contemporary campaigners and critics, by contrast, are concerned with the adverse impact of khat use on the well-being of the individual user, their family and the whole Somali community. At the forefront of these concerns are the claims that khat use leads to a range of mental health disorders, including hypnagogic hallucinations, mood swings, functional mood disorder, anxiety, sleeping disorders, loss of appetite and depression.28–32 However, many commentators are cautious about making direct causal links between khat and the above conditions, because most studies have been conducted on small samples and have failed to control for possible confounding factors.33 This is of particular importance in studies of immigrants, many of whom suffer from severe post-traumatic stress disorder after fleeing the violence of a civil war as well as famine, and experiencing the traumas of migration. Advocates for khat control have therefore sought to base their assertions on more solid ground. Khat, it is claimed, diverts active Somali men from the workplace, drains state-benefit-dependent household budgets, puts a strain on family relationships, and prevents the integration of Somalis into the UK mainstream.
The rise of global research trends on cathinones during 1994-2018: lessons from a systematic bibliometric analysis
Published in Journal of Substance Use, 2022
Kang Wang, Yijie Duan, Haihong Chen, Jin Hu, Man Liang
Our scientometric study (Figure 3) revealed past and current cathinone research trends and patterns. For instance, khat has had a long history of traditional indigenous use as a psychoactive plant, although its pattern of usage has changed due to immigration and government control on consumption and trade (Anderson & Carrier, 2009; Gebissa, 2010; Reuters, 2014). Indigenous use has persisted for eight centuries as a mild stimulant for enhancing energy during work, maintenance of prayers during long fasts, facilitation of social ties, and as a commodity for trade (Anderson & Carrier, 2009; Gebissa, 2010). Initially regarded as a substance used only by adult immigrants with experience of khat from their home country, anecdotal evidence suggests that khat is, in fact, used by both first generation immigrants and UK born young adults for its uniqueness, “mellow” high, and presumed safety (BBC News, 2009). In addition, the traditional use of khat, as guided by culture, is believed by users to be of little more harm than other stimulants such as coffee or tea. It is possible that the same factors leading to its adoption by new users in the UK could also hold true in the US. However, the future application of khat is unclear (Lemieux et al., 2015), with some suggesting that it could move toward either widespread legal commercialization or containment as an illicit substance (Gebissa, 2010).
Epidemiology of Khat (Catha edulis) Chewing in Ethiopia: A Systematic Review and meta-analysis
Published in Journal of Psychoactive Drugs, 2022
Getinet Ayano, Mohammed Ayalew, Asres Bedaso, Bereket Duko
In several countries around the southern part of the Red Sea, East and South-East Africa, the shrub Catha edulis (khat) leaves are chewed for their stimulant properties. Khat-chewing is also an integral part of traditional, social and cultural life (Gatherings 1976; Kennedy, Teague, and Fairbanks 1980). The khat leaf is an “amphetamine-like” stimulant (Kalix 1992) that is culturally embedded and widely practiced in some regions of Africa and the Arabian Peninsula (Odenwald, Klein, and Warfa 2010), as well as in the diaspora communities of these regions (Griffiths 1998; Kassim and Croucher 2006). Khat is an acceptable and customary practice for this population and in areas where Islamic religion was dominant (Al‐Motarreb, Baker, and Broadley 2002; Armstrong 2008).
Couple’s concordance or discordance of khat use and intimate partner violence (IPV) among Ethiopian women
Published in Journal of Substance Use, 2022
Khat (Catha edulis) is a green leafy plant cultivated in East-Africa and the Arabian Peninsula that is known for its stimulant leaves (World Health Organization [WHO], 2018). It is commonly known as “chaat” in Ethiopia, but is also called “kat” in Yemen, “qaad” or “jaad” in Somalia, and “miraa” in Kenya (Hoffman & Al’Absi, 2010; Odenwald et al., 2011). Khat is often consumed in group settings, in which young shoots and leaves are chewed and the pulp ingested, or kept inside the cheek while the juicy extracts are swallowed in a session that may last about six hours or longer (Cox & Rampes, 2003; Hansen, 2010; Patel et al., 2005; World Health Organization [WHO], 2018).